Term
| what are the 4 articulations of the shoulder girdle complex? |
|
Definition
| sternoclavicular joint, acromioclavicular joint, scapulothoracic joint, glenohumeral joint |
|
|
Term
| what is the only articulation of the upper extremity to axial skeleton? |
|
Definition
|
|
Term
| what type of joint is the sternoclavicular joint? |
|
Definition
|
|
Term
| how many degrees of freedom do saddle joints usually have? |
|
Definition
|
|
Term
| how many degrees of freedom does the sternoclavicular joint have? |
|
Definition
|
|
Term
| what special thing does the sternoclavicular joint have? |
|
Definition
|
|
Term
| what are the 3 ligaments of the sternoclavicular joint? |
|
Definition
| sternoclavicular ligament, costoclavicular ligament, interclavicular ligament |
|
|
Term
| what joint do all forces of the arm go through ? |
|
Definition
|
|
Term
| what joint moves anytime you move the scapula? |
|
Definition
|
|
Term
| what are the 2 parts of the sternoclavicular ligament? |
|
Definition
| anterior and posterior sc ligaments |
|
|
Term
| what is the function of the costoclavicular ligament |
|
Definition
| tether/pivot point/mechanical axis for frontal and transverse plane motions |
|
|
Term
| which ligament in the sternoclavicular joint acts as the mechanical axis for frontal and transverse plane motions |
|
Definition
|
|
Term
| is the sternoclavicular ligament stable? |
|
Definition
|
|
Term
| is the sternoclavicular ligament prone to osteoarthritis? |
|
Definition
|
|
Term
| what would happen if the sternoclavicular joint dislocated? |
|
Definition
| would hit subclavian artery |
|
|
Term
| does the sternoclavicular joint dislocate often? |
|
Definition
|
|
Term
| what is the frontal plane movement of the sternoclavicular joint? |
|
Definition
|
|
Term
| about what axis does the sc joint elevate/depress |
|
Definition
|
|
Term
| how far can the sternoclavicular joint elevate the shoulders? |
|
Definition
|
|
Term
| how far can the sternoclavicular joint depress the shoulders? |
|
Definition
|
|
Term
| what shape is the clavicle in elevation/depression at the SC joint? |
|
Definition
|
|
Term
| what shape is the manubrium in elevation/depression of the SC joint? |
|
Definition
|
|
Term
| what are the arthrokinematics of elevation at the SC joint? |
|
Definition
| convex clavicle rolls superiorly and slides inferiorly on concave manubrium |
|
|
Term
| what are the arthrokinematics of depression at the SC joint? |
|
Definition
| convex clavicle rolls inferiorly and slides superiorly on the concave mabubrium |
|
|
Term
| what motion happens at the SC joint in the transverse plane? |
|
Definition
|
|
Term
| how much can the SC joint protract/retract? |
|
Definition
|
|
Term
| what is the shape of the clavicle in the transverse plane? |
|
Definition
|
|
Term
| what is the shape of the manubrium in the transverse plane? |
|
Definition
|
|
Term
| describe the arthrokinematics of protraction at the SC joint |
|
Definition
| concave clavical rolls and slides anteriorly on convex manubrium |
|
|
Term
| describe the arthrokinematics of retraction at the SC joint |
|
Definition
| concave clavicle rolls and slides posteriorly on convex manubrium |
|
|
Term
| describe the arthrokinematics of protraction at the SC joint in the up phase of a pushup |
|
Definition
| convex manubrium rolls anteriorly, slides posteriorly on concave clavicle |
|
|
Term
| what is the shape of clavicle/manubrium in frontal plane at SC joint? |
|
Definition
| in frontal plane, clavicle is convex, manubrium is concave |
|
|
Term
| what is the action of the SC joint in the sagittal plane? |
|
Definition
| posterior rotation: looks like flexing shoulder |
|
|
Term
| what is the arthrokinematics of posterior rotation at the SC joint? |
|
Definition
|
|
Term
| how far can the sc joint posteriorly rotate? |
|
Definition
|
|
Term
| what bone moves on what at sc joint in transverse plane |
|
Definition
| concave clavicle on convex manubrium |
|
|
Term
| what bone moves on what at sc joint in sagittal plane? |
|
Definition
| clavicle spins on sternum/manubrium |
|
|
Term
| what are the functions of the SC joint? |
|
Definition
| stabilizes closed kinematic chain of shoulder complex, absorbs and distributes forces, allows movement of clavicle |
|
|
Term
| what are the 2 bones of the acromioclavicular joint? |
|
Definition
|
|
Term
| what type of joint is the acromioclavicular joint? |
|
Definition
|
|
Term
| how many degrees of freedom in AC joint? |
|
Definition
|
|
Term
| what 3 things suppor the AC joint |
|
Definition
| capsule, ligaments, disc (in 10% of people) |
|
|
Term
| describe the AC joint capsule |
|
Definition
|
|
Term
| what are the 2 main ligaments of the ac joint? |
|
Definition
| acromioclavicular, coracoclavicular |
|
|
Term
| what are the 2 parts of the coracoclavicular joint |
|
Definition
| trapezoid, conoid ligaments |
|
|
Term
| which is lateral, trapezoid or conoid? |
|
Definition
| trapezoid is lateral, conoid is medial |
|
|
Term
| what does the trapezoid ligament do? |
|
Definition
| resists posterior forces to clavicle |
|
|
Term
| what does the conoid ligament do? |
|
Definition
| resists inferior forces to acromion |
|
|
Term
| how does the conoid ligament affect the clavicle? |
|
Definition
| prevents clavicle from displacing superiorly |
|
|
Term
| how does the trapezoid affect the clavicle? |
|
Definition
| prevents clavicle from displacing posteriorly |
|
|
Term
| are the coracoacromial ligaments strong or weak? |
|
Definition
|
|
Term
| are the acromioclavicular ligaments strong or weak? |
|
Definition
|
|
Term
| what are the 2 acromioclavicular ligaments? |
|
Definition
| superior an dinferior ac ligaments |
|
|
Term
| what do the acromioclavicular ligaments do? |
|
Definition
| prevent anterior-posterior translation of the clavicle |
|
|
Term
| what is internal/external rotation of the scapula? |
|
Definition
| moving the glenoid cavity forward or backwards about a vertical axis |
|
|
Term
| what are the 3 scapular planes? |
|
Definition
| internal/external rotation, anterior/posterior tipping, upward/downward rotation |
|
|
Term
| movement in which plane gives scapular winging? |
|
Definition
|
|
Term
| what is anterior/posterior tipping? |
|
Definition
| movement of acromion forward and back |
|
|
Term
| what is upward and downward rotation? |
|
Definition
| rotation of glenoid cavity up and down |
|
|
Term
| what are the functions of the AC joint? |
|
Definition
| maintain relatoinship between scapula and clavicle, allow rotation of scapula and clavicle to permit full shoulder flexion, translate forces from arm to axial structures, prevent superior dislocation of clavicle on acromion, limits clavicle rotation |
|
|
Term
| are AC joint sprains common? |
|
Definition
|
|
Term
| is it more common to sprain AC or SC joint? |
|
Definition
|
|
Term
| how is the ac joint sprained? |
|
Definition
| fall on shoulder or contact in sports |
|
|
Term
| how are ac sprains graded? |
|
Definition
|
|
Term
| what is a grade 1 ac sprain? |
|
Definition
|
|
Term
| what is a grade 2 ac sprain |
|
Definition
|
|
Term
| what is a grade 3 ac sprain |
|
Definition
| rupture of ac and coracoclavicular ligaments |
|
|
Term
| how are ac sprains/seprations treated? |
|
Definition
| non-surgically, with a sling. AROM exercises started after several days |
|
|
Term
| is it common to develop arthritis at the AC joint? |
|
Definition
|
|
Term
| what can arthritis/degeneration at AC joint do? |
|
Definition
| restrict/alter shoulder moement |
|
|
Term
| how does horizontal adduction affect ac, sc joints |
|
Definition
|
|
Term
| what is the scapulothoracic joint? |
|
Definition
| the "articulation" between the scapula and the thorax |
|
|
Term
| what type of joint is the scapulothoracic joint? |
|
Definition
| functional joint, not a true anatomical joint |
|
|
Term
| is the scapulothoracic joint mobile or stable? |
|
Definition
|
|
Term
| what is the bony attachment of the scapulothoracic joint |
|
Definition
| SC joint through clavicle |
|
|
Term
| what are the scapular roles of movement of the upper extremity? |
|
Definition
| orient glenoid, add range of motion for arm, base of support |
|
|
Term
| what is the position of the scapula at rest? |
|
Definition
| 2.5 inches away from midline of the body |
|
|
Term
| where is the superior angle of the scapula? |
|
Definition
|
|
Term
| where is the inferior angle of the scapula? |
|
Definition
|
|
Term
| what is the scapular plane's orientation? |
|
Definition
| 3-50 degrees anterior to frontal plane |
|
|
Term
|
Definition
| glenohumeral elevation in scapular plane |
|
|
Term
| what are the 3 scapulothoracic motions? |
|
Definition
| elevation/depression, protraction/retraction, downward/upward rotation |
|
|
Term
| what is elevation/depression at SC joint? |
|
Definition
|
|
Term
| what is retraction/protraction at SC joint? |
|
Definition
| shoulders forward and backward |
|
|
Term
| what is posterior rotation at SC joint? |
|
Definition
|
|
Term
| what is internal/external rotation at the AC joint? |
|
Definition
| moving glenoid cavity forward and backward (like protraction/retractoin) |
|
|
Term
| what is anterior/posterior tipping at AC joint? |
|
Definition
| moving acromion forward and backward (like flexing/extending arm) |
|
|
Term
| what is upward/downward rotation at AC joint? |
|
Definition
| moving glenoid cavity up and down like abducting arm |
|
|
Term
| what AC and SC joint movements provide elevation of scapulothoracic joint? |
|
Definition
| SC elevation, AC downward rotation |
|
|
Term
| what AC and SC joint movements provide depression of scapulothoracic joint? |
|
Definition
| SC depression, AC upward rotation |
|
|
Term
| what AC and SC movements contribute to scapulothoracic upward rotation? |
|
Definition
| SC elevation, AC upward rotation |
|
|
Term
| what AC and SC movements contribute to scapulothoracic downward rotation? |
|
Definition
| SC depression, AC downward rotatoin |
|
|
Term
| what AC and SC movements contribute to scapulothoracic protraction? |
|
Definition
| SC protraction, AC internal rotation |
|
|
Term
| what AC and SC joint movements contribute to scapulothoracic retraction? |
|
Definition
| SC retraction, AC external rotation |
|
|
Term
| what muscles elevate the scapula? |
|
Definition
| upper trap, levator scapuloae |
|
|
Term
| what muscles depress the scapula? |
|
Definition
| lower trap, latissimus dorsi, pectoralis minor |
|
|
Term
| what muscle protracts the scapula? |
|
Definition
|
|
Term
| what muscles retract the scapula? |
|
Definition
|
|
Term
| what muscles are upward rotators of scapula? |
|
Definition
| upper trap, lower trap, serratus anterior |
|
|
Term
| what muscles are downward rotators of scapula? |
|
Definition
| levator, rhomboids, assisted by gravity |
|
|
Term
| what is it called when the inferior border of the scapula sticks out? |
|
Definition
|
|
Term
| what is it called when the whole medial border of the scapula sticks out? |
|
Definition
|
|
Term
| what type of joint is the glenohumeral joint? |
|
Definition
|
|
Term
| how many dof in glenohumeral joint? |
|
Definition
|
|
Term
| what are the articulations of the glenohumeral joint? |
|
Definition
| glenoid fossa, humeral head |
|
|
Term
| what are the support structures of the glenohumeral joint? |
|
Definition
| capsule, ligaments, labrum |
|
|
Term
|
Definition
| glenoid has 5 deg of retroversion relative to scapula and 5 deg of upwards inclination relative to vertical |
|
|
Term
| what is the angle of inclination (up) of humeral head |
|
Definition
|
|
Term
| what is the angle of torsion of humeral head? |
|
Definition
| angle back of retroversion, 30 deg |
|
|
Term
| why is 30 deg retroversion of humeral head good? |
|
Definition
| aligns humeral head with glenoid, which is about 30 deg behind the thorax |
|
|
Term
| what is the relationship between humeral retroversion and glenohumeral external rotation? |
|
Definition
| direct: the more humeral retroversion you have, the greater your humeral external rotation |
|
|
Term
| what are the glenohumeral motions? |
|
Definition
| flexion/extension, adduction/abduction, horizontal adduction/abduction, internal rotation/external rotation |
|
|
Term
| what are the arthrokinematics of abduction? |
|
Definition
| humeral head rolls superiorly and glides inferiorly |
|
|
Term
| what is scapulohumeral rhythm? |
|
Definition
| movement of humerus is dependent on scapular movement |
|
|
Term
| what joints are needed for full shoulder flexion and abduction? |
|
Definition
|
|
Term
| in glenohumeral elevation, which joint does the first 30 deg? |
|
Definition
|
|
Term
| what is the relationship of glenohumeral to scapulothoracic movement in glenohumeral elevation? |
|
Definition
|
|
Term
| is the glenohumeral joint stable? |
|
Definition
|
|
Term
| how much surface area on the humeral head does the glenoid fossa cover? |
|
Definition
|
|
Term
| what provides passive support to glenohumeral stability? |
|
Definition
| bones, labrum, capsule, ligaments, negative intra-articular pressure, scapular positioning |
|
|
Term
| what provides active support to glenohumeral stability |
|
Definition
|
|
Term
| what is the negative intra-articular pressure of the GH joint? |
|
Definition
| humeral head is sucked up against fossa, helps keep it connected |
|
|
Term
| what is the glenoid labrum |
|
Definition
| fibrous ring around the periphery of the glenoid |
|
|
Term
| what is the function of the glenoid labrum? |
|
Definition
| anchor point on the glenoid for the capsuloligamentous structures; contributes to stability by increaseing socket depth by 50% |
|
|
Term
| in order to dislocated your humeral head, what must be disruped? |
|
Definition
|
|
Term
| is the glenohumeral joint capsule normally loose or tight? |
|
Definition
| loose to allow more motion |
|
|
Term
| what are the 3 main parts of the glenohumeral capsule? |
|
Definition
| posterior capsule, glenohumeral ligaments, coracohumeral ligament |
|
|
Term
| what are the 3 glenohumeral ligaments? |
|
Definition
| superior GH ligament, middle GH ligament, inferior GH ligament complex |
|
|
Term
| what forms the rotator cuff interval? |
|
Definition
| hole between supraspinatus and subscapularis tendons |
|
|
Term
| what fills the rotator cuff interval? |
|
Definition
| coracohumeral ligament, superior GH ligament |
|
|
Term
| what do the SGHL and coracohumeral ligaments do in the rotator cuff interval? |
|
Definition
| limit inferior translation and external rotation for the first 30 deg of abduction |
|
|
Term
| what does the middle GH ligament do? |
|
Definition
| primary restraint to anterior translation in 45-75 deg abduction. Also limits external rotation |
|
|
Term
| what are the 3 parts of the inferior glenohumeral ligament complex? |
|
Definition
| anterior band, axillary pouch, posterior band |
|
|
Term
| what does IGHL complex do at 90 deg abduction and neutral rotation? |
|
Definition
| supports humeral head like a sling |
|
|
Term
| what does IGHL complex do at 90 deg abduction and ER |
|
Definition
| forms a sling anteriorly preventing anterior dislocatoin |
|
|
Term
| what does IGHL complex do at 90 deg abduction and internal rotation? |
|
Definition
| form sling posteriorly preventing posterior dislocation |
|
|
Term
| what is the function of the posterior capsule? |
|
Definition
| limits IR and horizontal adduction |
|
|
Term
| what does the coracoacromial ligament do? |
|
Definition
| provides protection, prevents superior humeral translation on glenoid |
|
|
Term
| how does space under coracoacromial arch diminish? |
|
Definition
|
|
Term
| what things can become impinged in subacromial space? |
|
Definition
| bursa, supraspinatus, biceps |
|
|
Term
| what are the 2 bursa in the shoulder? |
|
Definition
|
|
Term
|
Definition
| reduce friction, make sure things are gliding as much as possible |
|
|
Term
| what movement is necessary for full elevatoin? |
|
Definition
|
|
Term
| as you go into more shoulder elevation, what movement increases in glenohumeral joint? |
|
Definition
|
|
Term
| what muscles abduct at the glenohumeral joint? |
|
Definition
| supraspinatus, middle deltoid |
|
|
Term
| what muscles adduct the glenohumeral joint? |
|
Definition
| latissimus dorsi, sternal head of pectoralis major |
|
|
Term
| what muscles flex at the GH joint? |
|
Definition
| anterior deltoid, long head of biceps |
|
|
Term
| what muscles extend at GH joint? |
|
Definition
| latissimus dorsi, sternal head of pectoralis major |
|
|
Term
| how do internal and external rotation force productions compare at glenohumeral joint? |
|
Definition
| internal rotation much greater than external rotation |
|
|
Term
| what muscles externally rotate the GH? |
|
Definition
| posterior deltoid, teres minor, infraspinatus |
|
|
Term
| what muscles internally rotate the GH |
|
Definition
| pec major, subscapularis, latissimus dorsi, teres major, anterior deltoid |
|
|
Term
| what are the active GH stabilizers? |
|
Definition
|
|
Term
| what offsets the superior force of the deltoid on the GH? |
|
Definition
| infraspinatus, subscapularis, teres minor |
|
|
Term
| what kind of arthrokinematics does the supraspinatus provide? |
|
Definition
| rotation (very little translation_ |
|
|
Term
| if a patient has impingement and little inferior translation, what is probably the problem? |
|
Definition
|
|
Term
| what is the force couple of arm elevation? |
|
Definition
| glenohumeral abduction and scapulothoracic upward rotation |
|
|
Term
| GH motions always require action from what? |
|
Definition
|
|
Term
| what are pathomechanics of the GH joint? |
|
Definition
| adhesive capsulitis, impingement, dislocation, rotator cuff injury/deterioration, bicipital tendonitis |
|
|
Term
| what is the difference between subluxation and dislocation? |
|
Definition
| dislocation bone comes all the way out, subluxation = bone slips and partially dislocates but relocates right away |
|
|
Term
| most GH dislocations are what kind? |
|
Definition
|
|
Term
| what is the typical mechanism of injury of anterior GH dislocations? |
|
Definition
| combined elevation and external rotation |
|
|
Term
|
Definition
| surgical repair of a stretched capsule: incision along capsule, pull it tighter, sew it up again |
|
|
Term
| what is a bankart repair? |
|
Definition
| surgical repair of a torn capsule: torn joint capsule is trimmed, holes are drilled through the edge of the glenoid cavity, ligaments are sutured back into place |
|
|
Term
| what movements cause pain if you have impingement syndrome? |
|
Definition
| elevation and internal rotation |
|
|
Term
| what happens to cause pain in impingement syndrome? |
|
Definition
| tendons/bursa become entrapped in subacromial space |
|
|
Term
| what conditions are related to impingement syndrome? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what tendons can cause pain in the shoulder? |
|
Definition
|
|
Term
| what is calcific tendonitis? |
|
Definition
| common painful condition of shoulder due to crystaline depositis |
|
|
Term
| where does calcific tendonitis usually occur? |
|
Definition
| near the insertion of supraspinatus |
|
|
Term
| describe repetitive stress injury of shoulder |
|
Definition
| overuse of shoulder results in irritation of rotator cuff or bursa and may lead to inflammation and impingement. Happens most frequently in occupations requiring frequent overhead arm use |
|
|
Term
| what is the vicious cycle of tendonitis/bursitis/impingement syndrome |
|
Definition
| inflammation - less space - greater impingement - rupture/tear |
|
|
Term
| describe adhesive capsulitis |
|
Definition
| frozen shoulder; adhesions grow within capsular fibers, restricting motion |
|
|
Term
| what causes frozen shoulder |
|
Definition
| idiopathic or post trauma |
|
|
Term
| what part of capsule is most affected by frozen shoulder |
|
Definition
|
|
