OMM approach to the shoulder Flashcards
(31 cards)
How many joints comprise the shoulder joint? What are they?
4: Sternoclavicular joint Acromioclavicular joint Scapulothoracic joint Glenohumeral joint
What are the three bones that comprise the shoulder?
Clavicle
Scapula
Humerus
What are the ligaments that surround the shoulder joint?
Ligament capsule
What is Wolf’s* law?
Areas of bone stress will cause new bone deposition to reinforce that area
What are the areas of the diagnosis and treatment for OMM of the shoulder?
- Axial skeleton
- S/CS tender points
- Specific SDs of the GHJ, SCJ, ACJ
What are the five areas of the axial skeleton that should be treated with shoulder SDs?
- Thoracic vertebrae
- Ribs
- Inlet
- Neck (AA joint)
- Head (OA joint)
Diaphragmatic irritation may refer pain to where? What are the spinal nerves that are involved in this?
Shoulder Phrenic nerve (C3, C4, C5)
What are some of the syndromes that arise from the abdomen, can irritate the diaphragm, and thus cause subsequent shoulder pain? (5)
- Liver abscesses
- General peritonitis
- Gallbladder disease
- Splenic rupture
- Perforated peptic ulcer
Pancoast tumors may impinge on what nerve plexus to cause pain in the cervical distribution? What trunk is affected? What peripheral nerve, then, would be affected?
Brachial plexus
Lower trunk
Ulnar nerve
What are the three main joint restrictions that are amenable to OMM treatment?
- Glenohumeral joint
- Sternoclavicular joint
- Acromioclavicular joint
What are the ssx of sternoclavicular joint restrictions (usually)?
Usually adducted and extended
What are the two main forms of OMM that are used to treat the scapulothoracic joint?
Scapular lift
Shoulder mobilization
What are the major SDs of the glenohumeral joint?
Tight shoulder capsule
What are the 7 stages of Spencer? (in order)?
- Extension
- Flexion
- Circumduction
- Circumduction with traction
- Abduction/adduction
- Internal rotation
- Abduction with traction
What is the use of the 7 stages of spence?
Order of articulatory techniques, in order of progressing difficulty with movement
What is Boas’s sign?
Right shoulder pain secondary to cholecystitis
What is the relationship between the movements of the distal and proximal ends of the clavicle?
Inverse relation (e.g. Anterior/superior motion at the distal end, results in posterior/inferior motion at the proximal end)
What is the movement of the ACJ and clavicle with abduction of the shoulder?
ACJ moves upward
Medial clavicle moves downward
What is the movement of the ACJ and clavicle with adduction of the shoulder?
ACJ moves downward
Medial clavicle moves upward
What is the movement of the ACJ and clavicle with extension of the shoulder?
ACJ moves posteriorly
Medial clavicle moves anteriorly
What is the movement of the ACJ and clavicle with flexion of the shoulder?
ACJ moves anteriorly
Medial clavicle moves posteriorly
What are the two primary dysfunction of the SCJ?
Adducted clavicle
Extended clavicle
True or false: patient may have pain at the ACJ with movement of the arm, or the scapula, but not usually both
False- can be both
What causes the glenohumeral joint pain (outside of a fracture), when falling on an outstretched arm?
Folding of the fascia in and around the glenohumeral joint
