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  1. What are the functions of the shoulder?
    • Mobility – the shoulder motion (combined withthe elbow) allows for infinite possibilities of hand positioning in space
    • Stability – the shoulder must be stabilized tomaximize hand function
  2. What bones make up the shoulder?
    • Sternum & ribs
    • Clavicle
    • Scapula
    • Humerus
  3. What joints make up the shoulder?
    • steroclavicular
    • acromioclavicular
    • glenohumeral
    • scapulothoracic (not a true joint)
  4. What is the only axial skeleton attachment of the upper limb?
  5. What are the parts of the sternum?
    • Manubruim - clavicular facets and costals facets
    • body - rib attachment
    • xiphoid process
    • sternal (jugular) notch
    • sternal angle - used to count the ribs starting with the second
  6. How is the clavicle of strut?
    The clavicle links the axial skeleton to appendicular skeleton
  7. What are the parts of the clavicle?
    The clavicle is s-shaped. It anterior surface is convex medially and concave laterally. When the bone breaks, it fractures at the part between both ends
  8. What is the normal clavicular position?
    • angled 20 degrees posterior to frontal plane
    • angled 10 degrees superior to horizontal plane (medial to lateral)
  9. What are the parts of the scapula?
    • Bony shape - thin, triangular bone
    • 3 angles - inferior, superior medial, and lateral
    • 3 borders - medial, superior, and lateral
    • invested in muscle
    • structures - scapular spine, acromion, glenoid fossa, and coracoid
  10. The scapular spine divides the posterior surface into what two areas? What muscles attach there?
    • The spine divides posterior scapular surface into supraspinous fossa and Infraspinous fossa
    • Muscles attached here are Deltoid and Trapezius
  11. Where is the acromion located?
    the acromion is the lateral end of the scapular spine and articulates with the clavicle at the clavicular facet
  12. What muscles attach to the acromion?
    the deltoid and the lower/middle fibers of trapezius
  13. What ligament forms an arch over the glenohumeral joint?
    coracoacromial ligament
  14. What is the glenoid fossa?
    pear shaped concavity for the humerus and it articulates with the humeral head
  15. What is the shape of the glenoid fossa?
    only 25% surface area of the humeral head
  16. What is the glenoid labruim?
    • composition - dense fibrous tissue
    • function - deepens glenoid from 2.5mm to 5mm
    • long head of biceps brachia attaches on the superior aspect
  17. What is the normal glenoid fossa orientation?
    • glenoid tilt - 4 degrees upward tilt (range - 7 degrees downward tilt; 16 degrees upward tilt)
    • plane of the scapula - angled at 35 degrees from frontal plane (lateral edge is more anterior than medial edge)
  18. What is shaped like a “crow’s beak”?
    coracoid process
  19. What ligaments attach to the coracoid process?
    • Coracoacromial
    • Coracohumeral
    • Coracoclavicular
  20. What muscles attach to the coracoid process?
    • Pectoralis minor
    • Short head biceps
    • Corcobrachalis
  21. What are landmarks of the proximal humerus? And what muscles attach there?
    • Necks - anatomic and surgical
    • tuberosities - greater [subscapularis] & lesser [teres minor, infraspinatus, supraspinatus]
    • bicipital groove - pectorals major, teres major, and latissimius dorsi
    • deltoid tuberosity - deltoid
    • radial groove
  22. What is the angle of inclination for the humerus?
    130° - 150° (normal)
  23. What is the angle of torsion for the humerus?
    30° - 50° retroverted (does itlook anterior or posterior – so the humeral looks back about 30-50 degreescompared to the epicodyles)
  24. What controls the scapulothoracic motions?
    AC joint & SC joint
  25. What are the motions of the scapula?
    • Elevation – depression of scapula
    • Protraction-retraction of scapula
    • Upward-downward rotation of scapula - coupling must occur in order to complete this action [AC joint] [inferior angle]
    • Anterior-posterior tilting of scapula (based on the top of the scapula) – again coupling must occur in order to complete this action [AC joint]
    • Internal-external rotation of scapula [medial and lateral rotation] [based on glenoid cavity) – coupling must occur in order to complete this action
  26. What is the sternoclavicular joint?
    Axial attachment – most proximal joint links shoulder complex to axial skeleton
  27. What kind of joint is the sternoclavicular joint?
  28. What are some characteristics of the articular disc of the sternoclavicular joint?
    • Fibrocartilage
    • Joint congruity improves fit
    • Shock absorption
  29. What are the ligaments of the steroclavicular joint? What are some characteristics of each?
    • Sternoclavicular ligaments intrinsic ligament; reinforces the capsule {anterior and posterior}
    • Costoclavicular ligaments - 1. First rib to clavicle 2. Major SC stabilizer 3. Limits all motions but depression
    • Interclavicular ligament limits depression
  30. How many degrees of freedom does the SC joint have? What are they?
    • Three - elevation/depression, protraction/retraction & axial rotation of clavicle
  31. For clavicle elevation and depression, what isthe plane and axis? What are the normal available ranges for this movement?
    • Plane & axis frontal plan; anterior/posterior axis
    • Available ranges 45 degree elevation, 10 degree depression [what position is start position in normal posture? – 10 degrees]
  32. What are the arthrokinematics of elevation and depression of the clavicle?
    • Elevation - clavicle rolls superior; clavicle glides inferior
    • depression - clavicle rolls inferior; clavicle glides superior
  33. For clavicle protraction and retraction, what is the plane and axis? What are the normal available ranges for this movement?
    • Plane & axis horizontal plane; axis
    • Available ranges 15-30 degrees each direction
  34. What are the arthrokinematics of protraction and retraction of the clavicle?
    • retraction - clavicle rolls superior; glides superior
    • protraction - clavicle rolls inferior; glides inferior
  35. For clavicle axial rotation what is the plane and axis? What are the normalavailable ranges for this movement?
    • Plane sagittal plane; medial/ laterial axis
    • Ranges superior aspect of clavicle rotates posterior 40-50 degrees with should elevation
  36. What are the arthrokinematics of axial rotation of the clavicle?
    spin of clavicle on sternum [no roll and glide – SPIN]
  37. What kind of joint is the AC joint?
    plane joint
  38. What are the articulating surfaces of the AC joint?
    • Lateral end of clavicle
    • Clavicular facet on acromion
  39. What are the ligaments of the AC joint?
    • Acromioclavicular {intrinsic}- Superior and Inferior
    • Coracoclavicular [ice hockey] - Trapezoid & Conoid
  40. How many degrees of freedom does the AC joint have? What are they?
    • Upward/downward rotation of scapula
    • Anterior/posterior tipping of scapula
    • Medial/lateral rotation of scapula
  41. What is the scapulothoracic joint?
    • No bone-bone contact - NOT A TRUE JOINT
    • Anterior surface of scapula
    • Posterior thoracic wall
  42. What is the scapula’s normal position?
    • Between ribs 2 &7
    • Medial border 6cm from thoracic spinous processes
    • Scapular plane: 35 degrees anterior to frontal plane
  43. What are the articular surfaces of the clavicle? What ligaments are attached to the clavicle?
    • Articular surfaces - Sternal end & Acromial end
    • Costal tuberosity - attachment of costocalvicular ligament
    • Conoid tubercle - attachment of coraclavicular ligament
  44. Does the AC joint have a disc?
    it varies!
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