ch17: shoulder Flashcards
(28 cards)
phases of throwing motion
- windup
- stride
- acceleration
- deceleration and follow-through phase
coord sh movements
30+deg of abd and 45-60drg sh flexion = scapula helps by rotating up (scapular thoracic rythm)
first 90deg of humeral elevation = elevation of clavicle 35-45deg motion @ SCjnt
sh ROM deg
abd = 170-180
flexion= 160-180
extension = 50-60
ext rot = 80-90
internal rot = 60-100
ADD= 50-70
hz abd/add = 130
paxinos sign
AC jnt insability
- apply pressure to the acromion w/ the thumb in an anterosuperior direction and inferiorly to the midpart of the clavicle shaft w/ the indes and long fingers
+ve= inc p!
AC distraction
grasping the arm and applying steady downward traction while palpating the jnt w/ the other hand
+VE= pain or mvt at the AC jnt
neer test
impingement
- supraspin
- long head biceps
btw greater tub and acromion process or coracoacrmial arch
painful arc sign
shoulder impingement
pain experienced btw 60-120 deg
lift-off test
subscapularis pathology
- full int rot of sh
- pt tries to lift off dorsum of hand off back
+ve = cant lift hand off back
addedd scap wing = rhomboids may also be affected
drop arm test
integrity of supraspin muscle/tendon
- instructed to lower arm slowly
+ve= arm does not smoothly descend
empty can/ full can
no pain on full can = +ve supraspinatus tear
transverse h+umeral lig test
- pt sh 90deg abd, external rot + elbow 90deg flex
- AT place finger over bicipital groove
+ve= audible snap/ palpable snap, possible pain = torn lig.
yergason
bicipital tendinitis
- elbow flex 90deg, pronated
- pt goes into resisted supination, elbow flex, sh ext rot
+ve = pain w/o popping
if popping = transverse humeral lig tear
speeds
bicipital tendinitis
- arm supinated and fully extended
- AT places hand on bicipital groove and resists flexion of arm
+ve= tenderness over groove
- false positive common bc low specificity
ludington test
biceps brachii pathology
- pt has ands behind head with finger interlassed
- AT stands behind palpating bicep brachii tendon in bicipital groove
- PT asked to contract one bicep ata time
+ve = no contraction or tension is palpable on one side
adson test
TOS
- palpate raidal pulse
- pt turn head toward arm and extend neck
- passive extension and ext rot of arm
+ve = diminished pulse
scalenes might be the issue
allen test
TOS
- again palpate radial pulse
- sh abd, felx elbow and look away from arm
+ve = diminished pulse
pec minor possibly compression neurovasculature
costoclavicular syndrome test
military brace
- palapte radial pulse
- PT retracts scaps and hyperextends neck
- AT bring arm in extension and abd 30deg
+ve = diminished pulse
subclavian being compressed by costoclavicular structures
classification of AC jnt sprains
I= stretch or partial damage of the AC lig capsule
II= rupture of AC lig and partial strain of coracoclav lig
III= rupture of AC lig and coracoclav lig
IV-VI = rupture of AC lig and costoclavicular lig and tearing of deltoid and trap fascia
bankart lesion
inf GH lig avulsed from ant lip of labrum or in combination w/ a portion of the labrum
factors that place pt at risk for dev post instability
- excessive glenoid retroversion
- inc internal and external rot strength
hill-sachs lesion
small defect in the articular cartilage of the humeral head caused by the impact of the humeral head on the glenoid fossa as the humerus dislocates
- lesion usually located on the post aspect of the humeral head
dead arm syndrome
feeling of the repeated dislocation in chronic sh dislocations
slap lesion
disrups the attachment of the long head of the bicep tendon to the sup glenoid tubercle
TOS types
- neurological : involve lower trunk of brachial plexus, abnormal nerve stretch or compression
- VAScular: subclavian artery and vein
