ch 18 - shoulder complex

Which of the following special or stress test is used to check for glenohumeral instability?

Apprehension test

Which of the following is the most important and most commonly injured bursa of the shoulder joint?

Subacromial bursa

Which of the following rotator cuff muscles abducts the shoulder?

Supraspinatus

In the context of shoulder injuries, identify the true statements about a sternoclavicular joint sprain. (Check all that apply.)

- A sternoclavicular sprain is a relatively uncommon occurrence in sports. - The mechanism of the injury is either an indirect force transmitted through the humerus, the shoulder joint, and the clavicle, or a direct impact to the clavicle.

Identify the guidelines that should be followed to prevent shoulder injuries. (Check all that apply.)

- All the muscles involved in movement of the shoulder complex should be strengthened through a full range of motion. - Extensive physical conditioning must be used if the shoulder is at risk for sudden traumatic injury. - Emphasis should be placed on strengthening the muscles of the rotator cuff.

In the context of shoulder injuries, identify the true statements about biceps tenosynovitis. (Check all that apply.)

- It can be associated with weakness of the rotator cuff muscles. - It is prevalent among pitchers, tennis players, volleyball players, and javelin throwers.

Match the groups of muscles that act on the glenohumeral joint of the shoulder complex (in the left column) with the muscles included in them (in the right column).

- Muscles that originate on the axial skeleton and attach to the humerus matches Choice, - The latissimus dorsi and the pectoralis major - Muscles that originate on the scapula and attach to the humerus matches Choice, - The deltoid, the teres major, the coracobrachialis, and the rotator cuff - Muscles that attach the axial skeleton to the scapula matches Choice, - The levator scapula, the trapezius, the rhomboids, and the serratus anterior and posterior

Which of the following procedures are involved in immediate care of an acromioclavicular joint sprain? (Check all that apply.)

- Referring to a physician for definitive diagnosis and treatment - Stabilizing the joint by a shoulder immobilizer

A dislocated shoulder outwardly displays which of the following?

A flattened deltoid

In the context of shoulder injuries, match the types of sternoclavicular joint sprains (in the left column) with their descriptions (in the right column). Instructions

A grade 1 sternoclavicular sprain matches Choice, It is characterized by little pain and disability, with some point tenderness but no joint deformity. A grade 2 sternoclavicular sprain matches Choice, It displays subluxation of the sternoclavicular joint with visible deformity, pain, swelling, point tenderness, and an inability to abduct the shoulder through a full range of motion or to bring the arm across the chest. A grade 3 sternoclavicular sprain matches Choice, It presents a picture of complete dislocation with gross displacement of the clavicle at its sternal junction, swelling, and disability, indicating complete rupture of the sternoclavicular ligament.

What direction is an athlete's arm in when an anterior glenohumeral dislocation occurs?

Abduction and external rotation

In which phase of the throwing motion is maximum external rotation achieved?

Cocking

Prevention of shoulder injuries can be accomplished by all of the following except for which statement?

Development of extreme flexibility

Which of the following is the mechanism of injury (MOI) for an acromioclavicular (AC) sprain?

FOOSH?

The rotator cuff muscle most commonly injured is the infraspinatus.

False

Which of the following is known as the true shoulder joint?

Glenohumeral joint

In the context of shoulder injuries, which of the following statements is true about a fracture of the humerus?

It is not easy to recognize by visual inspection alone.

Which of the following is the reason that impingement injuries occur?

Reduction of the space through which the supraspinatus muscle can pass

Which of the following shoulder injuries most likely involves a mechanical compression of the supraspinatus tendon, the subacromial bursa, and the long head of the biceps tendon, all of which are located under the coracoacromial arch?

Shoulder impingement syndrome

In the context of the anatomy of the shoulder, match the joints (in the left column) with the corresponding statements (in the right column).

The glenohumeral joint matches Choice, It is the true shoulder joint. The scapulothoracic joint matches Choice, It is not a true joint.

In the context of shoulder injuries, which of the following represents the most common glenohumeral dislocation?

The head of the humerus is forced out of its joint capsule in an anterior direction past the glenoid labrum and then downward to rest under the coracoid process.

In the context of shoulder injuries, identify a true statement about contusions of the upper arm.

They are frequent in contact sports.

True or false: Management of shoulder impingement syndrome involves restoring normal biomechanics to the shoulder joint in an effort to maintain space under the coracoacromial arch during overhead activities.

True. Management of impingement involves restoring normal biomechanics to the shoulder joint in an effort to maintain space under the coracoacromial arch during overhead activities. Exercises should concentrate on strengthening the rotator cuff muscles and those muscles that produce movement of the scapula, and on stretching the posterior and inferior joint capsule.

When an athlete has suffered a clavicular fracture which of the following signs and symptoms will be apparent?

all of the above

Carlos, a football player, suffers an injury because of an arm tackle in a football game. After the incident, he displays a flattened deltoid contour and carries the affected arm in slight abduction and external rotation and is unable to touch the opposite shoulder with the hand of his affected arm. He often complains of moderate to severe pain along with disability. Carlos most likely suffers from a shoulder injury called a(n) _____.

anterior glenohumeral dislocation

What direction does the shoulder joint most commonly dislocate?

anteriorly

Ryan is a tennis player. One day, he notices that his anterior upper arm has some swelling, increased warmth, and crepitus, and there is tenderness in the area. He complains of pain when playing tennis. In this scenario, Ryan most likely has a shoulder injury called _____.

biceps tenosynovitis

All of the following athletes are prone to overuse throwing injuries of the shoulder except:

bowlers*

Although any muscle of the upper arm is subject to bruising because of contusions of the upper arm, the area most often affected is the lateral aspect, primarily the _____ muscle and portions of the triceps and biceps muscles.

brachialis

In which phase of the throwing motion are the external rotators of the rotator cuff contracting eccentrically?

deceleration

Signs of biceps tenosynovitis include pain in the posterior aspect of the shoulder, swelling, and crepitus

false

The acromioclavicular joint is a strong joint reinforced by several key ligaments.

false

An athlete comes off the field supporting an injured arm with the head tilted towards the injured shoulder and the chin turned towards the opposite side. Which injury has likely been sustained?

fractured clavicle

In which phase of observation is thoracic kyphosis detected?

lateral

In the context of shoulder injuries, tears of the rotator cuff muscles are almost always _____.

near their insertion on the humerus

Which of the following muscles is not a part of the rotator cuff group?

not Subscapularis, deltoid?

Which of the following muscles major function is to assist with stabilization of the humeral head into the glenoid fossa?

pectorals major??

The acromion process is part of which bone?

scapula

In the context of the anatomy of the shoulder, the only direct connection between the upper extremity and the trunk is the _____.

sternoclavicular joint

The shoulder joint is subject to chronic inflammatory conditions resulting from trauma or overuse. The bursa that is most often inflamed is the ______.

subacromial bursa

Bianca, an athlete, falls on the tip of the shoulder. After the fall, she has pain when trying to move the shoulder, especially in abduction or with flexion, adduction, and internal rotation. There is also tenderness to palpation in the area just under the acromion. She takes an impingement test, and the result is positive. In this scenario, Bianca most likely has a shoulder injury called _____.

subacromial bursitis

In the context of shoulder injuries, most rotator cuff tears occur in the _____ muscle in individuals with a long history of shoulder impingement or instability and are relatively uncommon in athletes under the age of 40.

supraspinatus

The empty can test is used to determine injury to what muscle?

supraspinatus

The sternoclavicular joint is the only bone-to-bone joint that holds the shoulder complex onto the thorax.

true

In a sternoclavicular sprain, the clavicle is generally displaced in what direction?

upward and anteriorly

Identify the points that should be kept in mind when training athletes in collision and contact sports to prevent shoulder injuries. (Check all that apply.)

- The athletes must be taught not to try to catch themselves with an outstretched arm. - The athletes should be instructed and drilled on how to fall properly.

Identify the bones that comprise the shoulder complex and shoulder joint. (Check all that apply.)

- The clavicle - The scapula - The humerus

In the context of the shoulder complex, in which of the following phases of throwing do most throwing injuries occur? (Check all that apply.)

- The deceleration phase - The acceleration phase

Match the tests used to assess the shoulder complex (in the left column) with the procedures involved in them (in the right column).

- The apprehension test matches Choice, - With the arm abducted 90 degrees, the shoulder is slowly and gently externally rotated as far as the athlete will allow. - The full can test for supraspinatus muscle weakness matches Choice, - The athlete brings both arms into 90 degrees of forward flexion and 30 degrees of horizontal adduction, the arms are externally rotated with thumbs pointing upward, and a downward pressure is then applied. - The test for sternoclavicular joint instability matches Choice, - With the athlete sitting, pressure is applied anteriorly, then superiorly, and then inferiorly to the proximal clavicle. - The test for acromioclavicular joint instability matches Choice, - Pressure is applied to the distal clavicle in all four directions, and pressure is applied to the tip of the shoulder.

Identify the major articulations associated with the shoulder complex. (Check all that apply.)

- The glenohumeral joint - The scapulothoracic joint - The acromioclavicular joint - The sternoclavicular joint

Identify the muscles that are part of the rotator cuff muscles of the shoulder complex. (Check all that apply.)

- The teres minor - The supraspinatus - The infraspinatus - The subscapularis

In the context of shoulder injuries, identify the true statements about contusions of the upper arm. (Check all that apply.)

- They can lead to pain and tenderness, increased warmth, discoloration, and difficulty in achieving full extension and flexion of the elbow. - The key to treatment is to provide protection to the affected area to prevent repeated episodes that increase the likelihood of myositis ossificans.

In the context of shoulder injuries, which of the following statements are true about clavicle fractures? (Check all that apply.)

- They may require surgical management occasionally. - They result from a fall on the outstretched arm, a fall on the tip of the shoulder, or a direct impact.