Lecture 6- Shoulder Complex

Question 1

Shoulder questions to ask?

Answer 1

Which hand do you write with?
Activities you are having difficulty with?
Have you ever had a history of neck pain, upper back pain, or headaches?

Other shoulder?

Question 2

Shoulder Questionnaire

Answer 2

Quick DASH
UCLA shoulder scale
UEFS
Patient Specific Functional Scale

Question 3

Shoulder performance measures

Answer 3

Hand Grip Dynamometry
Time Weighted Overhead Test
Upper Quarter Y Balance
UE Endurance
Apely Scratch
UE CKC Stability Test

Question 4

from the front the clavicle is elevated __ degrees

Answer 4

20

Question 5

From the side,
the ________ is in line with the ear
___________ kyphosis
transition at ____
elbow is directly below __________ head

Answer 5

the acromion in line with the ear
thoracic kyphosis
transition at cervical-thoracic
elbow directly below humeral head

Question 6

an elevated clavicle leads to a lengthened ________ &
a short _________

Answer 6

lengthened pec major (clavicular head)
shorted upper trap

Question 7

a depressed clavicle leads to a lengthened ___________ and a short ___________

Answer 7

lengthened upper trap, short pec major (clavicular)

Question 8

T or F: cubital fossa should face primarily anteriorly and slightly lateral with arms at side

Answer 8

F
Correct answer: cubital fossa should face primarily anteriorly and slightly medial with arms at side

Question 9

Increased thoracic kyphosis:
gravity has a _________ moment arm for flexion
correlated with scapular _________ and cervical __________

Answer 9

gravity has stronger moment arm for flexion
correlated with scapular protraction and cervical extension

Question 10

decreased thoracic kyphosis:
gravity _____ through vertebral bodies
possibly __________ work on muscles that attach to scapular

Answer 10

Gravity more through vertebral bodies
Possible increased work on
muscles that attach to scapula

Question 11

T or F: the CT junction should have some kyphosis

Answer 11

T

Question 12

in excessive kyphosis, what is the breakdown point for the CT junction?

Answer 12

hinge in the lower cervical spine

Question 13

excessive kyphosis increased the work for what muscles?

Answer 13

scapular stabilizer muscles

Question 14

excessive kyphosis is possibly associate with scapular __________ & _________

Answer 14

scapular depression and abduction

Question 15

T or F: decreased kyphosis is common

Answer 15

F!
decreases kyphosis is rare

Question 16

Scapulae positioned
between which vertebral levels

Answer 16

T2-T7

Question 17

scapulae is about __ inches from spinous processes

Answer 17

3

Question 18

what to look for with overhead reach test

Answer 18

symmetry
single versus multiple reps
muscles that are dominant
muscles that are weak

Question 19

causes of AC joint sprain

Answer 19

FOOSH
downward force on acromion
upward force on clavicle

Question 20

AC joint sprain pt presentation

Answer 20

“pop”
weakness at end range arm
pain at 90 degrees shoulder flex
pain with horizontal adduction
pain at joint
piano key sign

Question 21

causes of AC joint arthritis

Answer 21

repetitive overhead
prior related injury

Question 22

AC joint arthritis pt presentation

Answer 22

pain at end range
pain with shoulder flexion, Hor. adduction
pain at joint
palpable bony growth

Question 23

shoulder impingement causes

Answer 23

bony growth
poor mechanics
prior injury
FOOSH

Question 24

shoulder impingement pt presentation

Answer 24

pain at 60-120 abductions
pain irritated with overhead reach
click/pop

Question 25

causes of rotator cuff tendinopathy

Answer 25

repeated micro trauma

Question 26

rotator cuff tendinopathy is a progression of what condition

Answer 26

shoulder impingement

Question 27

rotator cuff tendinopathy pt presentation

Answer 27

pain with contraction or stretching, overhead reach, repetitive load, lying on shoulder atrophy in muscle belly

Question 28

cause of rotator cuff tear

Answer 28

FOOSH, repetitive microtrauma

Question 29

pt presentation of rotator cuff tear

Answer 29

**weakness** and **pain** based on degree of tear, muscle **atrophy**, scapular **malpositioning**

Question 30

what motions are limited after rotator cuff surgery?

Answer 30

PROM flexion, abduction, ER, IR no shoulder AROM

Question 31

what is another name for a labral tear?

Answer 31

bankart lesion

Question 32

causes of labral tears

Answer 32

FOOSH, direct trauma, violent pull of shoulder, loaded lifting

Question 33

pt presentation labral tear

Answer 33

pop, click, clunk arm feels heavy pain with overhead reach weakness

Question 34

type 1 SLAP lesion

Answer 34

frayed not detached or bucket handle

Question 35

type 2 SLAP lesion

Answer 35

detached

Question 36

type 3 SLAP

Answer 36

frayed and bucket handle

Question 37

type 4 SLAP

Answer 37

detached and bucket handle

Question 38

pt presentation of SLAP lesion

Answer 38

pop, click, clunk arm feels heavy **pain with flexion and/or IR** weakness in shoulder/scapular stabilizers difficulty lying on side

Question 39

frozen shoulder (adhesive capsulitis) causes

Answer 39

insidious, may correlate with middle age, T2 DM, or hypothyroidism

Question 40

"freezing" frozen shoulder stage

Answer 40

losing ROM, painful

Question 41

"frozen" frozen shoulder stage

Answer 41

minimal ROM, less painful

Question 42

"thawing" frozen shoulder stage

Answer 42

regaining ROM, pain varies

Question 43

shoulder end feels

Answer 43

FIRM

Question 44

subacromial bursitis end feel

Answer 44

empty

Question 45

frozen shoulder end feel

Answer 45

hard capsular

Question 46

for shoulder MMT, how would you test functionality?

Answer 46

you resist at a longer lever arm location

Question 47

normal shoulder flexion range

Answer 47

180

Question 48

normal shoulder extension range

Answer 48

AAOS- 60 AMA- 50

Question 49

shoulder abduction norm range

Answer 49

180 AMA- 170

Question 50

shoulder IR range

Answer 50

AAOS- 70 AMA- 80

Question 51

shoulder ER range

Answer 51

AAOS- 90 AMA- 60

Question 53

decreased kyphosis leads to possible _________ weight bearing though vertebral bodies and ________ movement through vertebral bodies

Answer 53

possible **increased** weight bearing though vertebral bodies and **increased** movement through vertebral bodies (NOT facets)