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Questions and Answers
Which of the following nerves and arteries are most vulnerable during shoulder dislocation and intramuscular injection?
What is the primary cause of painful arc/impingement syndrome in rotator cuff problems?
What is the direction of the humeral head in an anterior dislocation of the shoulder?
Which of the following structures provides stability to the shoulder joint superiorly?
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What is the nerve most likely to be injured during an anterior dislocation of the shoulder?
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Which of the following muscles is NOT involved in the development of a frozen shoulder?
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What is the most common direction of dislocation in the glenohumeral joint?
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What is the primary cause of pain in a frozen shoulder when elevating the arm?
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What is the result of tendons rubbing under the coraco acromial arch?
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Which of the following conditions is most likely to cause a recurrent dislocation of the shoulder?
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What is the primary reason for the instability of the glenohumeral joint?
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What is the function of the subscapular bursa in the shoulder joint?
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Which of the following structures is NOT directly involved in providing stability to the glenohumeral joint?
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What is the significance of the small opening in the capsule of the glenohumeral joint?
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What is the effect of the capsule's laxity on the glenohumeral joint?
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Study Notes
Brachial Plexus and Shoulder Movement
- The brachial plexus roots C5 and C6 affect shoulder movement.
- Upper brachial plexus injuries affect shoulder movement.
Neurovascular Relations and Clinical Applications
- Axillary nerves and circumflex artery are vulnerable during intramuscular injections and shoulder dislocation.
- Rotator cuff problems:
- Tendons rubbing under the coracoid acromial arch causes irritation and inflammation.
- Leads to subacromial bursitis, supraspinatus tendonitis, rotator cuff injury, and degeneration or rupture of tendons.
Rotator Cuff Problems
- Causes of rotator cuff injuries:
- Overuse (e.g., sports, overhead use of arms)
- Degenerative changes in tendons (in older people)
- Avascularity of the supraspinatus tendon
- Slight differences in anatomy (making impingement more likely)
- Rotator cuff problems result in painful arc/impingement syndrome (pain between 70-120 degrees of abduction).
Stability of the Shoulder Joint
- Provided by:
- Tendons of the rotator cuff (anteriorly, posteriorly, and superiorly)
- Glenohumeral intracapsular ligaments (anteriorly and inferiorly)
- Coraco humeral ligament (superiorly)
- Coraco acromial arch (superiorly)
- Deepening of the glenoid cavity by the glenoid labrum
- Splinting effect of the long head of the biceps and triceps
Dislocation of the Glenohumeral Joint
- The inferior aspect of the glenohumeral joint is the least protected.
- Dislocation in the inferior direction is common, but clinically defined as an anterior dislocation.
- The capsule and rotator cuff tendons may tear, leading to recurrent dislocation if they heal poorly.
Axillary Nerve Injury
- Injured during dislocation due to its close relation to the inferior part of the joint capsule.
- Indicated by:
- Paralysis of the deltoid muscle with loss of abduction
- Loss of sensation in a small area of the skin over the central part of the deltoid
Frozen Shoulder
- Adhesive fibrosis and scarring between:
- The inflamed capsule
- Rotator cuff
- Subacromial bursa
- Deltoid
- Difficulty in abducting the arm and lack of movement of the glenohumeral joint causes strain on the acromioclavicular joint, resulting in pain when elevating the shoulder.
The Shoulder Joint
- Formed between the articular surfaces of the glenoid cavity of the scapula and the head of the humerus.
- A ball and socket synovial joint allowing a wide range of movements in multiple planes.
- Joint stability is affected by bone conformation and range of movement.
Glenohumeral Joint
- Lined by synovium and enclosed by a fibrous capsule.
- Glenoid cavity is deepened by a rim of fibrocartilage (the glenoid labrum).
- Stability is provided by a capsule, various ligaments, and the rotator cuff muscles.
- Capsule is attached to the glenoid labrum, scapula, and the anatomical head of the humerus.
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Description
This quiz covers the effects of upper brachial plexus injuries on shoulder movement, neurovascular relations, and clinical applications. It also explores rotator cuff problems and tendons inflammation.
