Ch. 10 Shoulder Joint

What are the four groups of motions possible at the shoulder joint?

(1) Flexion, Extension, Hyperextension (2) Abduction and Adduction (3) Medial and Lateral Rotation (4) Horizontal Abduction and Adduction

Shoulder flexion is from _____ to _____ degrees, and extension is the return to anatomical position. Approximately _____ degrees is possible from anatomical position. Abduction and adduction with _____ degrees of motion possible. Medial and lateral rotation is possible to move _____ degrees in each direction.

- 0 to 180 degrees - 45 degrees - 180 degrees - 90 Degrees

The greatest amount of arthokinematic motion is possible when the gleohumeral joint is in the open packed position of _____ degrees abduction and _____ degrees of horizontal adduction.

- 55 degrees - 30 degrees

_____ usually involves the long head of the biceps proximally as it crosses the humeral head, changes direction, and descends into the bicipital groove. A rupture of the biceps long head tendon commonly occurs during repetitive of forceful overhead positions. Irritation as it slides in the groove can lead to _____ (long head). Overloading the muscle in an abducted and laterally rotated position tends to be the force subluxing the tendon out of the bicipital groove.

- Bicipital Tendonitis - Subluxing of the Biceps Tendon

At the glenohumeral joint, the _____ humeral head moves within the _____ glenoid fossa.

- Convex - Concave

Viewing anteriorly, the _____ muscle lies deep to the pectoris major and anterior deltoid and lies medial to the short head of the biceps. The _____ muscle is truly a a deep muscle; with the pectoralis major and deltoid muscles removed and with the arm slightly abducted, the muscle can be seen as it passes between the rib cage and the scapula, and it runs horizontally through the axilla to he proximal end of the anterior humerus.

- Coracobrachialis muscle - Subscapularis muscle

Anteriorly, the _____ muscle covers most of the superficial chest wall, whereas the _____ and _____ muscles cover most of the anterior and posterior arm.

- Pectoralis Major muscle - Biceps Brachii and Triceps Brachii muscles

Shoulder joint muscles tend to originate on the _____ or _____ and insert on the _____, causing movement of the shoulder joint.

- Scapula or Trunk - Humerus

There are several bursae in the shoulder joint area. The _____ bursa is large located between the deltoid muscle and the joint capsule. The _____ bursa lies below the acromion and coracoacromial ligament, between them and the joint capsule.

- Subdeltoid bursa - Subacromial bursa

What four muscles are referred to as the Rotator Cuff, or SITS, muscles?

- Supraspinatus muscle - Infraspinatus muscle - Teres Minor muscle - Subscapularis muscle

Several shoulder muscles can been seen posteriorly if the trapezius muscle is removed. The _____ muscle lies deep to the trapezius above the scapular spine. In descending order, the _____, _____, and _____ muscles lie below the scapular spine. The _____ muscle covers the lumbar and lower thoracic regions of the back.

- Supraspinatus muscle - Infraspinatus, Teres Minor, and Teres Major muscles - Latissimus muscle

Shoulder gridle originate on the _____ and insert on the _____, causing either movement or stabilization of the scapula.

- Trunk - Scapula

Broad, flat area on the superior lateral aspect, providing attachment for the middle deltoid muscle.

Acromion Process

_____ refers to the inflammation and fibrosis of the shoulder joint capsule, which leads to pain and loss of shoulder range of motion. Also known as a frozen shoulder.

Adhesive Capsulitis

Circumferential groove separating the head from the tubercle of the humerus.

Anatomical Neck

Most shoulder dislocate in an _____ direction.

Anterior

______ is a forced shoulder abducted and lateral rotation tends to be the dislocating motion causing the humeral head to slide anteriorly out of the glenoid fossa.

Anterior Shoulder Dislocation

Providing attachment for the teres major and teres minor muscles.

Axillary Border

Also called the "intertubercular groove"; the longitudinal groove between the tubercles, containing the tendon of the long head of the biceps.

Bicipital Groove

Also called the lateral and medial lips of the bicipital groove, or the crests of the greater and lesser tubercles, respectively. It (crest of the greater tubercle) provides attachment for the pectoralis major, and the medial lip (crest of the lesser tubercle) provides attachment for the latissimus dorsi and teres major.

Bicipital Ridges

Chronic inflammation of the supraspinatus tendon can lead to an accumulation of mineral deposits and can result in _____, which may be asymptomatic or quite painful.

Calcific Tendonitis

_____ is a term used to describe the arc or circle only a combination of all the shoulder motions.

Circumduction

The _____ ligament attaches from the lateral side of the coracoid process and spans the joint anteriorly to the medial side of the greater tubercle. It strengthen the upper part of the joint capsule.

Coracohumeral Ligament

On the lateral side near the midpoint of the shaft of the humerus; not usually a well-defined landmark.

Deltoid Tuberosity

The _____ muscles forms a superficial cap over the anterior, lateral, and posterior sides of the shoulder.

Deltoid muscles

The normal end feel for all shoulder joint motions is _____.

Firm

The rotator cuff and deltoid muscles form a _____ that allows them to pull in different directions to achieve the same motion.

Force Couple

The superior, middle, and inferior _____ ligaments reinforce the anterior portion of the joint capsule. These are not well-define ligaments but actually pleated folds of the capsule.

Glenohumeral Ligaments

_____ is commonly seen in individuals who have hemiplegia, usually from a cerebrovascular accident (stroke). Paralysis of the shoulder muscles leaves them no longer able to hold the head of the humerus in the glenoid fossa. This paralysis, combined with the pull of gravity and the weight of the arm, over time causes this partial dislocation.

Glenohumeral Subluxation

The _____ joint demonstrates convex on concave joint surface motion where the head of the humerus moves in the opposite direction from the distal end of the humerus.

Glenohumeral joint

A shallow, somewhat egg-shaped socket on the superior end, lateral side; articulates with the humerus.

Glenoid Fossa

Fibrocartilaginous ring attached to the rim of the glenoid fossa, which deepens the articular cavity.

Glenoid Labrum

The _____ is a fibrous ring that surrounds the rim of the glenoid fossa. It function is to deepen the articular cavity.

Glenoid Labrum

The humeral head articulates with the _____ of the scapula makes up the shoulder joint.

Glenoid fossa

It is the arthrokinematic motion of _____, _____, and _____ that keep the head of the humerus articulating with the glenoid fossa.

Glide, Spin, and Roll

Large projection lateral to head and lesser tubercle; provides attachment for the supraspinatus, infraspinatus, and teres minor muscle.

Greater Tubercle

Semirounded proximal end of the humerus; articulates with the scapula.

Head of humerus

A _____ is another injury caused by a fall on the outstretched hand. It is commonly in the elderly and usually results in an impacted fracture.

Humeral Neck Fracture

The _____ is the longest and largest bone of the upper extremity.

Humerus

_____ is an overuse condition that involves compression between the acromial arch, the humeral head, and soft tissue structures. A type of impingement known as swimmer's shoulder is common with swimmers specializing in freestyle, butterfly, and backstroke.

Impingement Syndrome

Below the spine, providing attachment for the infraspinatus muscle.

Infraspinous Fossa

The _____ is a thin-walled, spacious container that attaches around the rim of the glenoid fossa of the scapula and the anatomical neck of the humerus. It is formed by an outer fibrous membrane and an inner synovial membrane.

Joint Capsule

A _____ involves damage to the glenoid labrum. It can have a degenerative or traumatic etiology and results in pain and limited motion in the shoulder joint.

Labral Tear

Smaller projection on the anterior surface, medial to the greater tubercle; provides attachment for the subscapularis muscle.

Lesser Tubercle

_____ are often caused by direct blow or a twisting force.

Midhumeral Fractures

_____ of the humerus may caused by benign tumors or metastatic carcinoma from primary sites such as the lung, breast, kidney, and prostate.

Pathological Fractures

Spinal fractures in this region increase the risk of a _____, as the nerve passes next to the bone in the spinal groove.

Radial Nerve Injury

The _____ is the tendinous band formed by the blending together of the tendinous insertions of the subscapularis, supraspinatus, infraspinatus, and teres minor muscles.

Rotator Cuff

_____ is a motion similar to flexion and abduction but occurs in the scapular plane as opposed to the sagittal or frontal plane.

Scaption

_____ is a specific type of glenohumeral joint elevation that happens in the plane of the scapula (30 degrees anterior to the frontal plane).

Scaption

The _____ plane is approximately 30 degrees forward of the frontal plane.

Scapular plane

Or "body"; the area between the surgical neck proximally and the wider distal end

Shaft

The _____ is a triaxial ball-and-socket joint and is one of the most movable joints in the body, and consequently, one of the least stable.

Shoulder joint

Includes most of the area on the anterior (costal) surface, providing attachment for the subscapularis muscle.

Subscapular Fossa

The _____ and _____ muscles is very important in stabilizing the head of the humerus against the glenoid fossa.

Supraspinatus and Infraspinatus muscles

above the spine, providing attachment for the supraspinatus muscle.

Supraspinous Fossa

Slightly constricted area directly below tubercles where the head meets the body of the humerus.

Surgical Neck

The _____ muscle has an important role in stabilizing the head of the humerus against the glenoid fossa as the shoulder joint moves in various directions.

Teres Minor muscle

The _____ (lumbar aponeurosis) is a superficial fibrous sheet that attaches to the spinous processes of the lower thoracic and lumbar vertebrae, the supraspinal ligament, and the posterior part of the iliac crest, covering the sacrospinalis muscle. It provides a very broad attachment for the latissimus dorsi muscle.

Thoracolumbar Fascia

A _____ involves the distal tendinous insertion of the supraspinatus, infraspinatus, teres minor, and subscapularis on the greater/lesser tubercle area of the humerus. Tears can be the result of acute trauma or gradual degeneration.

Torn Rotator Cuff