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119 Cards in this Set
- Front
- Back
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Four joints of shoulder complex
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acromioclavicular joint
sternoclavicular joint glenohumeral joint scapulothoracic interface |
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What is the purpose for the shoulder complex?
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to position the hand for function
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What is the angle of the long axis of the clavicle relative to the frontal plane?
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20 degrees posterior to the frontal plane
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What vertebral level is the base of the scapular spine?
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T3
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What vertebral level is the inferior angle of the scapula?
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T7
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What is the angle for the plane of the scapula relative to the frontal plane?
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35 degrees anterior to the frontal
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What is scaption?
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Elevation of the upper limb in the plane of the scapula
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What is the angle of the glenoid fossa relative to the border of the scapula and what is the purpose of this angle?
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5 degrees to support the head of the humerus
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What is the angle of the humerus relative to the frontal plane?
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30 degrees posterior to the frontal plane
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What are the bony components of the SC joint?
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medial end of the clavicle, manubrium, 1st rib
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What is the purpose of the ligaments at the SC joint?
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to restrain lateral and/or superior displacement of clavicle at SC joint
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What is the location of the costoclavicular ligament?
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from the first costal cartilage to the inferior surface of the proximal aspect of the clavice
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What is the orientation of the anterior costoclavicular ligament?
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superior/lateral orientation
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What is the orientation of the posterior costoclavicular ligament?
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superior/medial orientation
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What is the only type of scapular motion that the costoclavicular ligament does not restrain?
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depression
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What type of roll/glide is experienced by the SC joint during elevation?
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superior roll, inferior glide
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What type of roll/glide is experienced by the SC joint during depression?
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inferior roll, superior glide
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How many degrees of movement does the clavicle get in elevation?
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45 degrees
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How many degrees of movement does the clavicle get in depression?
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10 degrees
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What is elevation of clavicle limited by?
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the costoclavicular ligament
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What is depression of the clavicle limited by?
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the superior capsule and interclavicular ligament
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What type of roll/glide is experienced by the SC joint during protraction?
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anterior roll AND glide
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What type of roll/glide is experienced by the SC joint during retraction?
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posterior roll AND glide
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How many degrees of movement are experienced by the clavicle during protraction/retraction?
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15-30 degrees
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What is protraction of the clavicle limited by?
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posterior capsular structures
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What is retraction of the clavicle limited by?
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anterior capsular structures
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How many degrees of axial rotation are experienced by the clavicle during elevation and depression of the scapula?
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40-50 degrees
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What type of motion is experienced by the clavicle during shoulder elevation?
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posterior rotation
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What type of motion is experienced by the clavicle during shoulder depression(also going back to neutral from elevation)?
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anterior rotation
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What are the surfaces of the AC joint?
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lateral end of the clavicle with the acromion process
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What ligaments reinforce the fibrous capsule of the AC joint?
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superior and inferior acromioclavicular ligaments
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What are the two purposes of the coracoclavicular ligament?
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primary AC stabilizer
maintains relationship between clavicle and scapula |
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What are the attachments of the trapezoid ligament?
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superior surface of the coracoid and the trapezoid line of the clavicle
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What are the attachments of the conoid ligament?
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superior surface of the coracoid process and the conoid tubercle of the clavicle
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What plane of movement does the AC joint rotate in during upward/downward rotation of the scapula?
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scapular plane
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What type of movement occurs in the AC joint during upward/downward rotation of the scapula?
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superior/inferior hinging movement
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Movement of the AC joint in the horizontal (transverse) plane is associated with what type of scapular movement?
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protraction
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Movement of the AC joint in the saggital plane is associated with what type of scapular movement?
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anterior/posterior motion of the inferior angle ("scapular tipping")
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Maximum mobility of the scapula is permitted because of what joint?
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AC joint
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Movement of the scapula is dependent on what two joints?
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AC and SC
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What movement is compromised if scapular motion cannot occur?
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movement at the glenohumeral joint
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During scapular elevation/depression, how much movement is experienced by the AC joint?
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2 degrees
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How many degrees of rotation are experienced by the scapula in full upward rotation?
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60 degrees
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What types of movement do flexion and ABduction of the humerus cause in the scapula?
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upward rotation, medial (and some lateral at the end) rotation, posterior tilt
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What is the tradeoff for the GH joint?
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less stability for more mobility
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What deepens the socket of the GH joint?
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glenoid labrum
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What is the glenoid labrum?
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fibrocartilaginous ring attaching along the edge of the glenoid fossa
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What type of movement does the capsular space of the GH joint allow for?
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translational movement
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What type of movement is limited by the superior GH ligament?
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posterior and inferior translation of the humeral head
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What is the purpose of the superior GH ligament?
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reinforce anterior and inferior joint capsule
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What are the attachments of the superior GH ligament?
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supraglenoid tubercle and the anatomical neck of the humerus
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When is the superior GH ligament taut?
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adduction
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What is the purpose of the middle GH ligament?
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provide restraint to anterior translation and extremes of lateral rotation
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When is the middle GH ligament taut?
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full lateral rotation
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What are the attachments of the middle GH ligament?
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anterior aspect of capsule/subscapularis tendon and anterior anatomical neck of the humerus
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What are the attachments of the inferior GH ligament?
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anterior-inferior glenoid rim and labrum and anterior-inferior through posterior-inferior anatomical neck of the humerus
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What are the three components of the inferior GH ligament?
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anterior band, posterior band, axillary pouch
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When is the anterior band of the inferior GH ligament taut?
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abduction and lateral rotation
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When is the posterior band of the inferior GH ligament taut?
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abduction and medial rotation
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When is the axillary pouch of the inferior GH ligament taut?
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abduction
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What is the purpose of the axillary pouch?
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anterior-posterior stability of the GH joint in abduction
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What occurs in glenohumeral internal rotation deficit (GIRD)?
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tightness of the posterior inferior GH ligament and a decrease in total arc of motion (lose internal rotation)
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What are the attachments of the coracohumeral ligament?
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lateral border of the coracoid process and the anterior greater tubercle
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When is the coracohumeral ligament taut?
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extremes of lateral rotation, flexion, or extension
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What movement does the coracohumeral ligament restrict?
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inferior translation of the humeral head
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What form the compressive force that holds the humeral head in the glenoid?
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coracohumeral ligament/capsule and gravity
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What is compression-concavity?
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taking a convex surface and matching it up with a concave surface to increase joint stability
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What is negative intra-articular pressure?
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as you stretch the capsule, the pressure becomes more negative and the joint surfaces become tighter and tighter
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What are the attachments for the coracoacromial ligament?
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anterior acromion process and lateral coracoid process
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What are the contents of the subacromial space?
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supraspinatus muscle/tendon
subacromial bursa LH biceps brachii tendon superior fibrous capsule |
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How much space is in the subacromial space?
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~1cm
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How many bursae are in the shoulder?
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8
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What are the three degrees of motion of the GH joint?
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abduction/adduction
flexion/extension medial/lateral rotation |
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Functional movement at the GH joint requires movement where?
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scapulothoracic interface
SC joint AC joint |
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What muscle group holds the humeral head in the glenoid when you move your arm?
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rotator cuff
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Is the GH joint open or close chain?
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open chain
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During abduction, what is the roll and glide of the humeral head?
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rolls superior and glides inferior
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During adduction, what is the roll and glide of the humeral head?
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rolls inferior and glides superior
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How many degrees of motion come from the GH joint during overhead abduction?
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120 degrees
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The head of the humerus would sublux inferiorly without the help of what?
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the axillary pouch
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Roll without slide of the GH joint results in what?
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impingement of the subacromial bursa
(humeral head jams into subacromial arch) |
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What type of movement is experienced by the GH joint during flexion/extension?
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spinning (NO rolling/gliding)
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How many degrees of motion in the GH joint are achieved through arm extension?
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45-55 degrees
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How many degrees of motion in the GH joint are achieved through medial rotation?
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75-85 degrees
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How many degrees of motion in the GH joint are achieved through lateral rotation?
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60-70 degrees
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During medial rotation, what is the roll and glide of the humeral head?
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roll anterior and slide posterior
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During lateral rotation, what is the roll and glide of the humeral head?
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roll posterior and slide anterior
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What is the ratio of movement between the humerus and the scapula?
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2:1
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For 30 degrees of upward rotation of the scapula, how much comes from the SC joint? (early phase)
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20-25 degrees
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For 30 degrees of upward rotation of the scapula, how much axial rotation comes from the AC joint? (early phase)
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5-10 degrees
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For 30 degrees of upward rotation of the scapula, how much comes from the SC joint? (late phase)
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5 degrees
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For 30 degrees of upward rotation of the scapula, how much axial rotation comes from the AC joint? (late phase)
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20-25 degrees
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During humeral elevation, what types of motion are experienced by the scapula?
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upward rotation, medial rotation, posterior tilting
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During the setting phase of abduction, what doesn't move at all?
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the scapula (for the 1st 20 degrees)
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How much rotation occurs in the clavicle during the late phase of abduction?
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40 degrees posterior rotation
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Most of the muscles that contribute to the shoulder complex come from what?
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branches of the brachial plexus
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What are the proximal stabilizers of the shoulder joint?
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scapula and clavicle
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What are the distal mobilizers of the shoulder joint?
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humerus and forearm
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What muscles are involved in scapular elevation?
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upper trapezius
rhomboid major rhomboid minor levator scapulae |
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What muscles are involved in scapular depression?
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lower trapezius
pectoralis minor latissimus dorsi subclavius |
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What muscles are involved in scapular protraction?
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serratus anterior
pectoralis minor |
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What muscles are involved in scapular retraction?
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middle trapezius
entire trapezius working together rhomboid major rhomboid minor |
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Loss in function of what nerve can cause scapular winging?
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long thoracic nerve
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What muscles are involved in upward rotation of the scapula?
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serratus anterior
upper trapezius lower trapezius |
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What muscle initiates upward rotation of the scapula?
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upper trapezius
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What are the muscles of the rotator cuff?
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supraspinatus
infraspinatus teres minor subscapularis |
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Tendons of the rotator cuff blend with and reinforce what?
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the fibrous capsule
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What is the primary function of the supraspinatus muscle?
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abduction
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What is the primary function of the subscapularis muscle?
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medial rotation
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What is the primary function of the infraspinatus muscle?
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lateral rotation
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What is the primary function of the teres minor muscle?
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lateral rotation
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What muscles are involved in arm abduction?
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middle deltoid
entire deltoid working together supraspinatus |
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What muscles are involved with arm flexion?
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anterior deltoid
pectoralis major coracobrachialis long head of biceps brachii |
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What muscles are involved in arm adduction?
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supraspinatus
middle deltoid traps other upward rotators |
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What muscles are involved with medial rotation of the arm?
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pectoralis major
latissimus dorsi subscapularis anterior deltoid teres major |
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What muscles are involved with lateral rotation of the arm?
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infraspinatus
teres minor posterior deltoid |
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What type of roll/glide is experienced by the GH joint during medial rotation?
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humeral head: roll anterior, glide posterior
glenoid fossa: roll and glide anterior |
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What type of roll/glide is experienced by the GH joint during lateral rotation?
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humeral head: roll posterior, glide anterior
glenoid fossa: roll and glide posterior |
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Is the arm stronger in medial or lateral rotation? Why?
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medial rotation because of more mass, strength, and cross-sectional muscle mass in the medial rotators
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