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OTA 130 - Kinesiology > Shoulder > Flashcards

Flashcards in Shoulder Deck (21)
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1
Q

Shoulder Joint

A
  • Ball and Socket, Synovial joint
  • Moves in 3 degrees/planes, and is Triaxial
  • Flexion, Extension, Abduction, Adduction, Internal Rotation, External Rotation, Horizontal ABduction, Horizontal Adduction
  • Greatest ROM of all joints
  • Shoulder can compensate for loss of elbow/wrist motion
  • If it gets injured, ADLs abilities are affected
2
Q

Shoulder Complex

A

The four joints of the shoulder:

1) Glenohumeral Joint (GH): head of humerus, glenoid fossa of scapula
2) Sternoclavicular Joint
3) Acromioclavicular Joint
4) Scapular Thoracic Gliding Mechanism

3
Q

Shoulder Girdle

A

Connects upper limb to axial skeleton; the clavicle and scapula; AKA “pectoral girdle”
• Contains 5 different true and false joints
• 2 primary support functions:
- Stabilizing shoulder during static contractions
- Providing strong base of support for shoulder movements

4
Q

Scapulohumeral Rhythm

A

Motion of the clavicle, scapula and humerus together to achieve full elevation of arm. Exists between the scapula in shoulder girdle and the GH joint.
• 2 purposes:
- Scapular upward rotation; allows GH muscles to maintain length/tension
- Simultaneous movement of humerus/scapula; prevents impingement betw greater tubercle of humerus and acromion process
• First 30˚ GH flexion/abd is “Setting Phase”
• 2nd phase betw 30-90˚; scapula upward rotates 1˚ for every 2˚ of GH flex/abd (1:2 ratio)
• 2:1 ratio not consistent after 90˚

5
Q

Strength/Stability of Shoulder

A
  • Greatest strength produced in aDduction
  • Extension stronger than flexion
  • Internal rotation is stronger than external
  • Remember: strongest going INTO body
  • Weakest muscles are rotators
  • Shoulder very mobile, therefore LESS stable
  • Most frequently dislocated joint
  • Most common dislocation position is 90˚ aBd and external rotation (climbing, kayaking, throwing, monkey bars)
6
Q

Subluxation vs. Dislocation

A

Can be used interchangeably, but technically SUBLUXATION is when arm pops back in place, and true DISLOCATION is permanent (needs intervention).

7
Q

Nerves Innervating Shoulder

A

Innervated primarily by Brachial Plexus (with exception of long thoracic nerve and spinal accessory nerve, not part of plexus).

8
Q

Nerves of Brachial Plexus

A
  • Axillary Nerve (C5-C6): Delts, Teres Minor
  • Musculocutaneous Nerve (C5-C7): Coracobrachialis, Biceps
  • Suprascapular Nerve (C5, C6): Supraspinatus, Infraspinatus
  • Upper Subscapular Nerve (C5, C6): Upper Subscapularis
  • Lower Subscapular Nerve (C5, C6): Lower Subscapularis, Teres Major
  • Thoracodorsal Nerve (C6-C8): Lats
  • Lateral Pectoral Nerve (C5-C7): Pecs Major
  • Radial Nerve* (C5, C6): Triceps brachii (*easily damaged)
9
Q

What adds stability to shoulder?

A
  • Ligaments
  • Rotator Cuff
  • Joint Capsule
  • Labrum
10
Q

Shoulder Ligaments

A
  • 2: Glenohumeral and Coracohumeral ligaments (don’t need to remember names)
  • Hold head of humerus in place with glenoid fossa to provide stability (in addition to rotator cuff’s 4 tendons)
11
Q

Labrum

A

Ring of fibrocartilage surrounding and deepening the socket and increasing articulation with the humeral head.
• Increases stability of GH joint.
• Glenoid fossa deepened by glenoid labrum, joint capsule, GH ligaments, and long head of biceps
• These structures increase surface contact area of humeral head in glenoid fossa

12
Q

Rotator Cuff

A

4 muscle tendon insertions that stabilize the humerus in the glenoid fossa when arm is in motion.
• Head of humerus allowed to rotate internally/externally via rotator cuff
• Remember “SITS”: Supraspinatus, Infraspinatus, Teres minor, Subscapularis

13
Q

Muscles of Shoulder (GH Joint)

A

Most of larger/powerful muscles are superior, while smaller/weaker rotator cuff muscles are deeper.
• Flexion: Pecs Major, Ant Deltoid, Biceps
• Extension: Lats
• ABduction: Mid Deltoid, Supraspinatus
• ADduction: Pecs Major, Lats, Teres Major
• Internal Rotation: Pecs Major, Ant Deltoid, Lats, Teres Major, Subscapularis
• External Rotation: Post Deltoid, Teres Minor, Infraspinatus
• Horizontal ABduction: Post Deltoid
• Horizontal ADduction: Pecs Major, Ant Deltoid

14
Q

Muscles of Shoulder Girdle (Scapula)

A
  • Protraction: Rhomboids, Trapezius, Serratus Anterior, Pecs Minor
  • Retraction: Rhomboids, Trapezius
  • Elevation: Levator Scapula, Trapezius
  • Depression: Pecs Minor, Trapezius
  • Upward Rotation: Trapezius, Serratus Ant.
  • Downward Rotation: Pecs Minor
15
Q

Frozen Shoulder

A

Clinically known as “adhesive capsulitis.”
• Only occurs in shoulder
• Starts with inflammatory response to secondary injury
• Joint capsule contracts, joint becomes stiff (loss of ROM)
• Mostly in women age 40-50
• Usually resolves spontaneously

16
Q

Hemiplegia and Subluxation post CVA

A

Paralysis of one side of body after cardiovascular accident (CVA)
• Paralysis of shoulder muscles leave arm unsupported/susceptible to dislocation.
• Tx: wear a sling, short-term

17
Q

Erb’s Palsy

A

Abnormal posture of shoulder due to Brachial Plexus injury, usually in birth.
• Nerve roots C5, C6, C7 commonly affected
• Includes motor sensation
• Limb held in internal rotation, elbow extension, forearm pronation, wrist/finger flexion
• 1-2 babies per 1000 births
• Can heal in 6-12 mo, but 10% are permanent (leads to one-handedness)
• Wear brace during healing to promote proper/stable position

18
Q

Rotator Cuff Tendonitis

A

Impingement from pressure on the surface of rotator cuff from acromion process when arm is lifted.
• Pain/stiffness occurs when raising arm
• Night pain, difficulty sleeping
• Often in patients with history of poor posture/kyphosis

19
Q

Glenohumeral Joint (GH)

A

Where the humerus moves in synchronization with the scapula. Provides flexion, extension, aBduction, aDduction, internal rotation, external rotation, horizontal aBduction, and horizontal aDduction.

20
Q

Gibbus Deformity

A

This protrusion of the rib through the back along with a protruding scapula, occurs when a person with structural scoliosis bends forward.

21
Q

Radial Nerve (location)

A

Wraps around humerus; susceptible to injury in midshaft humeral fractures.