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ortho 3 > shoulder pre class > Flashcards

shoulder pre class Flashcards

1
Q

glenohumeral joint - joint type

A

multaxial ball and socket synovial joint

labrum deepens glenoid fossa by 50%

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2
Q

GHJ resting position

A

55 abduction, 30 horizontal adduction

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3
Q

GHJ close pack

A

full abduction, ER

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4
Q

GHJ capsular pattern

A

ER, Abd, IR

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5
Q

GHJ ROM - flexion

A

0-180

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6
Q

GHJ ROM - extension

A

0-60

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7
Q

GHJ ROM - abduction

A

0-180

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8
Q

GHJ ROM - IR

A

0-70

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9
Q

GHJ ROM - ER

A

0-90

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10
Q

GHJ inferior capsule

A

extends down humerus
does not add much stability
least supported

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11
Q

GHJ capsule attaches

A

to circumference of glendoid fossa and spans to anatomical neck of humerus

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12
Q

GH ligaments

A

superior, middle, inferior

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13
Q

superior GH lig

A

blends w/ labrum along head of biceps

suspends humerus

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14
Q

superior GH lig resists

A

inferior glide and ER during first 60 deg abduction

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15
Q

middle GH lig

A

variable present

restrains ER between 0-90 deg abduction

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16
Q

inferior GH lig

A

anterior, posterior, axillary pouch

-ant is primary restraint to anterior translation at 90 degrees abduction

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17
Q

coracohumeral ligament limits

A

inferior glide and ER below 60 deg abduction

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18
Q

coracohumeral ligament found in

A

rotation interval (ant border of supraspinatus tendon and superior border of subscap tendon)

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19
Q

coracoacromial ligament

A

limits superior glide

forms arch over humeral head

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20
Q

what ligament forms roof over bicipital groove?

A

transverse humeral lig

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21
Q

scapulohumeral muscles

A

deltoid
teres major
coracobrachialis
rotator cuff (SSIT)

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22
Q

scapulothoracic muscles

A 
Serratus ant
traps
rhomboids
levator scapulae
pec minor
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23
Q

thoracohumeral

A

latts

pec major

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24
Q

what joint has more fractures than dislocations

A

sternoclavicular

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25
Q

sternoclavicular movements

A 
elevation (around AP axis)
depression
protraction(around vertical axis)
retraction
rotation (around long axis)
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26
Q

moments at SC corresponding to scap movements

A

post glide - retraction - concave
ant glide - protraction - concave
inf glide - elevation - convex
sup glide - depression - convex

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27
Q

sc resting

A

arm at side

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28
Q

sc close pack

A

full elevation

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29
Q

sc capsular pattern

A

pain at extremes of ROM, esp horizontal adduction and full elevation

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30
Q

AC joint type

A

plane synovial w/ 3 deg freedom

acromion slides on clavicle in same direction as scapular movement

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31
Q

first ligaments to be injured when AC joint is stressed

A

acromioclavicular lig

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32
Q

primary support of AC joint

A

coracoclavicular lig

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33
Q

AC joint resting

A

arm by side

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34
Q

AC close pack

A

90 deg abduction

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35
Q

AC capsular pattern

A

pain at extremes of ROM, esp horizontal Add and full elevation

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36
Q

AC sprain type I

A

AC ligt stretched but stable

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37
Q

AC sprain type II

A

AC lig torn, coracoclavicular stretched

38
Q

AC sprain type III

A

AV and coracoclavicular torn and eventually tears deltoids and traps

39
Q

GHJ as humerus elevates

A

context rule
as humerus elevates from 30-60 deg, glides sup
then center of rotation remains fixed and spinning occurs

40
Q

greatest force on inf GH ligament

A

abd, ER

41
Q

what contributes the most to GH stability?

A

rotator cuff group

42
Q

scapulothoracic joint

A

upward rotation is most important (serratus and traps)

43
Q

resting position of scap

A

30 deg ant tilt, upward rotation 3 deg

44
Q

scapulohumeral rhythm

A

first 30 deg “setting phase” variable
last 60 about 1:1
average is 2:1 GH:scap

45
Q

scapulohumeral rhythm stage 1

A

humerus 30 deg ab
scapula minimal motion
clavicle 0-5 deg elvation

46
Q

scapulohumeral rhythm stage 2

A

humerus 40 deg ab
scapula 20 deg upward rotation, min protraction or elevation
clavicle 15 deg elevation

47
Q

scapulohumeral rhythm stage 3

A

humerus 60 deg ab, 90 deg ER
scapula 30 deg upward rotation
clavicle 30-50 post rotation 15 deg elevation

48
Q

instantaneous center or rotation

A

moves from root of spine to acromion

49
Q

early elevation

A

upper trap and serratus ant responsible for upward rotation and protraction
-as U trap loses MA, L trap kicks in, SA active throughout
ICR now at acromion

50
Q

Bankart Lesion

A

Labrum avulses from
anterior inferior part of fossa, stripping the
capsule

51
Q

Comparable sign

A 
A combination
of pain, stiffness and/or spasm that
the therapist finds on examination
and considers to be comparable to
the patient’s symptoms
52
Q

Hills-Sachs Lesion

A 
A radiological
finding thought to be a
compression fracture of the
posterior humeral head as it
translates anteriorly over the sharp
anterior lip of the glenoid rim
53
Q

Hypermobility

A

Excessive ROM
with muscular control to provide
stability

54
Q

Primary impingement-

A

Rotator cuff being
mechanically impinged underneath the
coracoacromial arch.

55
Q

Neer’s stages 1

A

Impingement

Edema and hemorrhage

56
Q

Neer’s stage 2

A

Impingement

Fibrosis and tendinitis

57
Q

Neer’s stage 3

A

Tear of rotator cuff, biceps rupture, bone changes

58
Q

Secondary impingement

A

Impingement as a result of GH or functional scapular instability

59
Q

Secondary impingement causes

A
  • decrease in SAS due to instability
  • high demand of overhead sport —> GHJ lax —> superior migration of HH
  • kyphosis TSpine and protracted scap
  • poor force coupling at small -> decreased upward rotation
60
Q

Instability leads to

A

Excessive displacement anterior or posterior of humeral head in relationship to glenoid fossa

61
Q

TUBS

A

Traumatic Unidirectional anterior
instability with Bankart lesion requiring
Surgery

62
Q

AMBRII

A

Atraumatic Multidirectional
Bilateral laxity Rehabilitation Inferior
capsule and rotator Interval

63
Q

GHJ instability grade 0

A

No translation

64
Q

GHJ instability grade 1

A

Mild
Humeral head moves slightly up face of glenoid
0-1cm translation

65
Q

GHJ instability grade 2

A

Moderate
Humeral head rides up glenoid face but not over the rim
1-2 cm translation

66
Q

GHJ instability grade 3

A

Severe
Humeral head rides up and over the glenoid rim
Usually reduces when stress removed
Main remain dislocated when stress removed
>2cm translation

67
Q

Painful arc

A

Range of 60-120 deg shoulder elevation

68
Q

SLAP lesion

A

Superior Labrum Anterior
Posterior (superior labrum avulsion at the
biceps insertion)

69
Q

Subluxation

A

partial loss of joint
congruency, but can be normally controlled
with dynamic stabilizers

70
Q

Joints of shoulder and shoulder girdle

A

Glenohumeral joint •  Acromioclavicular joint •  Sternoclavicular joint •  Scapulothoracic joint

71
Q

Key functional movement limitations if shoulder not working properly

A

Reaching above head –  Reaching behind back –  Lifting (flexion or extension) –  Pushing forward or backward –  Throwing/over head hitting

72
Q

Arthro of SC protraction

A

Concave rule
Role ant
Slide ant

73
Q

Arthro of SC retraction

A

Concave rule
Post roll
Post slide

74
Q

Arthro of SC elevation

A

Convex rule
Sup roll
Inf slide

75
Q

Arthro of SC depression

A

Convex rule
Inf roll
Sup slide

76
Q

Weight of dependent arm

A

Causes scap downward rotate, ab, forward tipping

Balanced by U trap, SA (forward tip by rhomb, M trap)

77
Q

Dynamic scapular stability

Flexion or ab

A

U and L trap w/ SA caused upward rotation

78
Q

Dynamic pushing activities

A

Scapular protraction by SA

79
Q

Dynamic pulling activities

A

Retraction and D rotation by: rhomb, lats, T major, rotator cuff

80
Q

Faulty scapular postures forward tilt

A

tight pec minor, weak SA (ab/IR humerus)

81
Q

Clavicular elevation and rotation

A

As scap rotates upward

  • clavicle first elevates 30 deg
  • coracoclavicular tights and rotation takes place, 38-50 deg
  • allowing xtra 30 deg of scap upward rotation
82
Q

Humeral ER

A

Must occur for full AB

Allows greater tubercle to clear coracoacromial arch

83
Q

Humeral IR and passive shoulder flexion

A

Starts at 50 deg of passive shoulder flexion
Ant capsule and lig tighten and pull humerus into IR

Countered by infraspinatus and teres minor

84
Q

Scaption

A

30 deg anterior to frontal place
Less tension on capsule
No humeral rotation necessary for clearing greater tubercle
Many functional activities occur here

85
Q

Telford and short rotator cuff

A

Delt alone - Upward translation of humerus

Combined short rotator cuff muscles compress head of humerus into glenoid fossa and prevent excess superior migration

Supraspinatus compress head into glenoid w/ slight upward translation

86
Q

What is suggestive of recent or recurrent subluxations?

A

Bankart lesion

87
Q

Adhesive capsulitis stage 1

A

0-3 months
Sig night pain
Pain w/ active and passive ROM
Limitation: forward flex, ab, IR, ER

88
Q

Adhesive capusilitis stage 2

A

Freezing stage
3-9 months
Chronic pain w/ active and passive ROM
Sig limits of forward flex, ab, IR, ER,

89
Q

Adhesive capsulitis stage 3

A

Frozen stage 9-15 mo
Minimal pain except at end ROM
Sig limitation of ROM w/ rigid end feel

90
Q

Adhesive capsulitis stage 4

A

Thawing phase
15-24 mo
Minimal pain
Progressive improvement in ROM

91
Q

Downward rotated

A

poor coordination of SA and U trap

92
Q

Adducted

A

hypertrophied rhomboids

ortho 3 (12 decks)

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