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MSK > Shoulder Complex > Flashcards

Shoulder Complex Flashcards

1
Q

Capsular Pattern: Glenohumeral Joint

A

SLAM

Shoulder: Lateral Rotation > Abduction > Medial Rotation

Loss of movement

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2
Q

Resting (loose pack) Positon: GHJ

A
  1. 30 Flexion
  2. 30 Abduction
  3. Slight IR
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3
Q

Thoracic Outlet Syndrome

Description & Border & Contains

A

The area along the brachial plexus between the nerve roots & lower border of the axilla

Borders:
- ANTERIOR: clavicle, coracoid process, pec minor
- POSTERIOR: Upper Fibers of Traps (UFT), scapula
- MEDIAL: scalene mm & R1(first rib - behind clavicle)
- LATERAL: axilla

Contains:
- Brachial Plexus
- Subclavian artery
- Subclavian vein
Starts outside medial border (infront of scalenes) & passes infront of rib 1 && then joins the other outlet

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4
Q

Thoracic Outlet Syndrome

Description & Types

A

A term used to describe a group of signs & symptoms resulting from compression of nerves or vascular structures in the thoracic outlet

Diagnosis of exclusion - tends to be overdiagnosed

Types:
1. Neurogenic (True TOS)
2. Nonspecific “symptomatic” neurogenic
3. Vascular syndromes - arterial
4. Vascular syndromes - venous

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5
Q

Neurogenic (true TOS)

2

A

Patient presents with an anatomical anomaly compressing the brachial plexus (cervical rib - extra, or elongated C7 TP)
True TOS is rare

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6
Q

Nonspecfic “Symptomatic” Neurogenic

4

A

Most common

  • Signs & symptoms similar to true TOS but there is no evidence of anatomical anomalies, mm atrophy, or EMG findings suggesting TOS.
  • Diagnosis based solely on S/S & exclusion of competing diagnosis
  • Typically, d/t to maladaptive posture. Related to adaptive shortening of sclene mm & pec minor (shortening of mm)
  • Most TOS complaints fall under this subtype
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7
Q

Vascular - arterial

3

A
  • Compression of subclavian artery
  • Typically, d/t anatomical anomaly (ie cervical rib)
  • Typically, aggravated by arm motion, especially overhead activity
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8
Q

Vascular - venous

2

A
  • Compression of subclavian vein does not typically result in TOS complaints
  • Typically, as a result of another cause (thrombosis)
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9
Q

TOS S/S

3 Types (4 + 5 + 2)

A

Neurogenic
1. Paresthesia
2. Numbness
3. Weak grip strength (?atrophy of thenar)
4. Loss of manual dexterity & precision movements in hand

Vascular - Aterial:
1. Cool skin
2. Pale extremity (BF interruptions)
3. Dimished or absent pulse
4. Rapid fatigue of limb
5. Lower BP on the affected side

Vascular - Venous:
1. Painful swelling in arm
2. Mottled, bluish discolouration

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10
Q

TOS: Epidemiology

(5)

A
  • F>M (neurological TOS)
  • Typically occurs b/t 20-50 years of age
  • Neurological symtpoms more common > vascular
  • Commonly involves lower roots of brachial plexus (C8-T1)
    Ulnar Distributions
  • Commonly seen in athletes, occupations, & sports that involve extreme ranges of abduction & ER
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11
Q

TOS: Etiology

(9)

A
  1. Congenital anatomical anomaly (ie cervical rib)
  2. Muscle hypertrophy of scalenes mm, subclaviusm or pec minor (APICAL breathing)
  3. Inflammation or scar tissue formation in structures surrounding brachial plexus (occupying space)
  4. Traumatic (ie clavicle #, WAD causing scalene spasm)
  5. Posture (adaptive shortening of scalene & pec minor mm)
  6. Pressure (ie bra strap, bookbag, shoulder purse)
    Bra strap: broad > thin = distributes forces
  7. Excessive overhead activities
  8. Thrombus (vascular - venous TOS)
  9. Pancoast tumor - occupy an area (associated w/ horners syndrome)
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12
Q

TOS: Classifications

(4)

A

Scalenus Anterior Syndrome
- Site of compression: Interscalene triangle - b/t the scalenus anterior & medius (supraclavicular)

Costoclavicular Syndrome
- Site of compression: Costoclavicular space - b/t the clavicle & first rib (subclavicular)

Hyperabduction Syndrome
- Site of compression: Axillary interval: Under the coracoid process & behind the pec minor (infraclavicular)

Cervical Rib Syndrome

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13
Q

Special Tests:
Adson Manuever
Costoclavicular Syndrome (Military Brace) Test
Halstead Manuever
Wright Test
Allen Test

A

All tests palpate RADIAL pulse in different postures
(+) = if radial pulse dissapears

Aterial type TOS

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14
Q

Special Test: Roos Test (Elevated Arm Stress Test)

A

Procedure:
PT open & closes fists with shoulder (horizontal abduction) & elbow at 90 degrees for 3 minutes

(+) = inability to hold position for 3 mins
- Ischemic pain - arterial
- Heaviness/weakness = arterial
- S/S of neurological weakness - ex. numbness & tingling

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15
Q

Special Test: Shoulder Girdle Passive Elevation (Cyriax Release Test)

A

Procedure:
- Pt crosses arms & PT lifts elbows up - elevation

(+) = relieves neurological S/S
- Skin colour changes / temp - arterial
- Pulse becomes stronger
- Less cyanotic - venous

Cyriax = switch arm positions: pt has elbows @ 90 & pronated & PT lifts the arms this way

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16
Q

Cross Body (Horizontal) Adduction Test

A

Shoulder Separation

  • The test is performed by passively bringing the patient’s arm into 90 degrees of forward flexion, with their elbow also flexed to 90 degrees.
  • The examiner then horizontally adducts the flexed arm across the patient’s body, bringing their elbow towards the contralateral shoulder

(+) = if the maneuver successfully reproduces the patient’s symptoms of pain localized over the AC joint

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17
Q

Shoulder Separation

Definition & Etiology

A

Trauma to the ligaments holding the acromion and clavicle togeter causing separation b/t the 2 joint surfaces (subluxation or dislocation)

Etiology
1. Downward force on the acromion
2. Directly falling on or hitting the acromion
3. Falling on outstretched hand or falling on elbow

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18
Q

Shoulder Separation: S/S

(3)

A
  1. Step deformity (clavicle is no longer attached & clavicle sticks up)
    Distal end of clavicle sticking up
    Grade 3 sprain: Both acromioclavicular & coracoclavicular ligaments have been torn
    Deltoid & trapezius mm may be torn from distal end of clavicle
  2. Tenderness & swelling over ACJ
  3. Pain with shoulder horizontal adduction (compressing joint together), elevation (Flex or abd - clavicle posterior roll), and HBB (hurts b/c of EXT & clavicle move - Anterior roll)
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19
Q

Shoulder Separation: Special Test

1

A

Cross Body (Horizontal) Adduction Test

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20
Q

Shoulder Separation: Radiology

1

A

Stress-view X-Ray:
- Patient hold weight onto each arm - longitudinal traction
- Places an inferior pressure on ACJ

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21
Q

Shoulder Separation: Rockword Classification

3

A

Type I: Sprain
- Capsule is intact
- No separation or excessive spacing is seen

Type II: Subluxation
- Increased ACJ spacing

Type III: Dislocation
- Increased ACJ & costoclavicular space - completely dislocates
- Joint surfaces not in contact with each

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22
Q

Glenohumeral Joint Instability: Classifications

4

A
  1. Direction
    Anterior, posterior, inferior, multidirectional
  2. Degree
    Subluxation (partially out), dislocation (out of socket)
  3. Etiology
    Traumatic, atraumatic - multidirectional instability
  4. Timing
    Acute, recurrent
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23
Q

Shoulder Dislocation

3

A

Separation of the humerus from the scapula

Most commonly dislocated joint in the body - very mobile - many degrees of freedom

Anterior dislocation is the most common = orthopedic population
Inferior dislocation = stroke population

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24
Q

Shoulder Dislocation: Epidemiology

(2)

A
  1. M>F
  2. Typically seen in patients <30 years of age - younger ppl d/t the activities they do
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25
Q

Shoulder Dislocation: Etiology

2 Types (3 + 1)

A

Traumatic
- Direct trauma to humeral head
- Indirect trauma (forced ROM) - key locked position in BJJ
- Most commonly while in abduction & ER = dislocate anteriorly
Stability in this position provided by subscapularis, GH ligaments (especially anterior band of the inferior ligament), and long head of biceps
ANTERIOR dislocations may damage the subscapularis, long head of biceps, GH ligaments, anterior capsule, and anterior glenoid labrum

Atraumatic
- General laxity in shoulder causes shoulder to become unstable - HYPER mobile

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26
Q

Shoulder Dislocation: S/S

(8)

A
  1. Feeling of slippage with pain
  2. Feeling of insecurity w/ specific activities
  3. Possible pain or apprehension when approaching extreme ROM
  4. DEC ROM during acute phase due to apprehension
  5. INC ROM during chronic phase due to instability - hypermobility into the range d/t stretching of the structures
  6. May appear normal on clinical examination, may become more apparent after repeated activity when fatigue sets in
    Fatigue = start to experience pain / slippage - clinical tests. Tx like an instability
  7. Possible atrophy on affected side due to disuse (chronic)
  8. Sulcus sign may be present
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27
Q

Shoulder Dislocation: Potential Complications

(5)

A
  1. Axillary nerve damage
    - Must check for axillary nerve damage prior to reducing a subluxed or dislocated shoulder
    - Check by testing the nerves they innervate (MMT) = deltoid, teres minor
  2. Axillary artery
    - May be damaged with injury or reduction
  3. Brachial Plexus
    - Less commonly damaged, may occur to other branches of the brachial plexus, of which the posterior cord is most common
  4. Bankart Lesion
    - Most anterior dislocations damage the labrum
  5. Hill-Sach’s lesion
    - Posterolateral humeral head compression (indentation) fracture (Hill-Sach’s lesion) may occur secondary to anterior shoulder dislocation d/t forceful impaction of the humeral head against the anteroinferior glenoid rim
    - Indentation - dent = compression #
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28
Q

Spectrum of Instabilty

2 Types

A

AMBRI > TUBS

AMBRI - “Born Loose”
- Atraumatic etiology, Mutli-directional w/ Bilateral shoulder findings with Rehabilitation as treatment choice, & rarely Inferior capsule shift surgery is required

TUBS - “Torn Loose”
- Traumatic onset, Unidirectional anterior with a Bankkart lesion responding to Surgery

29
Q

Special Test:
Crank (apprehension) & relocation test
Apprehension release (suprise) test
Load & shift test

A

Anterior Instability

30
Q

Special Test:
Jerk Test
Load & shift test
Posterior Apprehension

A

Posterior Instability

31
Q

Suclus sign
Feagin Test

A

Inferior & multidirectional instability

32
Q

Glenohumeral Labral Tear:

Description & Types

A

A tear in the labrum of the glenoid fossa

Types:
1. Bankart - Reverse Bankart (same but posterior - posterior dislocation)
2. SLAP

33
Q

Glenohumeral Labral Tear:
Bankart

Description & Etiology & S/S

A

Anterior inferior tear of the labrum (**3-7 o’clock)

Etiology:
- Commonly occurs with antertior dislocation of GH joint
- Common in overhead sports & occupational activities

S/S:
1. Sensation of clicking &/or popping w/ movement
2. Diffuse shoulder pain
3. Worse w/ HBB
4. Feeling of weakness & instability

34
Q

Glenohumeral Labral Tear:
SLAP

Description & Etiology & S/S

A

Superior Labrum Anterior & Posterior (10-2 o’clock)
- Long head of biceps inserts directly into superior labrum > LHB may pull forcefully & detach causing a SLAP lesion tear > if LHB becomes detached, shoulder becomes unstable
ECCENTRIC force

Etiology:
- Repetitive throwing & overhead activities
- Deceleration when throwing
- Direct trauma
- FOOSH (w/ shoulder abduction & slight forward flexion)
- Traction injury (to biceps) in inferior direction

S/S:
1. Sensation of clicking &/or popping with movement
2. GIRD - Glenohumeral INTERNAL rotation deficiency
DEC ROM in IR - affected vs unaffected
3. Pain w/ overhead activity (elevation) & lying on unaffected side (?night pain - related to lying on it)
4. Loss of strength & endurance in rotator cuff & scapular stabilizer mm
5. “Dead arm” syndrome in pitchers - prainful & lower velocity

35
Q

Special Test:
Clunk Test
Active Compression Test of O’Brien (specifc to..)
Biceps Load Test (Kim Test II)

A

Glenohumeral Labral Tear

Active Compression Test of O’Brien - specific to SLAP tear

36
Q

Adhesive Capsulitis

Decription & Epidemiology & Etiology

A

An idiopathic condition which is characterized by shoulder pain followed by progressive loss of glenohumeral joint (GHJ) ROM following a capsular pattern d/t the development of dense adhensions & capsular thickening surrounding the GHJ
- Shoulder pain > shoulder DEC ROM > capsular pattern loss (ER > Abd > IR)

Epidemiology:
- F>M
- Typical age of onset between 40-60 years old
- More common in non-dominant shoulder
- INC incidents in diabetes

Etiology:
1. Primary adhesive capsulitis: Idiopathic
2. Secondary adhesive capsulitis: secondary to other conditions which there is shoulder pain &/or restricted ROM may lead into adhesive capsulitis
Ie. trauma, immobilization (clinical relevant - need to encourage mvmt post-op), surgery, recent stroke, recent MI, thyroid disease, DM, OA, RA
3. Adhesive capsulitis has a high correlation w/ psychosocial issues (anxiety, stress)

37
Q

Adhesive Capsulitis: S/S

(6)

A
  1. Progressive GHJ ROM restrictions
  2. ROM restriction follows a capsular pattern of the shoulder (ER>ABD>IR)
  3. Difficulty w/ HBB, HBH, & overhead activities (activity & functional limitations)
  4. Reverse scapulo-humeral rhythm present with increasing GHJ ROM restrictions
    *Normal (2:1) - reverse in frozen shoulder - more mvmt w/ scapula. Compensations: shoulder hike)
  5. May present with trick movements during examination (ABD - side bending)
  6. General mm weakness & poor endurance may be present
38
Q

Adhesive Capsulitis:
Stages

(4)

A

Stage 1:
- Gradual onset of pain
- Increases w/ mvmt & present at night
- Loss of ER ROM w/ intact rotator cuff strength
- Duration < 3 months

Stage 2: “Freezing”
- Persistent & more intense pain, even at rest (dull & achy)
- Restricted ROM in all directions (capsular pattern)
- Duration: 3-9 months

Stage 3: “Frozen”
- Pain only with mvmt. Less night pain
- Significant adhensions. HARD capsular end feel in most directions
- Restricted ROM in all directions w/ increased scapula compensation mvmts
- May present with atrophy of deltoid, rotator cuff, biceps & triceps
- Duration: 9-15 months

Stage 4: “Thawing”
- Minimal pain
- Significant capsular restrictions at start of this stage, but gradual return of ROM
- Some patients may never regain full ROM
- Duration: 15-24 months or longer

As a whole, frozen shoulder takes approx ~2 years to run its course & is also SELF-LIMITING - meaning it will fix itself

39
Q

Subacromial Impingement Syndrome:

Description + structures (5)

A

Signs & symptoms resulting in increased pressure on the structurs running under a narrowed sub-acromial space

Structures:
1. Subacromial (subdeltoid) bursa
2. Supraspinatus tendon
3. Long head of biceps tnedon
4. Coracoacrominal ligament
5. Joint capsule

40
Q

Subacromial Impingement Syndrome:
Etiology

(3)

A

Primary (Structural) Impingement
- Impingement as a result of congenital abnormalities or degenerative changes ot the acromion process, coracoid process, greater tuberosity, RCm or anterior tissues d/t stress overload causing impingement
Ie. hooked acromion, greater tuberosity

Secondary (Functional) Impingement
- Impingement as a result of abnormal force coupling action leading to mm imbalances & abnormal mvmt patterns
- Muscle imbalances & altered mvmt pattersn may be in the scapula or GHJ
- Secondary impingement may result after instability (loose anterior capsule)
MM Imbalance & Posture
Tight pec minor > ANTERIOR tilt of scapula > narrowing of subacrominal space, winging or weak lower traps, or kyphotic posture

Calcific Tendonitis
- Calcific deposit w/in a tendon (typically supraspinatus)
- Deposits produce bulge in tendon which increases the likelihood for impingement
- Typically found in supraspinatus tendon

41
Q

Subacromial Impingement Syndrome:
S/S

(8)

A
  1. Glenohumeral painful arc (60-120) & end-range (posterior translation of clavicle) - HALLMARK
  2. Pain
    Worse w/ overhead activities (elevation) & lying on affected side
    Location: anterior & lateral shoulder
    Pain does not radiate below the elbow
    Typically, no pain at rest
  3. Tenderness on palpation of structures passing under subacromial arch (ie SSp tendon, LHB, subacromial bursa)
  4. Reversed scapula-humeral rhythm
  5. Decrease HBB & HBH ROM. Other mvmt may also be affected
  6. Pain & weakness on resisted abduction and ER. Other mvmts may also be affected
    INC pain when resistance is performed w/in painful arc (60-120)
  7. May present w/ antero-superior placed humeral head at rest
    Posterior capsule tightness > IR stretching - may not be a good idea if sensitive b/c you are closing that space > pain
  8. May present with decrease postero-inferior glide
42
Q

Special Test:
Hawkins Kennedy Impingement Test
Neer’s Impingement
Scapular Assist Test

A

Hawkins Kennedy Impingement Test
- IR arm in front of pt > placing the greater tubercle into the narrow aspect of the subacromial arch where it compresses the other structures
(+) = pain

Neer’s Impingement Test:
- PT places arm into IR (0 degree elbow ext) & passively flexes arm in scapular plane
- Bring the greater tubercle towards the narrow aspect of the subacromial arch SO compression happens earlier & more
(+) = pain

Scapular Assist
- ABD & PT helps facilitate the mvmt
(+) = decrease of pain

43
Q

Muscle/ Tendon Pathology

(4)

A
  1. Tendintis: inflammation of tendon
  2. Tendinosis: degenerative changes w/in a tendon w/out inflammation
    Thought to be as a result of overuse & repetitive stress on the tendon causing degenerative microdamage
    Typically takes longer to heal than tendinitis
  3. Tenosynovitis: inflammation of the synovium (fluid filled sheath surrounding the tendon)
  4. Tendon Rupture: tearing of a tendon
    Occurs when the forces placed on the tendon are greater than the tensile strength & capacity of the tendon
    May be partial or complete
44
Q

Shoulder Tendinopathy

A
  1. Biceps Tendinopathy
  2. Supraspinatus Tendinopathy
  3. Infraspinatus Tendinopathy
  4. Teres minor Tendinopathy
  5. Subscapularis Tendinopathy
45
Q

Shoulder Tendinopathy: S/S

A
  • Pain with mm contractions
    MMT, AROM or AROM w/ restriction
  • Tenderness upon palpation at tendon & insertion point
46
Q

Speed’s Test
Yergason’s test

A

Biceps (LHB)

Yergason’s - not specific for tendinitis - rather assess the ligament holding the LHB tendon

47
Q

Drop Arm Test
“Empty” Can Test

A

Supraspinatus

Drop Arm Test (TEAR): lifting pt arm passively & tell them to hold this position & let go && they can NOT hold the position

“Empty can” Test - pathology

48
Q

Belly Press Test
Lift-off sign
Internal Rotation Lag Sign

A

Subscapularis

49
Q

Infraspinatus Test
Lateral Rotation Lag sign

A

Infraspinatus

50
Q

Hornblower’s Sign

A

Teres Minor

51
Q

Scapular Dyskinesia

Description

A

An alteration in the normal position or movement of the scapula

52
Q

Scapular Winging

(3)

A

Static Winging:
- Winging at rest
- Typically a result of structural deformity of the scapula, clavicle, ribs or psine

Dynamic Winging:
- Winging with movement
- May be due to:
Lesions of long thoracic nerve (serratus anterior) Spinal accessary nerve (trapezius)
C3-4 (trapezius)
C5 (rhomboids)
C7 (serratus anterior, rhomboids
Serrratus anterior weakness
Rhomboid weajness
Multidirectional instability

53
Q

Wall or Floor Push Up Test
Scapular Load Test
Punch Out Test

A

Scapular Dyskinesia - Scapular Winging

Wall or Floor Push Up Test (wall = greater load)
Scapular Load Test - wt or manual resisting @ 45 of ABD ** Looking at scapula when doing the test.
Punch Out Test - making a fist w/ straight elbow & resisting protraction

54
Q
A
55
Q

Shoulder Separation

Description & Etiology

A

Trauma to the ligaments holding the acromion & clavicle together causing separation between the two joint surfaces (subluxation or dislocation)

Etiology:
- Downward force on the acromion
- Directly falling on or hitting the acromion
- Falling on outstretched hand or falling on elbow

56
Q

Shoulder Separation: S/S

3

A

Step Deformity
- Distal end of clavicle sticking up
- Grade 3 sprain: Both acromioclavicular & coracoclavicular ligaments have been torn
- Deltoid & trapezius mm may be torn from distal end of clavicle

Tenderness & swelling over AC joint

Pain w/ shoulder horizontal ADDuction, elevation, and HBB
- Horizontal = compressing the joint together
- Elevation = Flex or Abd > clavicle posterior rotates = any mvmt of clavicle = pain
- HBB = Extension + clavicle anterior rolls & any mvmt of clavicle = pain

57
Q

Shoulder Separation: Radiology

1

A

Stress-view x-ray
- Patient hold weight onto each arm - longitudinal TRACTION to see if INC spacing
- Places an interior pressure on ACJ

57
Q
A
58
Q

Shoulder Separation: Rockwood Classification

A

Type I: “Sprain”
- Capsule is intact
- No seperation or excessive spacing is seen

Type II: “Subluxation”
- Increased ACJ spacing

Type III: “Dislocaton”
- Increased ACJ & costcoclavicular space - completely dislocated
- Joint surfaces not in contact with each other

58
Q
A
59
Q

Glenohumeral Joint Instability:
Classification

4

A
  1. Direction: anterior, posterior, inferior, multidirectional
  2. Degree: subluxation, dislocation (out of socket)
  3. Etiology: traumatic, atraumatic - multi-directional instability
  4. Timing: acute, recurrent
60
Q

Shoulder Dislocation

(3)

A
  • Separation of the humerus from the scapula
  • Most commonly dislocatde joint in the body - very mobile - many degrees of freedom
  • Anterior dislocation is most common
    Stroke = inferior dislocation
61
Q

Glenohumeral Joint Instability:
Epidemiology

2

A

M>F
Typically seen in patients < 30 yo - younger ppl d/t the activities they do

62
Q

Glenohumeral Joint Instability:
Etiology

2 Types (3+1)

A

Traumatic
- Direct trauma to humeral head
- Indirect trauma (force ROM) - keylock position in BJJ
- Most commonly while in ABDUCTION & ER = dislocate anteriorly
1. Stability in this position provided by subscapularis, GH ligaments (especially anterior band of the inferior ligament), & long head of biceps
2. Anterior dislocation may damage the subscapularis, long head of biceps, GH ligaments, anterior capsule, and anterior glenoid labrum
Cut or shorten the SUBSCAO - restrictions into ER or resistance ER ~ 30 or contraction of subscap
​
Atraumatic:
- General laxity in shoulder causes it to become unstable (HYPER mobile)

63
Q

Glenohumeral Joint Instability:
S/S

8

A
  1. Feeling of slippage pain
  2. Feeling of insecurity w/ specific activities
  3. Possible pain or apprehension when appraching extreme ROMS
  4. DEC ROM during acute phase d/t apprehension
  5. INC ROM during chronic phase d/t instability - hypermobility into the range d/t stretching of the structures
  6. May appear normal on clinical examination, may become more apparent after repeated activity wehn fatigue sets in
  7. Possible atrophy on affected side d/t disuse (chronic)
  8. Sulcus sign may be present
    INFERIOR & LATERAL b/t glenohumeral head & acromion - instability (GHJ) or loss of mm control (stroke) or nerve palsy
64
Q

Glenohumeral Joint Instability:
Potential Complications

5

A
  1. Axillary nerve injury: Must check for axillar nerve damage prior to reducing a subluxed or dislocated shoulder
    Check by testing the mm s the nerves innervate (MMT) = deltoid & teres minor
  2. Axillary artery: may be damaged w/ injuyr or reduction
  3. Brachial plexus: less commonly damaged may occur to tohe branches of the plexus of which the posterior cord is most common
  4. Bankart lesion: Most anterior dislocations damage labrum
  5. Hill-Sach’s lesion: posterolateral humeral head compression (indentation) fracture (Hill-Sach’s lesion) may occur secondary to anterior shoulder dislocation d/t forceful impaction of the humeral head against the anteroinferior glenoid rim
    *Indentation - dent - compression #
65
Q

Shoulder Separation: Special Test

1

A

CrossBody (Horizontal) Adduction Test

66
Q

Shoulder Separation: Radiology

1

A

Stress-view X-Ray:
- Patient hold weight onto each arm - longitudinal traction
- Places an inferior pressure on ACJ

67
Q

Shoulder Separation: Special Test

1

A

CrossBody (Horizontal) Adduction Test

MSK (13 decks)

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