Arm

通報

問題一覧

One of the most mobile segment of the body

Shoulder complex

Mobility is provided by how many moving areas

Only connection to the axial skeleton

Static stability

Provided by the shoulder muscles

Dynamic stability

Most stable because of the muscles

Dynamic stability

Rotator cuff

Dynamic stability

SC joint

Static stability

Bone to bone

True joints

Sternoclavicular joint

True joints

Acromioclavicular joint

True joint

Glenohumeral joint

True joint

No bone to bone

False/functional joints

Bicipital groove

False/functional joints

Subacromial joint

False/functional joints

Scapulothoracic joint

False/functional joints

Long, slender bone that lies horizontally at the base/root of the neck

Clavicle

True about clavicle, except:

Lateral fracture fragment is tilted superiorly by Sternocleidomastoid

Clavicle correct orientation

Middle 2/3: Convex anteriorly, concave posteriorly, Lateral 1/3: Concave anteriorly, convex posteriorly

Most commonly fractured bone

Clavicle

If there is a complete clavicular fracture: Medial fragment

titled superiorly by sternocleidomastoid

If there is a complete clavicular fracture: Lateral fragment

goes downward by external force, medially by pectoralis major

Space between the clavicle and first rib

Costoclavicular space

Contents of costoclavicular space

Subclavian artery, Brachial plexus

Also known as shoulder blade

Scapula

Flat triangular bone that lies on the posterior chest wall between the 2nd and 7th ribs

Scapula

Landmarks of scapula

T2 superior angle, T3 spine of scapula, T7 inferior angle

Summit of the shoulder

Acromion process

Orientation of acromion process

Posterior, Lateral, Superior

Types of acromion process

Flat, Curved, Hooked, Upturn/convex

Orientation of coracoid process

Superior, Anterior

Most common type of acromion process

Curved

Most common type in impingement syndrome

Hooked

What prevents superior translation of the humerus?

Coracoacromial ligament

Painful arc: Tear or dislocation

0-60 deg

GH painful arc

60-120 deg

Impingement syndrome

60-120 deg

Tendinitis

60-120 deg

Painless

120-170 deg

AC joint is affected

170-180 deg

Extension of the acromion process medially

Spine of scapula

Shallow depression

Glenoid fossa

Above spine of scapula

Supraspinous fossa

Below the spine of scapula

Infraspinous fossa

Anterior to spine of scapula

Subscapular fossa

Glenoid labrum enhances the depth of the fossa by

50%

Its purpose if tot provide stability and shock absorption within the joint

Glenoid fossa

Parts of humerus

Surgical neck, Anatomical neck, Humeral head, Tuberosities, Bicipital groove, Spiral groove

Forms 1/3 of a sphere

Head

end attachment of capsule

Anatomical neck

Prone to fracture

Surgical neck

Nerve usually damaged: Axillary/circumflex nerve

Surgical neck

Shallow tail sign

Surgical neck

Shallow tails sign

Posterior deltoid weakness

Greater tuberosity is located

Laterally

Lesser tuberosity is located

Medially

Greater tuberosity can be palpated with

Lessed tuberosity can be palpated with

Muscle attachment for greater tuberosity

Supraspinatus, Infraspinatus, Teres minor

Lesser tuberosity muscle attachment

Subscapularis

Where the long head of biceps brachii tendon passes

Bicipital groove

Where the radial nerve/musculospiral nerve

Spiral groove

This contains the long head of the biceps within the bicipital groove

Transhumeral ligament

Special test for THL rupture

Yergason’s test

AKA intertubercular groove

Bicipital groove

AKAA radial groove

Spiral groove

Ligaments of SC joint

Interclavicular, Costoclavicular, Sternoclavicular

Articulation of SC joint

Medial end of clavicle, Manubrium of sternum

Accessory structure of SC joint

Sternoclavicular disc

Accessory structure of AC joint

Acromioclavicular disc

Kinematics of SC joint

3 degrees freedom, 3 axes EDS, CPR, Longitudinal Rot

SC joint type

synovial double plane joint, saddle/sellar joint

What ligament limits depression?

Interclavicular

What ligament limits elevation?

Costoclavicular

What ligament limits retraction and protraction?

Sternoclavicular

Articulation of AC joint

Lateral end of clavicle, Acromion process

Types of AC ligament

Superior AC ligament, Inferior AC ligament

Types of coracoclavicular ligament

Conoid ligament, Trapezoid ligament

Prevents superior translation of clavicle (secondary)

Inferior AC ligament

Prevents inferior translation of clavicle

Superior AC ligament

Prevents superior translation of clavicle (primary)

Conoid ligament

Prevents medial displacement of scapula

Trapezoid ligament

True about conoid ligament, except

It belongs in SC joint

Select what applied for trapezoid ligament

Located anteromedial, Quadrangular, horizontal fibers, Prevents medial displacement of scapula

AC joint kinematics

3 degrees freedom, 3 axes, Ext and Int Rot (pro/ret) - horizontal curvature of thorax, Ant and Post tilting (elev/dep) - vertical curvature of thorax, Longitudinal rot - up and down rotation

Horizontal curvature of thorax

Ext and int rot (pro/ret)

Vertical curvature of thorax

Ant and post tilting (elev/dep)

What type of joint is GH joint?

Ball and socket, universal joint

Articulation of GH joint

Humeral head, Glenoid head

Humeral head articulation

Superior medial posterior

Glenoid head articulation

Superior anterior lateral

Formed by axis of humeral head, neck and axis of humeral shaft

Angle of inclination

Formed by axis of humeral head, neck and axis of humeral condyles

Angle of Torsion

Angle of inclination

130-150 degrees

Angle of Torsion

approx. 30 degrees retroversion

Ligaments of GH joint

Coracohumeral ligament, Glenohumeral ligament

Accessory structure of GH joint

Glenoid labrum

Kinematics of GH joint

Multiaxial CIRCUMDUCTION= ERIR ABDADD FLEXEXT

Greatly involved in frozen shoulder/adhesive capsulitis

Coracohumeral ligament

Foramen between superior and middle GH

Foramen of Weitbrecht

100

Foramen between middle and inferior GH

Foramen of Rouviere

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