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Rec and Care > Final - Shoulder > Flashcards

Final - Shoulder Flashcards

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1
Q

3 bones of the shoulder

A

clavicle, scapula, humerus

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2
Q

4 joints of the shoulder

A

sternoclavicular
acromioclavicular
glenohumeral
scapulothoracic

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3
Q

clavicle - 3

A

slender s that limits shock to upper limb - distal part is the weakest (where it changes shape - #)
from sternum to acromion process
support ant aspect of shoulder

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4
Q

shoulder separation or SC SS - 3

MOI

A

ladder, cant abduct arm or move shoulder around

shoved into boards or fall

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5
Q

tests for shoulder seperation - 3

A

percussion, TOP, indirect pressure

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6
Q

scapula - 2
prominent projects - 3
fossas - 2
function

A

flat triangle - articular surface of humerus in glenoid fossa)
acromion, spine, coracoid process
infraspinatus and supraspinatus
site of attachment for muslces that move the shoulder - little midgits pulling on a floating iceberg

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7
Q

scapular resting position - 6

A 
arms at side, 
overlies ribs 2-7, 
vertebral border 2" lat to thoracic spinous processes, 
sup angle approx even with T1-T2
spine - T3
inf angle - T7/8
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8
Q

humeral head

A

spherical in glenoid fossa

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9
Q

humeral tuberosities

A

greater - lateal
lesser - medial
form bicipital groove for biceps tendon

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10
Q

sternoclavicular joint

A

plane joint formed by the larger medial end of clavicle that articulates with the manubrium of the sternum - compressed in dogpiles and strength depends on the lig

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11
Q

articular disc - 3

A

improves contact area on bony ends, enhances joint stability, prevent dislocation of clavicle

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12
Q

sternoclavicular lig - 3

A

ant SC lig

pos SC lig - reinforce ant and pos aspect of capsule

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13
Q

costoclavicular ligs - 2

A

inf surface of clavicle to sup surface of first rib - limit for elevation of pectoral girdle

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14
Q

interclavicular lig

A

attaches both clavicles across manubrium - strengthen sup capsule

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15
Q

AC joint

A

plane/gliding jt

clavicle and acromion that is covered by fibrocarilage

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16
Q

ac lig - 3

A

ac lig - reinforce sup aspect

cc lig - trapezoid and conoid

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17
Q

scapulothoracic jt - 3

A

not a true jt - shoulder blade on your rib cage
enables shoulder to function correctly
scapula and thoracic wall

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18
Q

larger shoulder blade

A

more force

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19
Q

3 types of movement of scapulothoracic jt

A

elevation/depression
protraction/retraction
lat/med rotation

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20
Q

glenohumeral jt - 6

A

synovial - ball and socket - multi axial
most movable jt in the body
active restraints of rotator cuff and deltoid, passive restraint of ligs and labrum
humeral head and glenoid fossa of scapula full with hyaline cartilage
incongruent becuase the head is too large

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21
Q

glenoid labrum

A

continuous with jt capsule
fibrocartilage ring
deepens the fossa and increases contact surface area and stability by 50%

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22
Q

purpose of lats and pec

A

movers of your arm - not biomechanically made to stablize your shoulder

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23
Q

ligs strengthening the ant capsule - 3

A

sup, mid and inf glenohumeral lig

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24
Q

ligs strengthening the sup capsule

A

coracohumeral lig

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25
coracoacromial arch | prominent diseases - 5
coracoid process, acromion and coracoacromial lig - impingement and tendinitis - cant lift it above your head overlies the humeral head and limit the sup displacement of humerus, supraspinatus tendon passes through arch
26
External rotator cuff muscles
supraspinatus - from supraspinous fossa to greater tuberosity of humerus - abduction infraspinatus - infraspinous process to greater tuberosity teres minor - lateral border of scap to greater tuberosity
27
to avoid shoulder problems if you work out
stabilize your scapula before you start
28
subscapularis
subscapular fossa to lesser tuberosity - internal rotation
29
serratus ant
inside of ribcase ribs 2-9 and goes to medial border of scap - push up with a plus , scapula protraction, rotation and stabilize scap against thorax when pushing weakness - scapular winging
30
rhomboids (maj and min)
spinous process of c7-t5 to medial border of scap from inf angle - scapular retraction and stabilize scap on thoracic wall, downward rotation weakness - scap winging
31
thumbs down reverse fly would test
rhomboids
32
thumbs up reverse fly would test
middle trap
33
who does the rhomboids work against
serratus ant
34
levator scapulae
transverse process of V1-4 to sup angle and med border of scap - elevates scap and extend head
35
cervical genic headache
when you are typing all the time - tight levator scapulae, stretch - flex head and side flex
36
trapezius
from occipital bone and lig nuchae and spinous processes of c7-12 to lat clavicle and spine of scap upper fibers - scap elevation, lower fibres - scap depression and external lat rotation, all retract scap
37
pec minor
ant rib 3-5 to coracoid protraction, depression, and downward rotation under the pec, ant and pos tilt release by foam rolls
38
how many muscles in the ST jt
5
39
history of pain
activity level, contractile tissue? referred pain? chronic vs acute
40
observation
resting posistion protracted? tilted? angulation in unilateral athlete
41
all the movements of the shoulder
flex/ext, int/ex rotate, ad/adduction, elevation/depression, retraction/protraction
42
functional movement of the shoulder
buckling - horizontal adduction
43
3 ways to test strength
bilateral, isometrically and functionally
44
apprehension test
dislocation/subluxation abduct 90 degree flexed arm 90 degrees then gentaly externall rotate - pos - spasm and tense up, apprehensive and watch for facial expressions - joint structure test for labral tear
45
relocation
apprehensive in apprehensive test - push humeral back | pos - apprehension improved
46
sulcus sign
GH instability seated and grab the elbow and pull down pos - depression under acromion for inf stability of labrum
47
load and shift
ant shoulder instability | grab head ant and pos - push into glenoid fossa and push ant or pos - >25% movement is bad
48
neers
shoulder impingement passively internally rotate and flex pos - pain at end ROM ramming it into acromion
49
hawkins kennedy
shoulder impingement passively flexed to 90 and internally rotated pos - pain at end range/with rotation
50
painful arc
shoulder impingement supraspinatus, subacromial bursa raise arm into full abduction pos - pain between 45-120 and 170-180
51
empty can
supraspinatus 90 degree forward flexion and 30 degree adduction then internally rotated with slight downward pressure pos - weakness and pain
52
supraspinatus vs delt
externally rotate and primary abduction until delt kicks in
53
scaption
30 degrees, where scap is sitting on your rib cage
54
drop arm test
RC (supraspinatus) tendon tear (punching and catching) abduct arm to 90 degrees - slowly lower pos - drop and sharp pain
55
why do we want to drop the arm?
delt will hold the arm in place
56
lift off
subscapularis muslce internal rotation - hand behind back and lift off against resistance pos - weakness and unble
57
door open test
SIT external rotation pos - cant
58
speeds
long head of bicep/suspect rotator tendon palpate bicipital groove - internal and external rotation resisted supinated straight arm flexion pos - pain over biceps tendon and weakness
59
if your humerus constantly subluxes
long head of biceps starts to act as a lig and works too hard - wear out as a pulley
60
sheer/AC compression test
fallen or jammed - AC stability/sprain should separation - cant sleep on your side or back put palm at distal end clavicle with finders interlocked on top pos - pain and laxity
61
AC cross over test
AC stability/sprain shoulder separation lift arm and horizontally adduct pos - pain with movement and unable to perform
62
hit the boards with their left shoulder, roll inward forcing his arm into cross flexion - pain on sup aspect of shoulder
AC jt sprain
63
``` AC joint sprain MOI S&S G1 G2 G3 management rehab ```
acromion goes down, back or inward and clavicle pushed against rib cage - foosh, landing on lat aspect of shoulder step deformity point tenderness and discomfort with movement of tip of clavicle/acromion, no deformity tearing of AC and CC lig, slight prominence of clavicle, lose abduction, and pt tender complete rupture of AC and CC, prominence of distal clavicle, more pain and loss of function PIER, sling, MD for #, tape it down for healing by primary intention - scar in 3-5 days jt ROM, stability, strength,
64
trips and grabs onto rail, forcing his arm into hyperextension and rotation, - come to you supporting it and cant move
glenohumeral dislocation
65
``` glenohumeral dislocation MOI S&S Management rehab ```
impact with shoulder abducted, externally rotate and extend, most often ant and downward - high chance of reoccurance - hitting someone about to throw a football flatten delt contour palpate axilla for prominence of humeral head loss of function, ROM and pain towel under arm and longitudinal traction conservative MD for reduction PIER and sling restore ROM, stability and strength tape/brace for RTP ROM - isometric scapular stability
66
``` instability of GH jt MOI SS management rehab ```
``` chronic instability of shoulder after recurrent subluxation/dislocation traumatic/congenital/repetitive overuse ant/pos instability or multidirectional pain, clicking, weakness, increased motion of humeral head, avoidance of positions due to pain/apprehension, impingement of rotator cuff because of poor stability conservative then surgical strengthen RC - sup, ant and pos strengthen scapular stabilization muslces and proprioception of the should - open and closed kinetic chain exercises - one hand on the mirror or hands and knees on a table cloth and slide - no pattern play with speeds ```
67
Sports for ppl with GH instability
no throwing sports, not biomechanically great
68
rotator cuff tear MOI - 4 management rehab
overuse or acute poor blood supply - not adequate healing begin with microtearing and impingement older pop pain, weakness, loss of ROM, partial can move with pain, full tear not normal ROM vague pain in area and catching when arm is moved, cant sleep on the affected side PIER, correct mechanics (muscle imbalance), prop up to 30 degress to give it room to heal conservative stretching to maintain and improve ROM, scap stabilization, strengthen, may be surgery.
69
chronic shoulder pain - progressively worse with overhead strokes
shoulder impingement syndrome
70
``` shoulder impingement syndrome MOI S&S Management Rehab ```
repetitive overhead - swimming, tennis, postural abnormalities, loss of scap control, mechanical compression of bursa, supraspinatus of biceps tendon under coracoacromial arch - irritation and inflammation generalized aching with abduction and flexion, pos painful arc and impingement tender over RC tendons, decreased strength with resisted muscle testing flexibility and rest strengthen RC - below 90 degrees then progress to overhead, PIER
71
increase weight for bicep curls, snap in front of shoulder, unable to lift, flatten bicpes muslce
biceps brachii rupture
72
Biceps rupture MOI S&S management
powerful concentric/eccentric contraction, often near the origin in the groove but can happen at distal end audible snap and intense pain, weakness with elbow flexion and resisted biceps PIER, sling, MD? surgery?
73
fit 40 yr judo with worsening shoulder pain - known history of RC tear, no new trauma, constant pain, full strength but poor ROM
adhesive capsulitis - frozen shoulder | painful restriction of GH due to thickening and contracture of capsule
74
adhesive capsulitis MOI S&S management
no exact, may be synovial inflammation causing pain and disuse, >40yr, shoulder immob increase risk, diabetes, hyperthyroidism, hypertriglyceridemia increases risk progressive onset, worse with movement and at night, decrease ROM aggresive stretching and manipulation - cortisone may feel good but not in the long run
75
jump to side with arms outstretched, lands hard on arm, immediate pain and hold on to support
clavicle fracture
76
``` clavicle fracture MOI S&S management rehab ```
FOOSH, fall on tip of shoulder or direct impact support arm at the elbow, deformity, pain, swelling sling up to 8 weeks, xrays ROM, strength, surgery?

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