Shoulder Complex Anatomy Quiz

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Questions and Answers

What is the typical range of External Rotation (ER) for the shoulder complex?

  • 0-70 degrees
  • 0-120 degrees
  • 0-180 degrees
  • 0-90 degrees (correct)

Which of the following is considered a 'false joint' within the shoulder complex?

  • Acromioclavicular Joint
  • Glenohumeral Joint
  • Scapulothoracic Joint (correct)
  • Sternoclavicular Joint

What is the primary function of the rotator cuff muscles (SITS) in the shoulder complex?

  • To maintain the humeral head in the glenoid fossa. (correct)
  • To stabilize the scapula.
  • To provide the greatest range of motion.
  • To facilitate flexion and extension.

Which bone of the shoulder complex is most commonly fractured?

<p>Clavicle (A)</p> Signup and view all the answers

What is the approximate ratio of Glenohumeral (GH) joint movement to Scapulothoracic (ST) joint movement, known as the Scapulohumeral Rhythm?

<p>2:1 (C)</p> Signup and view all the answers

What is the main characteristic of the middle two-thirds of the clavicle's orientation?

<p>Convex anteriorly (D)</p> Signup and view all the answers

What type of joint is the Glenohumeral (GH) joint?

<p>Synovial ball and socket (A)</p> Signup and view all the answers

Which of the following mechanisms of injury (MOI) is the acronym FOOSH related to, regarding clavicle fractures?

<p>Fall On Outstretched Hand (B)</p> Signup and view all the answers

According to the content, what causes the medial fragment of a fractured clavicle to tilt superiorly?

<p>Sternocleidomastoid muscle (A)</p> Signup and view all the answers

What is the primary goal of using a figure-of-8 bandage for an incomplete clavicle fracture?

<p>To facilitate shoulder retraction and decrease clavicular pressure (D)</p> Signup and view all the answers

The costoclavicular space is located between which two structures?

<p>The clavicle and the first rib (A)</p> Signup and view all the answers

Which of the following is the MOST common type of acromion process?

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

Based on the content, what anatomical event causes a painful arc of movement between 60 and 120 degrees?

<p>Narrowing of the space within the shoulder joint (A)</p> Signup and view all the answers

What action does the coracoacromial ligament primarily prevent?

<p>Superior translation of the humerus (C)</p> Signup and view all the answers

What is the orientation of the acromion process relative to its anatomical placement?

<p>Posterior, Lateral, Superior (B)</p> Signup and view all the answers

Which anatomical landmark is NOT directly used to locate the subscapular fossa?

<p>Spine of the scapula (D)</p> Signup and view all the answers

Damage to the radial nerve at the spiral groove of the humerus would primarily affect which muscle group?

<p>Finger extensors and wrist extensors (A)</p> Signup and view all the answers

Which of the following structures provides the only direct connection between the upper limb and the axial skeleton?

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

Which ligament primarily limits excessive depression of the distal end of the clavicle?

<p>Interclavicular ligament (D)</p> Signup and view all the answers

During protraction and retraction at the sternoclavicular joint, which structure transforms to become part of the clavicle?

<p>Sternoclavicular Disc (B)</p> Signup and view all the answers

Which motion at the sternoclavicular joint is primarily associated with long axial rotation?

<p>Elevation of the clavicle beyond 90 degrees (B)</p> Signup and view all the answers

What type of joint is the sternoclavicular joint classified as?

<p>Saddle / Sellar (B)</p> Signup and view all the answers

If posterior rotation of the clavicle is restricted, what is the impact on shoulder elevation?

<p>Shoulder elevation is only up to 110 degrees due to compensatory movements (D)</p> Signup and view all the answers

What is the primary function of the sternoclavicular disc?

<p>Provide Shock absorption and act as a hinge in UE motion (A)</p> Signup and view all the answers

Which of the following muscles forms the lateral boundary of the quadrangular space?

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

What nerve innervates the Serratus Anterior muscle?

<p>Long Thoracic Nerve (C)</p> Signup and view all the answers

Which of the following is NOT a branch of the brachial plexus?

<p>Femoral Nerve (D)</p> Signup and view all the answers

What is the primary action of the muscle innervated by the Thoracodorsal nerve?

<p>Shoulder extension (B)</p> Signup and view all the answers

Which muscle is NOT involved in forming the posterior wall of the axilla?

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

The axillary nerve innervates which of the following muscles?

<p>Deltoid and Teres Minor (C)</p> Signup and view all the answers

What structure passes through the triangular space?

<p>Circumflex Scapular Artery (D)</p> Signup and view all the answers

Which of the following nerves is formed by a combination of the lateral and medial cords of the brachial plexus?

<p>Median Nerve (A)</p> Signup and view all the answers

What is the scapulohumeral rhythm ratio between the glenohumeral joint and the scapulothoracic joint after 30 degrees of abduction?

<p>2:1 (C)</p> Signup and view all the answers

During phase III of the scapulohumeral rhythm, how many degrees of motion occur at the glenohumeral joint?

<p>60 degrees (D)</p> Signup and view all the answers

What is the role of the glenoid labrum in joint stability?

<p>It creates a vacuum effect that stabilizes the joint. (C)</p> Signup and view all the answers

What type of force does the rotator cuff provide to assist with glenohumeral joint stabilization?

<p>Negative translatory force (A)</p> Signup and view all the answers

Which is true regarding the role of the deltoids in shoulder abduction?

<p>They require assistance from other structures for effective abduction. (A)</p> Signup and view all the answers

What type of joint is the acromioclavicular joint?

<p>Synovial Plane Joint (D)</p> Signup and view all the answers

Which ligament prevents superior translation of the distal clavicle?

<p>Superior AC Ligament (D)</p> Signup and view all the answers

What is the primary function of the coracoclavicular ligaments?

<p>Provide vertical stability to the shoulder (D)</p> Signup and view all the answers

What kind of movement does the acromioclavicular disc have during the first two years of life?

<p>Fibrocartilaginous union (C)</p> Signup and view all the answers

Which of the following statements about the glenohumeral joint is true?

<p>It is classified as a synovial ball and socket joint. (A)</p> Signup and view all the answers

What is the primary purpose of the acromioclavicular ligament?

<p>To prevent inferior translation of the distal clavicle (D)</p> Signup and view all the answers

What is the role of the acromioclavicular disc in individuals over two years old?

<p>It serves as a fibrocartilaginous remnant that is meniscoid. (C)</p> Signup and view all the answers

Which movement is NOT a kinematic function of the acromioclavicular joint?

<p>Internal rotation (D)</p> Signup and view all the answers

Flashcards

Clavicle Fracture

A fracture of the clavicle, typically caused by a direct blow to the shoulder. The fracture can be either complete or incomplete.

Medial Fragment of Clavicle Fracture

The sternocleidomastoid muscle pulls the medial fragment of a clavicle fracture superiorly.

Lateral Fragment of Clavicle Fracture

The pectoralis major muscle pulls the lateral fragment of a clavicle fracture medially, while gravity pulls it downwards.

Costoclavicular Space

The space between the clavicle and the first rib, housing the subclavian artery and brachial plexus.

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Scapula

A flat, triangular bone situated on the posterior thoracic wall (T2 to T7 ribs).

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Acromion Process

The summit of the shoulder, which is the lateral extension of the scapula.

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Coracoid Process

Located anterior and superior to the scapula, it helps prevent superior translation of the humerus.

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Spine of the Scapula

An extension of the acromion process medially. It helps locate structures above and below it.

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Shoulder Complex Mobility

The shoulder complex is a highly mobile joint system, with a combined range of motion of 0-180 degrees in flexion and abduction, 0-90 degrees in external rotation, and 0-70 degrees in internal rotation. This exceptional mobility is achieved through the interaction of six moving areas, including both true and false joints.

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Scapulohumeral Rhythm

Scapulohumeral rhythm is the coordinated movement of the scapula and humerus during shoulder motion. It typically involves a 2:1 ratio, meaning the humerus moves twice as much as the scapula. This synchronized movement helps to maintain stability and optimize range of motion.

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SC Joint Significance

The SC (Sternoclavicular) joint is the only direct connection between the shoulder complex and the axial skeleton. It is responsible for providing stability and transmitting forces from the upper limb to the trunk.

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GH Joint Mobility

The GH (Glenohumeral) joint is the most important true joint in the shoulder complex, providing the greatest mobility. It's a synovial ball and socket joint, allowing for a wide range of movements.

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Rotator Cuff Function

The rotator cuff muscles, including supraspinatus, infraspinatus, teres minor, and subscapularis, play a crucial role in stabilizing the humeral head within the glenoid fossa. They contract during movement to maintain stability.

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Clavicle Properties

The clavicle is a long, slender bone located at the root of the neck, and is S-shaped. It plays an important role in supporting the shoulder and transmitting forces from the upper limb to the trunk.

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Clavicle Fracture MOI

The clavicle is frequently fractured due to falls on an outstretched hand (FOOSH) or falls on the shoulder (FOS). These injuries are common in the elderly population due to their slower reaction times.

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Acromioclavicular Joint

The acromioclavicular (AC) joint is a joint that allows the clavicle to move slightly against the scapula. It is located at the top of the shoulder. This joint is often injured in athletes or people who fall on their shoulder.

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Posterior Humeral Shaft Fracture

A fracture of the humerus in the posterior shaft region that can damage the radial nerve. This injury affects the muscles responsible for finger and wrist extension, but elbow extension remains intact due to the triceps being innervated higher on the radial nerve.

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Sternoclavicular Joint

The only joint that connects the upper limb to the axial skeleton, allowing for movement and stability of the shoulder.

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Sternoclavicular Joint - Type

A saddle-shaped joint allowing for a variety of movements and acting as the central connection between the clavicle and the axial skeleton.

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Sternoclavicular Joint - Articulation

The sternoclavicular joint involves the articulation of two bones: the medial end of the clavicle and the manubrium of the sternum.

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Interclavicular Ligament

A strong ligament that stabilizes the sternoclavicular joint, limiting excessive depression of the clavicle (downward movement).

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Costoclavicular Ligament

A ligament that connects the first rib to the clavicle, preventing excessive elevation of the clavicle.

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Sternoclavicular Ligament

A strong ligament connecting the sternum and the clavicle that plays a vital role in stabilizing the joint and preventing various excessive movements.

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Sternoclavicular Disc

A disc-shaped structure found within the sternoclavicular joint. It functions as a shock absorber and acts as a pivot point for various movements of the upper limb.

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Translatory Force

A force that causes movement in a straight line.

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Force Couple

A combination of two forces that act in opposite directions to create a rotational movement. For example, upward and downward forces can cause rotation.

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Rotator Cuff

The muscles surrounding the shoulder joint, mainly the supraspinatus, infraspinatus, teres minor, and subscapularis, which help stabilize the humeral head within the glenoid fossa.

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Deltoid and Gravity Interaction

The upward force of the deltoid muscle is balanced by the downward force of gravity, allowing the shoulder to abduct smoothly.

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Acromioclavicular Joint: What type of joint is it?

A type of synovial joint that allows for slight gliding movements. It is found where the acromion (part of the scapula) meets the lateral end of the clavicle (collarbone).

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Acromioclavicular Joint: What ligaments are associated with this joint?

The ligaments that support the acromioclavicular joint and help to prevent excessive movement. They include the acromioclavicular ligament (AC), coracoclavicular ligament (CC), and the acromioclavicular disc.

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Acromioclavicular Ligament (AC)

A strong ligament that attaches the acromion process to the clavicle bone. It plays a crucial role in stabilizing and supporting the joint.

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Coracoclavicular Ligament (CC)

This ligament has two parts: the conoid and trapezoid ligaments. It connects the coracoid process of the scapula to the clavicle.

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Acromioclavicular Disc

A fibrocartilaginous structure found within the acromioclavicular joint. It acts as a shock absorber and helps to improve joint stability.

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Glenohumeral Joint: What type of joint is it?

A type of synovial joint that allows for a wide range of motion, including flexion, extension, abduction, adduction, internal and external rotation, and circumduction. It is found where the humerus (upper arm bone) articulates with the scapula (shoulder blade).

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Glenohumeral Joint: What are the orientations of the humeral head?

The head of the humerus bone has specific orientations, which contribute to the overall shape and stability of the joint. The angle of inclination is a key factor in determining this.

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Angle of Inclination: What does it represent?

A measurement of the angle between the axis of the humeral head and neck and the axis of the humeral shaft. This angle plays a role in the overall stability and mobility of the shoulder joint.

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Quadrangular Space

The space in the shoulder that is formed between the teres minor, teres major, long head of the triceps, and humerus. It contains the axillary nerve and posterior circumflex humeral artery.

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Triangular Space

The space in the shoulder that is formed between the teres minor, teres major, and the long head of the triceps. It contains the circumflex scapular artery.

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What muscles form the anterior wall of the axilla?

The anterior (front) wall of the axilla is made up of the pectoralis minor, pectoralis major, and subclavius muscles.

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What muscles form the posterior wall of the axilla?

The posterior (back) wall of the axilla is made up of the subscapularis, latissimus dorsi, and teres major muscles.

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What muscles form the lateral wall of the axilla?

The lateral (side) wall of the axilla is made up of the biceps brachii in the bicipital groove and the coracobrachialis muscle.

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What structures form the medial wall of the axilla?

The medial (inner) wall of the axilla is formed by ribs 2-6 and the serratus anterior muscle.

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What is the brachial plexus?

The brachial plexus is a network of nerves that provides innervation to the upper limb. It is formed by the anterior rami of spinal nerves C5-T1. This means that the brachial plexus includes the roots, trunks, divisions, cords and branches.

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What does the musculocutaneous nerve innervate?

The musculocutaneous nerve is a branch of the lateral cord of the brachial plexus. It travels through the coracobrachialis muscle and ultimately supplies the biceps brachii and brachialis.

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Study Notes

Upper Extremity 1: Shoulder Complex

  • The shoulder complex is one of the most mobile joints in the body, capable of 180 degrees of motion.
  • Shoulder complex mobility is facilitated by six interacting areas (joints), including true joints (bone-to-bone articulation) and false joints (functional joints).
  • Key true joints include the sternoclavicular (SC), acromioclavicular (AC), and glenohumeral (GH) joints, the latter providing the most mobility.
  • The GH joint is a synovial ball-and-socket joint, offering significant mobility.
  • The SC joint connects the clavicle to the sternum, which is the only direct connection between the shoulder complex and the axial skeleton.
  • The AC joint links the clavicle to the acromion process of the scapula.
  • The GH joint, which contains the glenoid cavity, allows for a wide range of movement.
  • The false joints in the shoulder complex include the scapulothoracic joint where the scapula moves against the thoracic wall and the bicipital groove within the humerus.
  • The scapulothoracic joint is crucial as it allows the scapula to move, facilitating the range of motion of the shoulder complex and its associated muscles.
  • The bicipital groove is an important anatomical landmark and acts as a functional joint housing the tendon of the biceps muscle.
  • Good dynamic stability is essential. The rotator cuff muscles (supraspinatus, subscapularis, infraspinatus, and teres minor) keep the humeral head securely within the glenoid fossa during movement.
  •  Less static/structural stability in the shoulder complex relies on dynamic control from its surrounding muscles.

Osseous Parts

  • The clavicle (collarbone) is a long, slender, S-shaped bone, horizontally positioned at the root of the neck.
  • It's commonly fractured due to a fall on an outstretched hand or shoulder.

Additional Notes

  •  Falls on an outstretched hand/shoulder are the most frequent cause for clavicle fractures, especially in older adults.
  • During falls, the body reacts according to Newton's Third Law, with the direction/impact of the fall often leading to the injuries seen.

Other Considerations

  • Different imaging can be crucial when diagnosing shoulder injuries or other associated conditions.

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