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54 Cards in this Set
- Front
- Back
Acromioclavicular joint is a
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plane joint; sliding, uniaxial
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Sternoclavicular joint is a
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saddle joint; biaxial
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Joint between the humerus and glenoid of the scapula
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ball and socket joint; multi-axial
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Synovial joints have the following:
Joint cavity Articular (hyaline) cartilage Synovial membrane Articular capsule Ligaments – reinforce fibrous capsule |
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Additional features of synovial joints:
Articular disc Fat pad Bursa |
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A bursa is a flattened sac of ___ membrane
A bursa exists between a tendon and a bone to ___ |
-synovial
-minimize friction |
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Synovitis
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inflammation of a synovial sheath
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Dislocation of the glenohumeral joint may affect what nerve?
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axillary n.
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glenoid labrum
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lip of fibrocartilage over glenoid fossa
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pectoral girdle
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clavicle and scapula
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Three synovial joints of the shoulder complex
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Glenohumeral – ball and socket between
Sternoclavicular - saddle Acromioclavicular - planar |
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Scapulothoracic joint
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functional joint of the shoulder complex
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The only bony attachment of the upper limb to the axial skeleton is at the
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sternoclavicular joint; saddle with an intra-articular fibrocartilage disc
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Scapulohumeral Rhythm: Pectoral Girdle & Shoulder Motion
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There is a 2:1 ratio of glenohumeral to scapulothoracic motion during overhead reaching (flexion and abduction)
When the arm is vertical at the side of the head (180 degrees of flexion or abduction – relative to the thorax) 120 degrees occurs at the glenohumeral joint while 60 degrees occurs at the scapulothoracic joint |
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The acromioclavicular joint contains a ___ that partially subdivides the articular space
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small articular disk
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It is a ___ joint that allows ___ , which occurs when the scapula rotates upward and outward
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-synovial plane
-gliding motion |
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AC joint is stabalized by ___; composed of
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-coracoclavicular ligament
-conoid and trapezoid ligaments |
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“AC separation” sometimes referred to as “a separated shoulder” occurs when
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-if the AC, coracoclavicular (conoid & trapezoid) ligaments all tear
-The scapula separates from the clavicle and falls because of the weight of the upper limb |
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falling directly on the shoulder or on the outstretched limb/elbow may affect what ligament(s)
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AC and possibly coracoclavicular (conoid & trapezoid) ligaments tear
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Which ligament is more weak, AC or coracoclavicular ligaments?
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AC
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Which joint has the greatest mobility? Type of joint?
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-glenohumeral
-ball and socket |
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Glenohumeral joint is held together by the tonic activity of the ___ , the fibrocartilage extension of the ___ , joint capsule and reinforcing ligaments.
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-rotator cuff muscles
-glenoid (glenoid labrum) |
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Subacromial (Subdeltoid) bursa reduces friction between the ___ and the ___
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-supraspinatus tendon
-coracoacromial arch |
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Scapulohumeral muscles =
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Intrinsic Shoulder Muscles
Deltoid Teres major Muscles of the rotator cuff Supraspinatus Infraspinatus Teres minor Subscapularis |
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Doctor gives resistance to the patient who is instructed to raise (abduct) his arm. She is also palpating for the contraction of the deltoid muscle. This tests for:
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deltoid muscle, axillary nerve, and 5th cervical spinal nerve (C5 neurological level).
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Muscles of the rotator cuff
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supraspinatus, infraspinatus, teres minor, subscapularis
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supraspinatus, infraspinatus, and teres minor muscles fuse together as they attach to the 3 facets of the
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greater tubercle of the humerus
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the supraspinatus muscle traverses an arch made by the acromion and the ___ on its route to the humerus
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coracoacromial ligament
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Suprascapular nerve reaches the supraspinous fossa by traversing the suprascapular notch ___ the cover of the transverse scapular ligament.
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beneath
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The suprascapular artery reaches the same area, runs ___ the suprascapular ligament.
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over
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To test for integrity of the suprascapular nerve, you ask the patient to
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abduct the arm from the fully adducted position
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“Abduction of the humerus at the glenohumeral joint is initiated by the ___. After the shoulder has been abducted to 10-15°, the ___ continues the movement.”
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-supraspinatus muscle
-deltoid muscle |
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Teres Minor Muscle passes through the
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quadrangular space
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A proximal humeral fracture puts this nerve at risk of injury
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axillary nerve
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Which of the rotator muscles insert onto the lesser tubercle of the humerus?
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subscapularis
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Rotator cuff tears most typically involve the ___; Patient has difficulty ___ the arm overhead and the movement is usually accompanied by pain.
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-supraspinatus
-abducting or flexing |
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Rotator cuff tears, Drop arm test
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arm drops as the slightest pressure when abducted
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Rotator cuff muscles act synergistically with the ___ during flexion and abduction; glenohumeral motion
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deltoid
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What muscles are active during overhead movements of the upper limb?
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rotator cuff muscles
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Borders of the quadrangular space are:
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teres minor
teres major long head of the triceps humerus |
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What passes through the quadrangular space?
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Axillary nerve and the posterior circumflex humeral artery
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Fracture of the surgical neck of the humerus may damage
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the axillary nerve and posterior circumflex humeral artery
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Axillary nerve injury will cause ___ atrophy and loss of sensation over the ___ side of the proximal arm
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-deltoid muscle
-lateral |
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Intercostal arteries anastomoses with the
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deep transverse cervical a. (dorsal scapular a.)
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During surgery or following trauma, arteries may be ligated (tied off) to avoid bleeding.
What enables this to be performed without causing tissue damage from ischemia (lack of blood)? |
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Arterial anastomoses
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Note:
Glenoid labrum Inferior capsule (note laxity) Lack of additional support from rotator cuff inferiorly. Lack of congruency between humerus and glenoid |
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Biceps Brachii Muscle
Proximal attachment Short head: Long head: Function regarding the shoulder: Stabilizes ___, weak ___ of the humerus |
Proximal attachment
Short head: tip of the coracoid process Long head: supraglenoid tubercle of scapula -anterior aspect of the shoulder -flexor |
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___ membrane when humerus is in adduction permits great freedom of movement
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Redundant synovial
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Glenohumeral ligaments (superior, middle, and inferior) are thickenings of the fibrous joint capsule that strengthen the capsule anteriorly
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Additional movers of the shoulder…
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Pectoralis major & minor
Serratus anterior Coracobrachialis Triceps longhead |