Shoulder Anatomy and Movement Quiz

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Questions and Answers

What movement does the clavicular head primarily perform at the glenohumeral joint?

  • Abduction
  • Adduction
  • Extension
  • Flexion (correct)

In adduction, which additional movement must occur for it to reach 30° to 45°?

  • Extension (correct)
  • Rotation
  • Circumduction
  • Elevation

Which range of flexion is possible at the shoulder joint?

  • Up to 90°
  • Up to 45°
  • Up to 135°
  • Up to 180° (correct)

What is the movement range of abduction from 0° to 60° primarily associated with?

<p>Shoulder joint movement (D)</p> Signup and view all the answers

Which statement about the abduction movement is true after reaching the 90° position?

<p>It requires the use of the scapulothoracic joint. (B)</p> Signup and view all the answers

What anatomical structure is primarily responsible for providing strength and stability to the shoulder area?

<p>Humeral head (D)</p> Signup and view all the answers

Which joint is described as a physiological joint contributing to shoulder kinematics?

<p>Scapulo-thoracic joint (A)</p> Signup and view all the answers

What are the boundaries of the space between the scapula and the serratus muscle?

<p>Scapula and subscapularis muscle (C)</p> Signup and view all the answers

Which condition is strongly related to the structures described in the content?

<p>Rotator cuff tears (A)</p> Signup and view all the answers

What muscle is involved anteriorly and medially in the space between the thoracic wall and the serratus muscle?

<p>Serratus anterior muscle (B)</p> Signup and view all the answers

Which structures correspond to the scapula's supero-medial angle?

<p>First thoracic vertebra (B)</p> Signup and view all the answers

What is the primary function of the inferior glenohumeral ligament?

<p>Stabilize the shoulder in abduction (C)</p> Signup and view all the answers

Where does the coraco-humeral ligament attach?

<p>Coracoid process to the greater and lesser tuberosities of the humerus (A)</p> Signup and view all the answers

What is the primary function of the glenoid labrum?

<p>To deepen the glenoid cavity (B)</p> Signup and view all the answers

Which ligaments support the acromioclavicular joint?

<p>Conoid and trapezoid ligaments (B), Anterior and posterior ligaments (D)</p> Signup and view all the answers

How far laterally does the medial spinal border of the scapula lie from the thoracic vertebrae?

<p>5 to 6 cm (C)</p> Signup and view all the answers

What is the role of the coracohumeral ligament?

<p>Support the arm and limit external rotation (C)</p> Signup and view all the answers

Which joint is the only one that directly connects the upper extremity to the thorax?

<p>Sternoclavicular joint (D)</p> Signup and view all the answers

What happens when the humerus moves in relation to the subdeltoid 'joint'?

<p>The subdeltoid 'joint' allows surfaces to slide against each other (A)</p> Signup and view all the answers

What is the origin of the tendon of the long head of the biceps brachii?

<p>Supraglenoid tubercle (D)</p> Signup and view all the answers

What does the interclavicular ligament connect?

<p>The two clavicles (A)</p> Signup and view all the answers

Which of these capsular ligaments is responsible for limiting external rotation in the lower ranges of abduction?

<p>Coraco-humeral ligament (D)</p> Signup and view all the answers

What is a notable characteristic of the glenoid cavity of the scapula?

<p>Its margin is grooved anteroposteriorly (B)</p> Signup and view all the answers

What action does the short head of the biceps perform in relation to the scapula?

<p>Lifts the humerus relative to the scapula (D)</p> Signup and view all the answers

What comprises the structure of the subdeltoid 'joint'?

<p>Two sliding surfaces (C)</p> Signup and view all the answers

What role do the costoclavicular ligaments play?

<p>They connect the clavicle to the first ribs (A)</p> Signup and view all the answers

What is the primary function of the long head of the biceps during abduction?

<p>It presses the humeral head against the glenoid. (D)</p> Signup and view all the answers

Which muscle connects the first to the ninth rib to the medial border of the scapula?

<p>Serratus anterior (C)</p> Signup and view all the answers

What is the function of the upper trapezius muscle?

<p>Elevation and upward rotation of the scapula (C)</p> Signup and view all the answers

What happens to the strength of abduction after the rupture of the long head of the biceps?

<p>There is a 20% drop in strength. (C)</p> Signup and view all the answers

Which muscle is described as performing downward rotation, adduction, and elevation of the scapula?

<p>Rhomboid Major (B)</p> Signup and view all the answers

What are the main actions of the Pectoralis Minor?

<p>Depression and ventral tilt of the scapula. (D)</p> Signup and view all the answers

Which muscle connects the cervical vertebrae to the medial border of the scapula?

<p>Levator Scapulae (C)</p> Signup and view all the answers

What is the insertion point of the Deltoid muscle?

<p>Deltoid tuberosity of the humerus (A)</p> Signup and view all the answers

What is the primary limiting factor for active flexion at the elbow joint?

<p>The apposition of anterior muscles of the arm (D)</p> Signup and view all the answers

What is the maximum angle that passive flexion can reach at the elbow joint?

<p>160° (B)</p> Signup and view all the answers

In which position do the radius and ulna lie parallel to each other?

<p>In supination (C)</p> Signup and view all the answers

Which joints are involved in the rotation (pronation-supination) of the forearm?

<p>Superior radio-ulnar joint and inferior radio-ulnar joint (B)</p> Signup and view all the answers

What type of joint is the superior radio-ulnar joint classified as?

<p>Trochoid joint (B)</p> Signup and view all the answers

What are the components of the superior radio-ulnar joint's ball-bearing system?

<p>Head of the radius and fibro-osseous ring (C)</p> Signup and view all the answers

Which ligament is associated with the superior radio-ulnar joint?

<p>Anular ligament (B)</p> Signup and view all the answers

What causes the crossing of the radius over the ulna during pronation?

<p>The articulation of the radius and ulna (A)</p> Signup and view all the answers

What anatomical structure separates the radial notch from the trochlear notch?

<p>Bony ridge (C)</p> Signup and view all the answers

What effect does passive flexion have on the elbow compared to active flexion?

<p>Enables a greater range of motion (D)</p> Signup and view all the answers

Flashcards

Subacromial Space

The space beneath the acromion, and important for shoulder health

Scapulo-thoracic Joint

A functional joint between the scapula and the thorax, not a true anatomical joint

Subacromial Impingement

A common shoulder problem caused by compression of structures in the subacromial space

Rotator Cuff Tears

A condition affecting tendons supporting the shoulder joint; often from impingement

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Scapulothoracic Joint Spaces

The two defined areas within the scapulothoracic 'joint': the space between scapula and serratus muscle, and between thoracic wall and serratus muscle

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Gleno-humeral joint

The ball-and-socket joint between the humerus and scapula's glenoid cavity.

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Glenoid labrum

Fibrocartilage ring that deepens the glenoid cavity, improving joint congruency.

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Acromioclavicular joint

Joint between the acromion process of the scapula and the clavicle.

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Acromioclavicular ligaments

Strong ligaments (conoid and trapezoid) that stabilize the acromioclavicular joint.

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Sternoclavicular joint

Joint where the clavicle meets the sternum.

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Sterno-clavicular Joint

Connects the upper extremity to the thorax (chest).

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Subdeltoid 'joint'

Not a true anatomical joint; instead, it's the interaction between the deltoid muscle and shoulder joint as movement occurs.

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Clavicle

Collarbone - a long bone connecting the sternum to the scapula.

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Coraco-humeral ligament

A ligament that connects the coracoid process of the scapula to the greater and lesser tuberosities of the humerus.

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Glenohumeral ligaments

Superior, middle and inferior ligaments that run within the shoulder joint capsule, connecting the glenoid and labrum to the humeral neck and lesser tuberosities.

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Inferior glenohumeral ligament

A key stabilizer of the abducted shoulder, forming a sling (hammock) around the head of the humerus.

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Biceps tendon (long head)

Arises from the supra-glenoid tubercle and superior glenoid labrum; passes through the shoulder joint capsule.

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Biceps tendon (short head)

Arises from the coracoid process and helps stabilize the humerus and prevent dislocation.

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Shoulder Joint Capsule

The structure surrounding the shoulder joint that contains ligaments and other tissues.

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Shoulder joint ligament support

Coracohumeral, and glenohumeral ligaments work together providing stability and restricting movement.

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Flexion of the shoulder

The movement of the arm forward, bringing the upper limb closer to the body in a sagittal plane. The range of motion can reach up to 180 degrees.

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Extension of the shoulder

The backward movement of the arm in the sagittal plane. The range of motion is limited, generally reaching only about 45 to 50 degrees.

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Adduction of the shoulder

The movement of the arm towards the midline of the body, usually combined with either extension or flexion.

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Abduction of the shoulder

The movement of the arm away from the midline of the body, performed in a frontal plane around an antero-posterior axis. This involves movement at the shoulder joint and, depending on the degree of abduction, the scapulothoracic joint.

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What is the role of the Latissimus Dorsi muscle?

This large back muscle plays a major role in internal rotation, extension, and adduction of the shoulder joint. It works as a powerful pulling force, drawing the arm backwards and downwards.

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Biceps Long Head Function

The long head of the biceps muscle contributes to shoulder abduction by pulling the humeral head closer to the glenoid.

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Biceps Rupture Effect

A ruptured biceps long head results in a 20% decrease in shoulder abduction strength.

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Serratus Anterior Function

The serratus anterior muscle helps with scapular abduction (moving away from the spine) and upward rotation.

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Trapezius Muscles

The trapezius muscle has three sections: upper, middle, and lower, each with different functions.

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Rhomboid Major and Minor Function

Rhomboids help with scapular downward rotation, adduction (moving towards the spine), and elevation.

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Pectoralis Minor Function

The pectoralis minor muscle helps with scapular depression (moving down) and tilting it forwards.

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Levator Scapulae Function

The levator scapulae muscle lifts the scapula up and rotates it downwards, also influencing neck movement.

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Deltoid Muscle Function

The deltoid muscle is responsible for abduction at the glenohumeral joint (shoulder joint).

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Active Flexion Limit

The maximum degree of elbow flexion achievable with muscle effort is limited to 145° due to the anterior arm and forearm muscles contracting and preventing further bending.

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Passive Flexion Limit

The relaxed muscles allow the elbow to flex beyond 145°, reaching 160°. This is limited by bone contact (radius and ulna against fossa) and ligament tension.

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Elbow Rotation

The movement of the forearm about its longitudinal axis, involving both the superior radio-ulnar joint (SRU) and the inferior radio-ulnar joint (IRU).

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Supination

The forearm position where the radius and ulna are parallel, with the ulna on the medial side.

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Pronation

The forearm position where the radius and ulna cross, with the radius lateral to the ulna proximally and medial distally.

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Superior Radio-Ulnar (SRU) Joint

A trochoid joint with a cylindrical shape, allowing one movement: rotation about the axis of the two cylinders in contact.

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SRU Joint Components

This joint consists of the head of the radius, with its cylindrical rim covered by cartilage, and a fibro-osseous ring formed by the radial notch and the anular ligament.

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Head of Radius

The cylindrical rim of the head of the radius is covered with cartilage and forms the proximal component of the SRU joint's 'ball-bearing' system.

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Fibro-Osseous Ring

The distal component of the SRU joint's 'ball-bearing' system, consisting of the radial notch of the ulna and the anular ligament.

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Radial Notch

The radial notch of the ulna is covered with cartilage, concave antero-posteriorly, and separated by a ridge from the trochlear notch.

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Study Notes

Upper Limb Anatomy

  • The upper limb is the most mobile joint in the human body and has three degrees of freedom.
  • This allows for movement in three planes and three major axes.
  • Five articulations are present in the shoulder.
  • The scapulo-humeral joint is the most important of the five, and is a true ball-and-socket joint.
  • The head of the humerus is spherical and roughly 3-4 cm in radius.
  • The neck-shaft angle is 135 degrees.
  • The retrotorsion angle is 30 degrees.
  • The head of the humerus contains two articulating tuberosities, the lesser and greater tuberosities, which are attachment points for muscles.
  • The glenoid cavity of the scapula is shallow and faces superiorly, medially, and posteriorly.
  • The glenoid cavity has a rim of fibrocartilage (glenoid labrum) that widens and deepens it.
  • The acromioclavicular joint connects the acromion (of the scapula) to the acromial end of the clavicle.
  • Its motion is limited by ligaments (trapezoid and conoid).
  • The sterno-clavicular joint connects the sternal end of the clavicle to the sternum. It is a true joint, and has separated sides joined by ligaments.
  • The subdeltoid joint is not an anatomical joint; it's defined by the sliding surfaces of the rotator cuff tendon and the humeral head. It's mechanically tied to the shoulder due to movement correlation.
  • The subacromial space is a clinically-relevant area prone to impingement and rotator cuff tears. The subacromial bursa is also present.
  • The scapulothoracic joint is a physiological, not anatomical, joint essential for shoulder kinematics and pain.
  • Two spaces are present between the serratus muscle and scapula.
  • A second "space" exists between the scapula and thoracic wall, bordered by the intercostals and serratus anterior.
  • The scapula lies from the second to the seventh rib.
  • The superior, middle, and inferior glenohumeral ligaments assist in support and limit range of motion.
  • The coracohumeral ligament supports the arm and limits rotation in the lower range of abduction.
  • The inferior glenohumeral ligament stabilizes the arm during abduction.
  • The biceps tendons originate at the supraglenoid tubercle and superior margin of the glenoid/labrum.
  • The long head of the biceps passes deep to the capsule, in the bicipital groove.
  • Short head rests on the coracoid process; it supports the humerus relative to the scapula.
  • Three muscle groups connect the upper limb to the trunk, neck and skull: muscles connecting the shoulder girdle to the trunk, neck and skull, muscles connecting the scapula to the humerus, and muscles connecting the trunk to the humerus.
  • Serratus anterior, trapezius, rhomboids, levator scapulae, pectoralis minor, are important additional muscles from trunk to shoulder girdle.
  • Deltoid, supraspinatus, infraspinatus, teres minor, subscapularis, teres major, pectoralis major, latissimus dorsi are significant muscles from the shoulder girdle to the humerus.
  • The Elbow is the intermediate joint of the upper limb. It contains a mechanical link in between the upper arm and the forearm.
  • The elbow has a single joint cavity although it performs both flexion/extension and rotation (pronation/supination) functions.
  • The trochlea and capitellum are the articular surfaces of the elbow.
  • The trochlea is a pulley-shaped structure with two convex lips bounding a central groove.
  • The capitellum is a concavity corresponding to the trochlea, that helps in flexion/extension of the elbow.
  • The coronoid fossa and olecranon fossa are located above these surfaces, providing room for the ulna during flexion and extension.
  • The distal end of the humerus is flattened. The trochlear notch of the ulna has a 180 degree range of movement.
  • Two types of ligaments exist in the elbow - medial and lateral collateral ligaments.
  • Three primary elbow flexor muscles are brachialis, brachioradialis and biceps brachii.
  • Accessory flexor muscles include extensor carpi radialis, pronator teres.
  • Triceps brachii is an extensor of the elbow.
  • The three heads of the triceps converge onto a common tendon that gets inserted into the olecranon process.
  • The elbow can perform 145-160 of flexion, and 0-10 of extension.
  • Supination is the lateral rotation of the forearm which involves the superior and inferior radio-ulnar joints.
  • Pronation is the inward/medial rotation of the forearm.
  • The supinator muscle wraps around the radius.
  • The biceps, also a supinator muscle, inserts into the apex of the "supinator bend".
  • The pronator quadratus and pronator teres are pronation muscles, respectively wrapping around the distal ulna and the apex of the 'pronator bend' of the radius.
  • The range of true rotation of the forearm is about 180 degrees.

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