Shoulder Ortho History/Inspection/Palpation

Question 1

15-35 YO typically present with

Answer 1

rotator cuff dysfunction

Question 2

40+ YO typically present with

Answer 2

degenerative change in the shoulder

Question 3

Frozen Shoulder typically presents bw ages of

Answer 3

40-60 YO

Question 4

Gender percentage question - Frozen Shoulder more with _ . What is the ratio men/women?

Answer 4

Women - 70%

Question 5

FOOSH injury means

Answer 5

Fall On Out-Stretched Hand

Question 6

SLAP lesion means

Answer 6

Superior Labral Anterior Posterior lesion

Question 7

FOOSH injury can cause a

Answer 7

SLAP lesion

Question 8

What could create an AC separation

Answer 8

Landing on elbow & driving the humoral head up against the acromion.

Question 9

Night pain & pain at rest may be likely relate to

Answer 9

Rotator cuff injuries

Question 10

What movement creates pain to the patient with shoulder inflammation & instability?

Answer 10

Lifting arm over head

Question 11

TOS

Answer 11

Thoracic Outlet Syndrome

Question 12

What type of pain with TOS?

Answer 12

deep, boring, achy in neck & shoulder

Question 13

When limb becomes tired after activity it could be an indicator of _______. What should be observed?

Answer 13

vascular involvement

Are fingers pale, cold, swollen?

Question 14

Which is the lower shoulder, dominant or non-dominant?

Answer 14

Dominant

Question 15

The shoulder with decreased ROM is the dominant or non-dominant shoulder?

Answer 15

Dominant (more musculature)

Question 16

5 important pain questions to ask:

Answer 16

1) WHERE? (Location)
2) TYPE? boring, achy, deep, radiating, dull achy vs. electrical numbness & pins & needles
3) Limb TIRED after activity?
4) Any indication of NERVE injury?
5) Which HAND is dominant?

Question 17

Step Deformity

Answer 17

(separated shoulder) AC dislocation, clavicle lying superior to acromion

Question 18

What ligaments are torn w/ Step Deformity (2)

Answer 18

acromio-clavicular, coraco-clavicular

Question 19

Sulcus Sign

Answer 19

gleno-humeral multidirectional instability

Question 20

Causes for Sulcus Sign

Answer 20

loss of muscle control d/t nerve injury

Question 21

Vertebral border of scapula moves away from the chest wall

Answer 21

‘Classic’ Winging

Question 22

Muscles involved in ‘Classic’ Winging

Answer 22

weak/paralyzed serratus anterior

Question 23

Nerves involved ‘Classic’ Winging

Answer 23

Long thoracic nerve injury (C5, C6, C7 nerve roots)
Trapezius nerves (C3, C4)
Rhomboids (C5)
Serratus anterior, Rhomboids (C7)

Question 24

‘Scapular tilt’ aka

Answer 24

Inferior border winging

Question 25

Most common type of scapular winging

Answer 25

'Scapular tilt'

Question 26

(4) Reasons for the 'scapular tilt'

Answer 26

* **d/t weakness a) lower trapezius b) latissimus dorsi c) serratus anterior * **d/t tightness d) pectoralis minor, pulling on coracoid process

Question 27

Palpation for shoulder, what should you palpate?

Answer 27

1) AC, SC joint tenderness 2) Is the biceps tendon of long head in groove? 3) Check LI-15 for supraspinatus injury 4) Check SI-10 for infraspinatus tendon/muscular junction 5) Rhomboids