Comp 11 and OSCE Flashcards
(20 cards)
what are the two functional joints of the shoulder?
- Suprahumeral
2. scapulothoracic
What are the two accessory joints of the shoulder?
- Costosternal
2. Costoverterbral
Which joints are involved in early shoulder abduction?
glenohumeral + suprahumeral
Which joints are involved in mid-late shoulder abduction?
scapulothoracic + sternoclavicular +acromioclavicular
When assessing the acromioclavicular ( AC) joint, internal rotation of the glenohumeral joint causes the AC joint to move in what direction and what is the normal ROM for the AC?
internal rotation, normal is about 10 degrees.
Explain how you’d test for sternoclavicular (SC) motion and are the normal motions when abducting and when during flexion.
Pt is supine and doc’s index finger is on clavicular head next to the sternum and ask patient to should shoulder for abduction. The distal end of the clavicle moves superiorly and proximal end moves inferiorly. Doc should feel an inferior movement at the SC joint. For adduction the motion would be opposite.
For flexion: doc places index finger on clavicular head next to sternum and pt flexes shoulder to 90 and reaches for ceiling forcefully. A posterior movement of clavicule should be palpated with normal motion at the SC joint. for Extension the motion is opposite.
when treating the scapulothoracic dysfunction, what is the patient’s and doc’s position?
pt is lateral recumbent, involved shoulder up, doc is facing the patient.
When treating the scapulothoracic dysfunciton using MFR, explain how a direct MFR would be treated.
Apply direct force toward restrictive barriers of the named motion pattern of the scapula and maintain force until tissue creep is felt. multiple restrictive barriers can be stacked.
Define what kind of technique the spencer’s technique is and what joint it treats.
Low velocity high amplitude springing articulatory technique that treats the GH joint involving the six motions: F, E, Ab, Ad, IR, ER).
When treating the GH using spencer’s technique, what is the patient’s and doc’s position?
Patient is lateral recumbent with affected shoulder up. Patient’s knee and hips are flexed, back straight and perpendicular to table, head supported by a pillow. Doc stands on the side of table facing patient.
Before performing spencer’s how do you prep the patient and what joints are locked?
Grab pt’s forearm with one hand flexing the pt’s elbow and the other hand is placed on top of shoulder to lock the shoulder girdle, limiting scapular movement.
What is the order of the spencer’s technique?
- Extension
- Flexion
- Circumduction
- Circumduction w/traction
- Abduction/adduction
- Internal rotation
- Traction stretch.
In the spencer’s technique, how is the circumduction technique performed?
Flex pt’s elbow sharply and abduct shoulder to 90. Lock patient’s shoulder in position and use pts elbow as pivot and rotate the shoulder in a circum fashion increasing diameter with each motion. start CW then CCW.
In Spencer’s technique, how is the internal rotation technique performed?
place pt’s hand behind their lower ribs with the elbow flexed. physician’s uses upper hand to lock scapula and lower hand to draw pt’s elbow forward and down (internal rotation).
(11c) ME tx for Flexion/Extension GH dysfunction
A. what is the normal ROM for Flexion and Extension?
B. When assessing these motion, where is linkage blocked?
C. What is the patient’s and doc’s position?
D. To tx flexion dysfunction, what is the patient’s activating force? during extension dysfunction?
A. Flexion 180; Extension 60
B. at the ipsilateral AC joint
C. Pt seated with doc standing behind pt.
D. For flexion tx patient’s activating force is towards flexion. For extension tx patient’s activating force is towards extension.
(11d) ME for internal/external GH somatic dysfunction:
A. when diagnosing, where is linkage blocked?
B. when performing the ME where do you stabilize?
A. at the ipsilateral AC joint
B. at the shoulder girdle
(11e) ME for abduction and adduction GH somatic dysfunction:
A. When diagnosing where do you block linkage?
B. What is the normal ROM for abduction and adduction at GH joint?
A. Ipsilateral AC joint
B. Adduction: 40-50; abduction: 180
(11f ) ME for adduction SC joint somatic dysfunction:
A. What is the patient and doc’s position?
B. How do you set up the patient to treat?
C. In what direction is the patient’s activating force?
A. pt is supine with the affected side at the edge. doc is standing on the side of dysfunction.
B. doc’s one hand is one proximal clavicular head and the other hand grasps the patients ipsilateral wrist and bring to barrier by pushing the arm down edge of the table.
C. lift arm up to the ceiling.
(11g): ME for horizontal extension SC joint somatic dysfunction:
A. what is the patient’s and doc’s position?
B. how do you set up the patient to treat?
C. In what direction is the patient’s activating force?
A. Pt supine at the edge of the table and doc is standing at the edge of dysfunction
B. Doc’s one hand is on the anterior aspect of the clavicular portion of the joint and the other hand is placed behind the ipsilateral shoulder to cover the scapula. The patient is asked to reach up with the hand of affected should and grasp the doc’s shoulder. Restrictive barrier is reached by doc horizontally flexing the clavicle toward manubrium (doc extending his back), and a posterior force is applied on the proximal clavicle.
C. patient tries to pull the ipsilateral should girdle toward the table against an equal resistance.
(11h): HVLA for SC adduction:
A. What is the patient’s and doc’s position?
B. how do you set up the patient to treat?
C. in what direction is the HVLA thrust provided?
A. Pt is supine, doc at the head of the table
B. doc contacts clavicular side of the dysfunctional SC joint with their eminence of one hand. The other hand is used to flex the ipsilateral upper extremity at the shoulder and then exert a cephalad traction on the arm with a simultaneous inferior force on the proximal clavicle
C. HVLA thrust by exerting a downward thrust through the SC joint while simultaneously inducing a rapid traction force through the patient’s arm
