KIN 365 Exam 2
What is the surgery often referred to that repairs the UCL? It is particularly common among high school, collegiate, and professional pitchers.
"Tommy John procedure"
The shoulder joint is frequently injured due to which three things?
1. anatomical design (shallowness of glenoid fossa and largeness of head of humerus) 2. lack of stability from ligaments 3. lack of strength and endurance in the muscles, which are essential in providing dynamic stability to the joint
While the exact number of degrees in one segment compared to another may vary within and between individuals, the generally accepted ratio is ____ to _____; that is, for every _____ degrees of glenohumeral motion, there is ____ degree of scapula motion.
2, 1, 2, 1
Without the accompanying movement of the scapula, we can only raise our humerus to around ______ to _______ degrees of total shoulder abduction and flexion.
90, 120
In recent years the phenomenon of ____________ has received attention. This represents a difference in internal rotation range of motion between an individual's throwing and nonthrowing shoulders. Studies have shown that overhead athletes who had this of greater than 20% had a higher risk of injury than those who did not. Appropriate stretching exercises may be used to regain the amount of internal rotation necessary to improve performance and reduce the likelihood of injury.
GIRD (glenohumeral internal rotation deficit)
The __________ is particularly crucial to those high-velocity sporting activities, such as baseball pitching, that require optimal stability of the medial elbow. Even moderate injury to this structure can seriously impact an athlete's ability to throw at the highest levels. Compromise of this structure often requires surgery using a tendon graft such as the palmaris longus tendon to reconstruct this ligament.
UCL
Many contact sports, particularly sports with throwing activities, place stress on the medial aspect of the joint, resulting in injury. Often this injury involves either acute or chronic stress to the ___________, resulting in partial to complete tears to it.
UCL (ulnar collateral ligament)
The radial head is maintained in its joint by the _______________ ligament.
annular
________________ glenohumeral subluxations and dislocations are quite common with physical activity.
anterior (or anteroinferior)
The ________________ glenohumeral ligaments become taut as external rotation, extension, abduction, and horizontal abduction occur, whereas the very thin __________________ capsular ligaments become taut in internal rotation, flexion, and horizontal adduction.
anterior, posterior
The acromioclaviular joint is classified as an _________________ joint.
anthrodial (multiaxial)
The sternoclavicular joint is classified as an _____________________ joint.
anthrodial (multiaxial)
All five shoulder girdle muscles have their origin on the __________ _________________, with their insertion locate on the _____________ and/or the ______________.
axial skeleton, scapula, clavicle
The supinators are located on the ___________ of the forearm.
back
Why does the deltoid not do adduction?
because it would have to have an origination underneath to come near to
What is the true elbow flexor?
brachialis
In the anatomical position, it is common for the forearm to deviate laterally from the arm from 5 to 15 degrees. This is referred to as the _______________ ______________ and permits the forearms to clear the hips in the swinging movements during walking and also is important when carrying objects.
carrying angle
The radius is much larger ______________ than the radius.
distally.
The trapezius must prevent the scapula from being pulled ________________.
downward
The shoulder girdle muscles are essential in providing ________________ stability of the scapula so that it can serve as a relative base of support for shoulder joint activities such as throwing, batting, and blocking.
dynamic
The scapulothoracic joint is supported ___________________ by its muscles and lacks ligamentous support, since it has no synovial features.
dynamically
The shoulder joint, specifically known as the glenohumeral joint, is a multiaxial ball-and-socket joint classified as ______________________.
enarthrodial
As the elbow reaches full extension, the olecranon process of the ulna is received by the olecranon fossa of the humerus. This arrangement provides increased joint stability when the elbow is fully ________________.
extended
True/False: The movement of the shoulder girdle is dependent on the shoulder joint and its muscles.
false
Typical action of the trapezius muscle is ______________ of the scapula for ____________ action.
fixation (isometric), deltoid
The elbow joint is classified as a ginglymus or hinge-type joint that allows only ____________ and _______________.
flexion, extension
The pronators are located on the ____________ of the forearm.
front
The only place the shoulder attaches is the ____________ ___________.
glenoid fossa
Elbow flexion with supination is ___________. Elbow flexion with shoulder movement is _________. Explain.
good, bad; it is bad because of bi-articulate insufficiency
Quite often, these joints are grouped together because of their close anatomical relationship. The elbow joint is intimately associated with the radioulnar joint in that both bones of the radioulnar joint, the radius and ulna, share an articulation with the _______________ to form the elbow joint.
humerus
Shoulder girdle muscles do not attach to the ______________, nor do they cause actions of the shoulder joint.
humerus
Rotator cuff ___________________ _________________ occurs when the tendons of these muscles, particularly the supraspinatus and infraspinatus, become irritated and inflamed as they pass through the subacromial space between the acromion process of the scapula and the head of the humerus. Pain, weakness, and loss of movement at the shoulder can result. Loss of function of the rotator cuff muscles, due to injury or loss of strength and endurance, may cause the humerus to move superiorly, resulting in this.
impingement syndrome
The _____________________ is vital to maintaining the posterior stability of the glenohumeral joint.
infraspinatus
What is the most powerful of the external rotators?
infraspinatus
What is the second most commonly injured rotator cuff muscle?
infraspinatus
What are the main external rotators?
infraspinatus and teres minor
Which muscles are your external rotators?
infraspinatus and teres minor
Typical movement occurs from the ______________ to the ______________.
insertion, origin
________________ is a forward shoulder posture, which is caused by further depression and protraction. It stems from scapular support muscles that are weak.
kyphosis
The shoulder joint's stability is enhanced slightly by the glenoid ______________, a cartilaginous ring that surrounds the glenoid fossa just inside its periphery.
labrum
Tennis elbow is known technically as _____________ ___________________. It is quite frequently associated with gripping and lifting activities.
lateral epicondylitis
What is the antagonist of the pectoralis major?
latissimus dorsi
What is the antagonist to the deltoid muscle?
latissimus dorsi
Which two muscles have a pull on the scapula?
latissimus dorsi and pectoralis major
It is important to note that, due to the wide range of motion involved in the glenohumeral joint, the ligaments are quite __________ until the extreme ranges of motion are reached.
lax
Because the shoulder joint has such a wide range of motion in so many different planes, it also has a significant amount of ______________, which often results in instability problems such as rotator cuff impingement, subluxations, and dislocations.
laxity
The shoulder joint is further stabilized by the glenohumeral ______________, especially anteriorly and inferiorly.
ligaments
______________ ________________, a somewhat less common problem frequently referred to as "golfer's elbow," is associated with the wrist flexor and pronator group near their origin on the medial epicondyle.
medial epicondylitis
Ligaments aren't tight in the ________________ (muscles are for stability here).
middle
The brachioradialis muscle acts as a flexor best in a _________________ or _________________ position between pronation and supination.
midposition, neutral
What stabilizes a joint during movement?
muscles
Does the scapula attach to the ribs?
no
The _____________ __________ can move the scapula. It pulls it into protraction (even though it is not attached to the scapula), it anteriorly pulls on the humerus.
pectoralis major
What is the main internal rotator?
pectoralis major
What are the anteriorly located muscles of the shoulder girdle?
pectoralis minor and serratus anterior (anteriolaterally)
The radioulnar joint is classified as a trochoid or ___________-type joint.
pivot
________________ dislocations are fairly rare but shoulder problems due to _______________ instability are somewhat commonplace.
posterior, posterior
Elbow flexion activities with the forearm ________________ isolate the brachialis to some extent by reducing the effectiveness of the biceps brachii.
pronated
The ulna is much larger ___________________ than the radius.
proximally
The ____________ head rotates around in its location at the proximal ulna. This rotary movement is accompanied by rotation of the distal radius around the distal ulna.
radial
The distal attachments of the radioulnar joint muscles are located on the ___________.
radius
A winged scapula condition usually results from weakness of the _______________ and/or the ______________ _______________.
rhomboid, serratus anterior
An inability to smoothly abduct the arm against resistance is indicative of possible _____________ ________ injury.
rotator cuff
The only attachment of the shoulder joint to the axial skeleton is via the ______________ and its attachment through the _______________ at the sternoclavicular joint.
scapula, clavicle
Two bones are primarily involved in movements of the shoulder girdle. They are the _____________ and _____________, which generally move as a unit.
scapula, clavicle
The ______________ muscles also play a role in spinal posture. Typically, due to poor posture and the way we use our muscles through life, we tend to develop a ______________ shoulder posture that results in the scapula protractors and depressors becoming stronger and tighter and the retractors becoming weaker.
scapula, forward
The _____________, _____________, and _____________ serve as proximal attachments for the muscles that pronate and supinate the radioulnar joints.
scapula, humerus, ulna
The _____________ and _______________ serve as the proximal attachments for the muscles that flex and extend the elbow. The ___________ and _____________ serve as the distal attachments for the same muscles.
scapula, humerus, ulna, radius
The shoulder joint is frequently injured because of its anatomical design. A number of factors contribute to its injury rate, including the _____________________ of the glenoid fossa, the _____________ of the ligamentous structures necessary to accommodate its wide range of motion, and the lack of ____________ and _________________ in the muscles, which are essential in providing dynamic stability to the joint.
shallowness, laxity, strength, endurance
The _____________ joint is both the most mobile and least stable joint in the body.
shoulder
The _______________ joint moves in all planes and is the most movable joint in the body.
shoulder
The concept that the more mobile a joint is, the less stable it is and that the more stable it is, the less mobile it is applies generally throughout the body, but particularly in the _________________ joint.
shoulder
Determining the exact range of each movement for the glenohumeral joint is difficult because of the accompanying ______________ ___________________ movement.
shoulder girdle
The muscles of the shoulder girdle are essential in providing a scapula-____________________ effect, so that the muscles of the shoulder joint will have a stable base from which to exert force for powerful movement involving the humerus.
stabilizing
The shoulder girdle muscles contract to maintain the scapula in a relatively _____________ position during many shoulder joint actions.
static
When analyzing shoulder girdle (scapulothoracic) movements, it is important to realize that the scapula moves on the rib cage as a consequence of joint motion actually occurring at the ____________________ joint and to a lesser extent at the _____________________ joint.
sternoclavicular, acromioclavicular
The rotator cuff muscles, which are not very large in comparison with the deltoid and pectoralis major, must possess not only adequate _______________ but also a significant amount of muscular __________________ to ensure the proper functioning, particularly in repetitious overhead activities.
strength, endurance
The __________________ is the only rotator cuff muscle that inserts on the lesser tubercle.
subscapularis
The ___________________ is the rotator cuff muscle that is not often injured because it is stable.
subscapularis
The biceps brachii is more powerful in flexing the elbow when the radioulnar joint is __________________.
supinated
What is the most often injured rotator cuff muscle?
supraspinatus
What is the only non-rotating rotator cuff muscle?
supraspinatus
Due to the radius and ulna being held tightly together between the proximal and distal articulations by an interosseus membrane, the joint between the shafts of these bones is often referred to as a _________________ type of joint. This interosseus membrane is helpful in absorbing and transmitting forces received by the hand, particularly during upper-extremity weight bearing. There is substantial rotary motion between the bones despite this classification.
syndesmosis
Even though the elbow and radioulnar joints can and do function independently of each other, the muscles controlling each work together in _____________ to perform actions at both to benefit the total function of the upper extremity. For this reason, dysfunction at one joint may affect normal function at the other.
synergy
The scapulothoracic joint is not a true _________________ joint, due to its not having regular _____________ features and to the fact that its movement is totally dependent on the sternoclavicular and acromioclavicular joints.
synovial, synovial
Quite often when these types of activities are conducted with poor technique, muscle fatigue, or inadequate warm-up and conditioning, the rotator cuff muscle group--particularly the supraspinatus--fails to dynamically stabilize the humeral head in the glenoid cavity, leading to further rotator cuff problems such as _______________ and rotator cuff _________________ within the subacromial space.
tendinitis, impingement
A common problem associated with the muscles of the elbow is "_____________ ___________," which usually involves the extensor digitorum muscle near its origin on the lateral epicondyle.
tennis elbow
What is the latissimus dorsi's "little helper"?
teres major
What is the most stable joint?
the elbow joint
Movement of the shoulder is dependent on what?
the scapula or shoulder girdle
What is the rotator cuff's main job?
to hold the head of the humerus in the glenoid fossa
The serratus anterior is the antagonist to which two muscles?
trapezius and rhomboids
What are the posteriorly located muscles of the shoulder girdle?
trapezius, rhomboids, and levator scapulae
True/False: Almost any movement of the upper extremity will involve the elbow and radioulnar joints.
true
True/False: It is unusual to have movement of the humerus without scapula movement.
true
True/False: Movements of the scapula or shoulder girdle do NOT depend on the shoulder joint.
true
True/False: None of the shoulder girdle muscles move the shoulder, however, the shoulder joint muscles can sometimes move the scapula.
true
True/False: The infraspinatus and teres minor have the same actions.
true
True/False: Wherever the scapula goes, the clavicle follows.
true
What is essential to providing medial support to prevent the elbow from abducting (not a normal movement of the elbow) when stressed in physical activity?
ulnar collateral ligament
The elbow joint becomes more _________________ as you flex it. This is dependent on collateral ligaments.
unstable
What is the pectoralis minor the antagonist of?
upper and middle fibers of trapezius and levator scapulae
When all parts of the trapezius are working together, they tend to pull ___________ and _____________ at the same time.
upward, adduct
In addition, radioulnar joint motion may be incorrectly attributed to the ___________ joint because it appears to occur there.
wrist
Do the teres major and teres minor oppose each other?
yes
Does the biceps brachii cross the shoulder joint?
yes
Can the deltoid be both its own agonist and antagonist?
yes, the anterior and posterior fibers can be antagonists during internal/external rotation and flexion/extension
