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Flashcards in OMM approach to the shoulder Deck (31):
1

How many joints comprise the shoulder joint? What are they?

4:
Sternoclavicular joint
Acromioclavicular joint
Scapulothoracic joint
Glenohumeral joint

2

What are the three bones that comprise the shoulder?

Clavicle
Scapula
Humerus

3

What are the ligaments that surround the shoulder joint?

Ligament capsule

4

What is Wolf's* law?

Areas of bone stress will cause new bone deposition to reinforce that area

5

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

6

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)

7

Diaphragmatic irritation may refer pain to where? What are the spinal nerves that are involved in this?

Shoulder
Phrenic nerve (C3, C4, C5)

8

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

9

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

10

What are the three main joint restrictions that are amenable to OMM treatment?

-Glenohumeral joint
-Sternoclavicular joint
-Acromioclavicular joint

11

What are the ssx of sternoclavicular joint restrictions (usually)?

Usually adducted and extended

12

What are the two main forms of OMM that are used to treat the scapulothoracic joint?

Scapular lift
Shoulder mobilization

13

What are the major SDs of the glenohumeral joint?

Tight shoulder capsule

14

What are the 7 stages of Spencer? (in order)?

1. Extension
2. Flexion
3. Circumduction
4. Circumduction with traction
5. Abduction/adduction
6. Internal rotation
7. Abduction with traction

15

What is the use of the 7 stages of spence?

Order of articulatory techniques, in order of progressing difficulty with movement

16

What is Boas's sign?

Right shoulder pain secondary to cholecystitis

17

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)

18

What is the movement of the ACJ and clavicle with abduction of the shoulder?

ACJ moves upward
Medial clavicle moves downward

19

What is the movement of the ACJ and clavicle with adduction of the shoulder?

ACJ moves downward
Medial clavicle moves upward

20

What is the movement of the ACJ and clavicle with extension of the shoulder?

ACJ moves posteriorly
Medial clavicle moves anteriorly

21

What is the movement of the ACJ and clavicle with flexion of the shoulder?

ACJ moves anteriorly
Medial clavicle moves posteriorly

22

What are the two primary dysfunction of the SCJ?

Adducted clavicle
Extended clavicle

23

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

24

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

25

What is the absolute contraindication (outside of fractures) to treating the glenohumeral joint with overfolding the mis-compressed fascia?

If patient has pain when compressing the shoulder

26

How do you do a generalized treatment of the ACJ and the SCJ?

Circumducting one way, and then the opposite

Move the clavicle while using the humerus as a lever and moving it in abduction/adduction and internal/external rotation

27

What axis is being utilized with generalized mobilization of the clavicle?

Long axis

28

What are the areas outside of the shoulder that should be addressed for their neurological tie to the shoulder?

-C5-T1 d/t brachial plexus
-T2-T8

29

What are the areas of the body that should be treated for the vascular concerns of the shoulder?

-Thoracic inlet
-Clavicle
-Ribs
-Axillary folds

30

Which ribs affect scapular movement?

1-8

31

Which ribs affect clavicular movement?

1-2