Term
| Most shoulder instability presents as what |
|
Definition
| anterior or multidirectional |
|
|
Term
| Etiology of shoulder instability |
|
Definition
|
|
Term
| Describe traumatic shoudler instability |
|
Definition
| forceful disruption creates permanent deformation of the GH capsule and/or labrum, allowing abnormal translation of the humeral head over the rim of the glenoid |
|
|
Term
| traumatic instability most often occurs in what direction |
|
Definition
|
|
Term
| atraumatic instability is generally associated with what |
|
Definition
| ligamentous laxity that is often a systemic occurence |
|
|
Term
| Atraumatic instability is generally associated with generalized ligamentous laxity that is often a systemic occurence. Such as what? (2) |
|
Definition
ehler's danlos
abnormality of the rotator interval |
|
|
Term
| Acquired instability is the result of what |
|
Definition
repetetive motions
occurs when the capsular ligaments are subjceted to repetitive microtrauma |
|
|
Term
| what happens as a result of the microtrauma associated with acquired instability |
|
Definition
| capsule is stressed beyond the elastic limit and strain deformation occurs resulting in permantent stretch of the capsule |
|
|
Term
| arthrokinematics of the gh: extension/flexion |
|
Definition
|
|
Term
| arthrokinematics of the gh: abduction |
|
Definition
superior roll
inferior glide |
|
|
Term
| arthrokinematics of the gh: ER |
|
Definition
posterior humeral roll
anterior glide |
|
|
Term
| arthrokinematics of the gh: IR |
|
Definition
anterior humeral roll
posterior glide |
|
|
Term
| Glenohumeral jt: structural classification |
|
Definition
| synovial (ball and socket) |
|
|
Term
| Glenohumeral jt: sagittal motions in neutral |
|
Definition
flexion
extension
hyperextension |
|
|
Term
| Glenohumeral jt: frontal movements in neutral |
|
Definition
|
|
Term
| Glenohumeral jt: movements in the transverse plane |
|
Definition
internal (medial) rotation
external (lateral rotation) |
|
|
Term
| Glenohumeral jt: transverse movemetns with the shoulder flexed to 90 |
|
Definition
horizontal abduction (extension)
horizontal adduction (flexion) |
|
|
Term
| Glenohumeral jt: axial and planar characteristics |
|
Definition
|
|
Term
| what makes up the shoulder complex (4) |
|
Definition
glenohumeral jt
acromioclavicular jt
sternoclavicular jt
scapulothoracic jt |
|
|
Term
| what is the principal mechanical principle of teh shoulder structure |
|
Definition
|
|
Term
| what does tensegrity imply |
|
Definition
|
|
Term
| structures of the sternocalvicular jt (6) |
|
Definition
interclavicular ligament
clavicle
costal cartilage of 1st rib
sternum
sternoclavicular ligament (atnerior)
costoclavicular ligament |
|
|
Term
| only attachment of the shoudler complex to the axial skeleton |
|
Definition
|
|
Term
| Sternoclavicular jt: structural classification |
|
Definition
|
|
Term
| Sternoclavicular jt: movement in the sagittal plane |
|
Definition
anterior rotation
posterior rotation |
|
|
Term
| Sternoclavicular jt: movement in teh frontal plane |
|
Definition
upward rotation
downward rotation |
|
|
Term
| Sternoclavicular jt: movement in the transverse plane |
|
Definition
|
|
Term
| Sternoclavicular jt: axial and planar characteristics |
|
Definition
|
|
Term
| what makes up the sternoclavicular jt |
|
Definition
|
|
Term
| Sternoclavicular jt: shape |
|
Definition
|
|
Term
| Sternoclavicular jt: purpose of the fibrocarilage disc |
|
Definition
|
|
Term
| Sternoclavicular jt: what structure pivots on the fibrocartilage disc |
|
Definition
|
|
Term
| movement of the clavicle at the SC jt leads to what |
|
Definition
| scapular movement and vice versa |
|
|
Term
|
Definition
elevation/depression
protraction/retraction
spin/rotation |
|
|
Term
| Sternoclavicular jt: elevation/depression axis |
|
Definition
|
|
Term
| Sternoclavicular jt: convex concave rule and structures for elevation/depression |
|
Definition
| convex clavicle on concave manubrium |
|
|
Term
| Sternoclavicular jt: protraction/retraction occur on what axis |
|
Definition
|
|
Term
| Sternoclavicular jt: concave convex rule and structures for protraction/retraction |
|
Definition
| concave clavicle on convex manubrium |
|
|
Term
| Sternoclavicular jt: ant/post rotation occurs how? |
|
Definition
| only rotates from neutral to posterior aspect |
|
|
Term
| how common are SC jt injuries |
|
Definition
| rare. 1% of all dislocations |
|
|
Term
| Acromioclavicular jt: purpose of the jt |
|
Definition
| attaches the scapula to the clavicle |
|
|
Term
| Acromioclavicular jt: type of jt |
|
Definition
|
|
Term
| Acromioclavicular jt: arthrokinematics orientation |
|
Definition
nonaxial
nonplanar
indiviaul variability is extensive therefore no specific arthorkinematic orientation |
|
|
Term
| Acromioclavicular jt: ______ is present and varies individually |
|
Definition
|
|
Term
| AC jt:_____ is present but weakn and not considered a stabilizer |
|
Definition
|
|
Term
| AC jt: stability comes from what structures (3) |
|
Definition
superior ac ligaments
inferior ac ligametns
coraclavicular ligaments (Trapezoid and conoid) |
|
|
Term
| AC jt: what makes up the coracoclavicular ligaments |
|
Definition
trapezoid ligament
conoid ligament |
|
|
Term
|
Definition
|
|
Term
| AC jt: which portion of the AC jt is stronger? |
|
Definition
| superior AC jt (capsule) stronger than inferior |
|
|
Term
| AC jt: why is the superior ac jt (capsule) stronger than the inferior |
|
Definition
| aponeurotic fibers of the deltoid mm and trapezius ligament |
|
|
Term
| AC jt: superior jt resists movement d/t what |
|
Definition
| anterior application of force on distal clavicle |
|
|
Term
| AC jt: coracoclavicular ligaments limit what motions |
|
Definition
| superior/inferior motions |
|
|
Term
| AC jt: "sort of useless" ligament |
|
Definition
|
|
Term
| AC jt: coracoacromial ligament is considered to be involved with what |
|
Definition
| superior stability of the GH jt |
|
|
Term
| AC jt: the coracoclavicular ligament creates (2) |
|
Definition
an area of impingement
an arch |
|
|
Term
| AC jt: the coracoacromial ligament is considered a source of... |
|
Definition
|
|
Term
| AC jt: serves as the axis for what motion |
|
Definition
|
|
Term
|
Definition
| winging/protraction-retraction of the scapula |
|
|
Term
|
Definition
|
|
Term
| AC jt: up/downward motions |
|
Definition
|
|
Term
| AC jt: ER results in what scapular motion |
|
Definition
| scapula moved medial (retraction) |
|
|
Term
| AC jt: IR results in what motion of the scapula |
|
Definition
| scapula moved laterally (protraction) |
|
|
Term
| AC jt: axis of motion for ER/IR through the ac jt |
|
Definition
|
|
Term
| AC jt: tipping/tilting has what axis of motion through the AC Jt |
|
Definition
|
|
Term
| AC jt: scapula and its relationship with the thorax |
|
Definition
| scapual needs to maintain contact with curve of thorax |
|
|
Term
| AC jt: what plays a significant role in scapular control |
|
Definition
|
|
Term
| AC jt: upward/downward rotation has what axis through the clavicle |
|
Definition
|
|
Term
| AC jt: injuries (tears) are usually result of what |
|
Definition
| high inferior loads on the distal clavicle |
|
|
Term
| AC jt: DJD is often associated with what |
|
Definition
|
|
Term
| AC jt: if AC DJD and/or GH impingement are present what is needed to open the jt |
|
Definition
|
|
Term
| AC jt: how is a resection performed? |
|
Definition
| form inferior aspect to avoid ligament compromise |
|
|
Term
| AC jt: where is the scope for a resection inserted? what happens to the distal end of the clavicle? |
|
Definition
inserted into the AC space from anterior portal
distal end taken back 4-8 mm |
|
|
Term
| Scapulothoracic jt: is it a true jt |
|
Definition
| no. an interaction between scapula and thorax |
|
|
Term
| Scapulothoracic jt: is dependent on the integrity of what 2 jts |
|
Definition
|
|
Term
| Scapulothoracic jt: any scapular movement must result in what other movements |
|
Definition
| movement at the AC/SC jts |
|
|
Term
| Scapulothoracic jt: how do motions of the scapula occur |
|
Definition
| do not occur in isolation, motions are combined |
|
|
Term
| Scapulothoracic jt: up/downward rotaiton is a primary motion with what other motion |
|
Definition
|
|
Term
| Scapulothoracic jt: how many degrees of upward rotation are available? |
|
Definition
|
|
Term
| Scapulothoracic jt: of the 50-60 degress of upward rotation available what portion belongs to the SC jt and what portion belogns to the clavicle |
|
Definition
2/3 posterior rotation of SC jt
1/3 elevation of clavicle |
|
|
Term
| Scapulothoracic jt: elevation/depression consists of what |
|
Definition
|
|
Term
| Scapulothoracic jt: pathologic positioning: winging is a result of what (2) |
|
Definition
muscle imablance
long thoracic nn injury |
|
|
Term
| Scapulothoracic jt: pathologic positioning: what is anterior tipping |
|
Definition
| increased prominence of the inferior angle of the scapula |
|
|
Term
| Scapulothoracic jt: pathologic positioning: how is anterior tipping caused (3) |
|
Definition
poor posture
mm imbalance
poor neuromuscular control |
|
|
Term
|
Definition
| Scapula, Inferior, Coracoid, Dyskinesis |
|
|
Term
| what is scapular dyskinesis |
|
Definition
| presnece of scapular winging (prominence of any border away from the thorax) or dysrhythmia (presence of aberrant movements) |
|
|
Term
| What does a SICK scapula a result of |
|
Definition
| faulty positioning of the scapula, tightness of the pectorals, specfically pec minor, weakness of the interscapular mm |
|
|
Term
| A SICK scapula can be a result of tight musculature. which specific mm? |
|
Definition
tight pectorals.
specifically pectoralis minor |
|
|
Term
| A SICK scapula can be a result of mm weakness. which mm weakness could contribute |
|
Definition
|
|
Term
| A SICK scapula is common in what population |
|
Definition
|
|
Term
| GH jt: what type of jt (2) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| GH jt: has poor _____ ____ to allow increased _______ |
|
Definition
articular congruency
mobility |
|
|
Term
| GH jt: is suspectible to what 3 pathologies |
|
Definition
DJD
internal derangement
instability |
|
|
Term
| GH jt: ext rot osteo/arthorkinematics |
|
Definition
convex on concave
humeral head glides anterior, humerus rolls posterior |
|
|
Term
| GH jt: int rot osteo/arthrokinematics |
|
Definition
convex on concave
humeral head glides posterior
humerus rolls anterior |
|
|
Term
| what is the scapular articulating surface |
|
Definition
|
|
Term
|
Definition
|
|
Term
| orientation of the glenoid |
|
Definition
| may be tilted sup/inferior-ant/posterior |
|
|
Term
| most common orientation of the glenoid |
|
Definition
retroversion 10 degrees
center of fossa posterior line of scapula |
|
|
Term
|
Definition
|
|
Term
| 1/3-1-2 of the humeral head's sphere is facing what direction |
|
Definition
| medial, superior, posterior |
|
|
Term
| what is the posterior orientation of the humeral head called |
|
Definition
|
|
Term
| what is the normal angle of inclination of the GH jt (angle between the humeral head and the neck of the humerus) |
|
Definition
|
|
Term
| if you were to draw a parallel line through the anterior aspect of the humeral head (across the chest) what angle would it make with the humeral head position |
|
Definition
30 degrees posterior orientation
the face of the humeral head that interacts with the glenoid is 30 degrees posterior from the chest |
|
|
Term
| what positions the humeral head too far posterior |
|
Definition
|
|
Term
| excess retroversion positions the humeral head too far posterior resulting in what risk |
|
Definition
| excess stress and subsequent strain to the posterior structures |
|
|
Term
| anteversion of the humeral head postions it how |
|
Definition
|
|
Term
| anteversion places the humeral head anterior raising what risk |
|
Definition
| stress and strain of the anterior structures |
|
|
Term
| an anteverted position of the humeral head is present in what populations |
|
Definition
|
|
Term
| GH stability comes from what statically |
|
Definition
| circumferentially from capsule and thickenings |
|
|
Term
| Where is the GH capsule the strongest |
|
Definition
|
|
Term
| where is the GH capsule the weakest |
|
Definition
|
|
Term
| Dynamic support/stability for the GH comes from what |
|
Definition
| cuff mm, deltoid, teres major |
|
|
Term
| where is the vast majority of GH jt instability |
|
Definition
|
|
Term
| what will load the anterior aspect of the GH jt |
|
Definition
| functional and athletic maneuvers |
|
|
Term
| what will help provide static stability in the anterior aspect |
|
Definition
| superior, mid, and inferior GH ligaments reinforce and have different roles dependent on ROM |
|
|
Term
| Benefit of the GH jt posterior capsule being thin |
|
Definition
|
|
Term
| GH jt: Additional structure of the inferior capsule |
|
Definition
| posterior band (thickening) |
|
|
Term
| When the GH ligaments are at the resting position which of the 3 ligaments is on slack |
|
Definition
|
|
Term
| When the GH ligaments are in teh resting position which the priamry restraint |
|
Definition
|
|
Term
| When the GH ligaments are in a resting position what does the superior gh ligament prevent |
|
Definition
| anterior translation of the humeral head |
|
|
Term
| When the GH jt is at 45 degrees, what happens to the inferior GH ligament |
|
Definition
| slack of the inferior GH ligament is being taken up |
|
|
Term
| at 45 degrees, which of the GH ligaments is the primary restraint and preventing anterior translation |
|
Definition
|
|
Term
| at 90 degrees abduction and IR which of the GH ligaments are on slack |
|
Definition
|
|
Term
| at 90 degrees abduction and IR which ligament is the primary restraint |
|
Definition
|
|
Term
| at 90 degrees abduction and IR what is the role of the inferior gh ligament |
|
Definition
primary restraint
prevents GH from dropping from glenoid
prevents anterior translation |
|
|
Term
| at 90 degrees abduction and IR what type of load could yield force strong enough to dislocate |
|
Definition
|
|
Term
| at 90 degrees abduction and ER what happesn to the inferior gh ligament |
|
Definition
|
|
Term
| this is a common source fo synovitis and a weak spot that can expand in the presence of instability |
|
Definition
|
|
Term
| what is the rotator interval |
|
Definition
coracohumeral ligament
superior gh ligament |
|
|
Term
| What is the coracoacromial ligament? what motion does it limit |
|
Definition
| an arch that limits superior translation |
|
|
Term
| the CA ligament/arch has these common pathologies and surgeries |
|
Definition
common area of impingement and spurs
often resected in cases of impingement |
|
|
Term
| stabilization via the ligamentous structures is low when less than what elevation |
|
Definition
|
|
Term
| stabilizaiton via the ligamentous structures is low when <90 elevation d/t what |
|
Definition
| superior capsule/ligament being tight |
|
|
Term
| static stability of the GH: relationship of the humerus and inferior glenoid in the resting position |
|
Definition
| humerus depresses on the inferior glenoid in the resting position |
|
|
Term
| static stability of the GH: when the humerus is in the resting position these structures are tight (3) |
|
Definition
rotator interval
coracohumeral ligament
superior capsule/ligament |
|
|
Term
| static stability of the GH: what compresses the humeral head into the glenoid |
|
Definition
| downward vector of the pull of the humerus |
|
|
Term
| static stability of the GH: how is the glenoid rotated downward |
|
Definition
|
|
Term
| static stability of the GH: if the glenoid is rotated downward as in inclination what msut the pt rely on |
|
Definition
|
|
Term
| static stability of the GH: if the glenoid is rotated downward, as in inclination, what is not successful |
|
Definition
bony geometry
ligamentous stabilization |
|
|
Term
| static stability of the GH: fibrocartilage ring around the glenoid |
|
Definition
|
|
Term
| static stability of the GH: thickness and variability of the labrum |
|
Definition
varying thickness
individual variablity |
|
|
Term
| static stability of the GH: purpose of the labrum |
|
Definition
|
|
Term
| static stability of the GH: KEY component of what, despite what some may say |
|
Definition
|
|
Term
| static stability of the GH: labrum will flatten d/t what |
|
Definition
| chronic impact of the humerus |
|
|
Term
| static stability of the GH: labrum that flattens d/t chronic impact of the humerus will allow for what |
|
Definition
| posterior translation of the humerus |
|
|
Term
| static stability of the GH: if a flattened/torn labrum is restored to its normal position what happens |
|
Definition
| pattern of instability is resolved |
|
|
Term
| static stability of the GH: the labrum is what when viewed histologically |
|
Definition
| thickening of the capsule |
|
|
Term
| static stability of the GH: intra-articular force that keeps the humerus in place |
|
Definition
negative intra-articular pressure
suction effect |
|
|
Term
| static stability of the GH: what can cause a loss in negative intraarticular pressure |
|
Definition
| tear in the capsule, labrum, bankhart tear, isolated labrum tear |
|
|
Term
| static stability of the GH: a tear in the capsule, labrum, bankhart results in a loss of negative intra-articular pressure which increases the need for what |
|
Definition
| static and dynamic support |
|
|
Term
| Dynamic stability of the GH: mm which play a major role (2) |
|
Definition
|
|
Term
| Dynamic stability of the GH: why are the deltoid and supraspinatus for dynamic stability |
|
Definition
| prime movers but also yield resultant forces that stabilize in dynamic movement |
|
|
Term
| Dynamic stability of the GH: the resultant vector of the deltoid's insertion yields what motion |
|
Definition
| superior humeral translation |
|
|
Term
| Dynamic stability of the GH: rotation occuring d/t the convex concave anatomy prevents the humerus from hitting what |
|
Definition
|
|
Term
| Dynamic stability of the GH: rotation of the convex/concave anatomy prevents the humerus from hitting the coracoarcomial arch. What triggers this rotation? |
|
Definition
|
|
Term
| Dynamic stability of the GH: which RC mm have a similar line of pull |
|
Definition
infraspinatus
teres minor
subscapularis |
|
|
Term
| Dynamic stability of the GH: the medial pull the infraspinatus, teres minor, and subscapularis mm results in what motions (2) |
|
Definition
|
|
Term
| Dynamic stability of the GH: the downward pull of the infraspinatus, teres minor, and subscapularis offest what motion |
|
Definition
| the superior pull of the deltoid |
|
|
Term
| Dynamic stability of the GH: RC mm which can independently abduct the humerus |
|
Definition
|
|
Term
| Dynamicstatic stabilization overview: 1/9 |
|
Definition
|
|
Term
| Dynamicstatic stabilization overview: 2/9 |
|
Definition
|
|
Term
| Dynamicstatic stabilization overview: 3/9 |
|
Definition
|
|
Term
| Dynamicstatic stabilization overview: 4/9 |
|
Definition
| articular surface geometry |
|
|
Term
| Dynamicstatic stabilization overview: 5/9 |
|
Definition
|
|
Term
| Dynamicstatic stabilization overview: 6/9 |
|
Definition
|
|
Term
| Dynamicstatic stabilization overview: 7/9 |
|
Definition
|
|
Term
| Dynamicstatic stabilization overview: 8/9 |
|
Definition
| (-) intraarticular pressure |
|
|
Term
| Dynamicstatic stabilization overview: 9/9 |
|
Definition
|
|
Term
| GH motion: convex concave rule |
|
Definition
| convex moving on fixed concave surface |
|
|
Term
| GH motion: convex articulating surface mvoes in a direction ______ to the direction traveled by the shaft of the bone |
|
Definition
|
|
Term
| GH motion: concave articulating surface moves in the ______ direction as the remaining portion of the bony lever |
|
Definition
|
|
Term
| Scapulohumeral rhythm: how much total elevation |
|
Definition
|
|
Term
| Scapulohumeral rhythm: of teh total 180 degrees of elevation how much is scapular? how much is humeral? |
|
Definition
|
|
Term
| Scapulohumeral rhythm: 2/1 ratio refers to what |
|
Definition
| for every 2 degrees of upweard humeral elevation there is 1 degree of scapular upward rotation |
|
|
Term
| Scapulohumeral rhythm: what 3 mm are involved in upward rotation with a changing axis of rotation |
|
Definition
Mid trap
Lower trap
Serratus anterior |
|
|
Term
| Scapulohumeral rhythm: recent cadaveric work suggests that which mm is the prime mover rather than the ____ |
|
Definition
|
|
Term
| Scapulohumeral rhythm: recent cadaveric work suggest the serratus is the prime mover rather than the traps which are viewed as what |
|
Definition
|
|
Term
| Scapulohumeral rhythm: recent cadaveric work suggest the traps are viewed as a stabilizer:what is the role of the upper trap |
|
Definition
| effects the clavicle 1st and the scapula 2nd |
|
|
Term
| Scapulohumeral rhythm: recent cadaveric work suggest the traps are viewed as a stabilizer: what is the role of the mid trap |
|
Definition
| initially upwardly rotates but the moment arm decreases lessening its force |
|
|
Term
| Scapulohumeral rhythm: recent cadaveric work suggest the traps are viewed as a stabilizer: what is the role of the lower trap |
|
Definition
| also has a smaller moment arm than thought, yielding less upward rotation and more stabilization |
|
|
Term
|
Definition
OA (popping, clicking, snapping)
RC tearing
hypermobility |
|
|
