Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
65 Cards in this Set
- Front
- Back
|
Clavicle
|
-connects upper limb to axial skeleton and trunk
-acts as a strut holding upper limb free from trunk -provedes attachments for muscles -transmits forces from upper limb to axial skeleton |
|
|
Scapula
|
-provides attachements for muscles
-foundation for proper shoulder stability and fuction -acromion coracoid process -spine of scapula |
|
|
Humerus
|
-extends from shoulder to elbow
-greater and lesser tubercles -medial and lateral eicondyle |
|
|
Sternoclavicular joint
|
-sternum and clavicle
-only ligamentous attachment of should girdle to axial skeleton |
|
|
Acromioclavicular joint
|
-acromion process and distal clavicle
-coracoacromial ligament (ligament arch) |
|
|
Glenohumeral joint
|
-scapula and head of humerus
-joint mobility greater than joint stability -slenoid labrum -glenohumeral ligaments |
|
|
GH joint - Sagittal plane
|
-flexion/extension
|
|
|
GH joint - Frontal plane
|
-abduction/adduction
|
|
|
GH joint - Transverse plane
|
-horizontal abduction/adduction
-internal(medial) rotation external (lateral) rotation |
|
|
Scapulothoracic joint
|
-scapula motion w/ respect to trunk
-stabilizes shoulder region -facilitates movement of uppper extremity |
|
|
Scapulothoracic movements
|
-elevation/depression
-protraction/retraction -superior/inferior rotation -scapulohumeral rhythm |
|
|
Scapulothoracic Muscles
|
-trapezius
-rhomboid -peck minor -levator scapulae -serratus anterior |
|
|
Trapezius
|
-upper, middle, lower
superior - elevate middle - retract inferior - depress superior and lower - rotation |
|
|
Rhomboid
|
insertion - medial scapula border
actioin - retract and rotate sca |
|
|
Peck Minor
|
-origion at ribs 3 + 5
-insertion at coracoid process -action to stabilize and rotate scaupla |
|
|
Levator Scapula
|
insertion -scapula
action - elevate and rotate scapula |
|
|
Serratus Anterior
|
origion - ribs 1 to 8
insertion - medial scaula border action - protract and rotate scapula |
|
|
Supraspinatus
|
origin - scapula
insertion - greater tubercule of humerus action - assist deltoid with abduction innervator - subscapular nerve |
|
|
Infraspinatus
|
origin - scapula
insertion - greater tubercle of humerus action - externally rotate humerus innervator - suprascapular nerve |
|
|
Teres Minor
|
origin - scapula
insertion - greater tubercle of humerus action - externally rotate humerus innervator - axillary nerve |
|
|
Subscapularis
|
origin - scapula
insertion - lesser tubercle of humerus actioin - internally rotate humerus innervator - upper and lower sub scap nerve |
|
|
Deltoid
|
anterior middle posterior
origin - clavicle + scapula insertion - humerus action - anterior = flex middle = abduct humerus posterior = extend innervator - axillary nerve |
|
|
Lattissimus Dorsi
|
origin - thoracic spine
insertion - humerus actioin - extend, adduct, and IR humerus innervator - thoracodorsal nerve |
|
|
Peck Major
|
origin - clavicle and sternum
insertion - humerus action - adduct and IR humerus innervator - lateral and medial pectoral |
|
|
Cocking Phase
|
Rhomboid concentrically pulls scapula and g-h joint posteriorly, assisted by serratus anterior for increased scapular stability
Horizontal adductors (pec major/lat dorsi) and internal rotators (subscap) are eccentrically loaded |
|
|
injuries of cocking phase
|
-glenohumeral instability
-labral tears -internal rotator strains -bursitis |
|
|
Acceleration phase
|
-forwars arm movement
-rapid forcefull extension of elbow -humeral horizontal adduction/internal rotatioin and elbow extension by pec major, lat dorsi, subscap and triceps |
|
|
injuries of acceleration phase
|
-glenohumeral subluxation
-labral tears -rotator cuff tendonitis/tear -bursitis -bicipital tendonitis |
|
|
Deceleration phase
|
-Following ball release, maximum shoulder internal rotation occurs - eccentric activation of posterior rotator cuff to control humerus
-Eccentric contraction of middle trapezius and rhomboid to control scapula |
|
|
injuries of deceleration phase
|
-glenohumeral subluxation
-labral tears -rotator cuff tendonities/tears |
|
|
Shoulder injuries
|
sprains - AC joint, GH joint
strain - rotator cuff tendonitis/rupture, rotator cuff impingement, bicep tendonitis/rupture -brachil plexus injury -fractures |
|
|
AC joint sprain
|
mechanism of injury - foosh
seperated shoulder |
|
|
AC signs and symptoms
|
-palable tenderness and joint
-step off deformity -pain with elevation and horizontal adduction |
|
|
AC grade 1 seperation
|
-No deformity
-Mild swelling, tenderness, ROM/strength limitation -Ice/NSAIDs, return (1-2 weeks) as tolerated with protection |
|
|
AC grade 2 seperation
|
-Slight deformity
-Moderate swelling and tenderness -Moderate ROM/ strength limitation 2% pain -Sling, NSAIDs, pain-relief modalities, exercise, return (2-4 weeks)with protection |
|
|
AC grade 3 seperation
|
-Step-off deformity (permanent)
-Severe swelling and tenderness -Severe ROM/strength limitation 2o pain -Joint instability -Ice, immobilize, rehabilitation, return (6-8 weeks) with protection |
|
|
GH joint sprain
|
instability
-anterior -multidirectional dislocation glenoid labram -slap lesion |
|
|
GH joint
|
-inherently unstable
-gold ball on a tee -temendous motion and little stability |
|
|
GH joint passive stabilizers
|
-bone structure
-Ligaments/capsule -Glenoid labrum -Negative intra-articular pressure -Adhesion/cohesion forces -Joint proprioceptors |
|
|
GH joint active stabilizers
|
-Rotator cuff
Supraspinatus muscle Infraspinatus muscle Teres minor muscle Subscapularis muscle |
|
|
Laxity
|
humeral head movement on glenoid
|
|
|
Instability
|
clinical condition in which unwanted movement of humeral head on glenoid compromises the comfort and function of the shoulder
|
|
|
Subluxation
|
complete seperation of joint suufaces with spontaneous reduction
|
|
|
Dislocation
|
complete seperation of joint surfaces without spontaneous reduction
|
|
|
AMBRI
|
Atraumatic
Multidirectional Bilateral Rehabilitation Inferior capsular shift |
|
|
TUBS
|
Traumatic
Unilateral Bankart lesion (hill- sachs lesion) Surgery (Bankart repair) |
|
|
Macrotrauma
|
Anterior dislocation
-Abduction and external rotation -Horizontal abduction Posterior dislocation -FOOSH -Pushing |
|
|
Microtrauma
|
Subtle episodes of instability depending upon activities, dynamic stability and fatigue
|
|
|
Complications of Dislocation
|
-Ligamentous/capsular changes
-Fractures -Rotator cuff tears -Neurovascular injuries -Recurrent dislocations <20 y.o. = >85% incidence >40 y.o. = <10% incidence Majority within 2 years of initial injury (M > F) |
|
|
Glenoid labrum tears
|
bankart lesion
-tubs -instablity and mechanical symptoms present |
|
|
Slap
|
-fraying and stripping of superios labrum and biceps tendon
-bucket handle tear superior labrum and biceps involvement |
|
|
Clinical presentation of dislocation
|
-prominent acromion and humeral head
-flattened shoulder -interternally rotated and slightly abducted shoulder -flexed elbow -pronated forearm, supported by other hand |
|
|
Management of shoulder instability
|
-immobilize, but encourage immediate motion
-immediate strengthening of rotator cuff and scapula in safe ROM to patients tolerance -dynamic stability, resistive endurance exercises -proprioceptive and neromuscular training -gradual work for patient to be in a position which they can work |
|
|
Supraspinatus outlet
|
-Subacromial space
Supraspinatus Infraspinatus Long head of biceps Subacromial bursa |
|
|
shoulder impingement
|
mechanical compression of structures within subacromial space between humeral head and acromion
|
|
|
shoulder impingement 2
|
swimmers shoulder
repetative external rotations |
|
|
Management of rotator cuff tendonitis
|
-NSAIDS
-restore ROM/flex -restore rotator cuff/scapula stabilizer muscles -regain shoulder stability/proprioception -modify skill technique -return to full activity |
|
|
Bicipital tendonitis
|
-rapid overhead movements
-excessive elbow flexion and wrist supination -forceful, repetitive eccentric loading during rapid elbow extension |
|
|
Brachial plexus injury
|
-“Burner” or “stinger”
-Tension force along nerve 2o shoulder depression & neck lateral flexion -Immediate, severe, burning pain with paresthesia down arm, usually subsiding within 10 minutes -Muscle weakness in shoulder abduction and external rotation -Diminished/absent reflexes possible with transient paresthesia/sensory loss |
|
|
nerve injury grade 1
signs and symptoms |
-temporary loss of sensation and loss of motor function
-recovery w/in days to weeks |
|
|
nerve injury grade 2
signs and symptoms |
-significant motor and mild sensory defecits
-last 2 weeks, usually restored to normal |
|
|
nerve injury grade 3
signs and symptoms |
-motor and sensory deficits persist for 12 months
-poor prognosis with surgical intervention often necessary |
|
|
Clacicular fracture
|
-Direct blow/compressive force to clavicle, FOOSH, fall on point of shoulder
-Contact sports/activities -Deformity often 2o pull of pec major and SCM -Immobilize 4-6 weeks (figure-8 clavicular straps?) -Restore ROM/flexibility, strength/endurance and proprioception as necessary |
|
|
Proximal Humeral fracture
|
-closed reduction if impacted
-ORIF with any displacement of fragments |
|
|
Midshaft Humeral fracture
|
-spiral fracture
-fracture along radial nerve groove at posterior humerus -often results in wrist drop (radial nerve palsy) |
