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Athletic Therapy > the shoulder complex > Flashcards

the shoulder complex Flashcards

1
Q

the humerus

A

spherical, shallow contricted neck, it faces upward, inward, backwards articulating with the scapulas glenoid fossa

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2
Q

sternoclavicular joint

A

articulation between the clavicle and the sternum
it functions to shock absorb against medial forces and helps prevent any displacement upward
clavicle can move up, down, forward, backward and rotate

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3
Q

acromioclavicular joint

A

irregular joint between acromion process of scapula and the lateral clavicle a thin, fibrous, capsule surrounds the joint

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4
Q

glenohumeral joint

A

the synovical ball and socket joint of the shoulder made stronger and deeper by the labrum as well as surrounding deltoid and rotator cuff

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5
Q

scapulothoracic joint

A

not a true joint
the area that provides movement of the scapula over the back side of the ribcage
allows for scapular elecvation, depression, protraction, retraction, abduction and adduction

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6
Q

sternoclavicular joint ligaments

A

anterior sternoclavicular ligament: which prevents upward displacement

posterior: prevents upward displacement
interclavicular: prevents lateral displacement
costoclavicular: prevents lateral and upward displacement

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7
Q

AC joint ligaments

A

acromioclavicular
coracoclavicular
conoid
trapezoid

*all try to keep AC joint together- most importantly keeping the joint from going superior

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8
Q

pec major

A

O: medial clavicle, sternum, costal cartilage of upper 6 ribs and aponeurosis of external oblique
I: greater tubercle of the humerus
A: flexes, adbucts and internally rotates shoulder
N: median and lateral pectoral

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9
Q

latissimus dorsi

A

O: SP of lower 6 thoracic and the lumbar vertebrae and posterior iliac crest and thoracolumbar fascia
I: medial margin of interbercular groove of humerus
A: extend, adduct and internal rotation
N: thoracodorsal

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10
Q

deltoid

A

O: lateral third clavicle, aromion process and spine of scapula
I: deltoid tuberosity of humerus
A: abducts the shoulder, anterior: flexion and internal rotation, posterior: extension, and external rotation
N: axillary

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11
Q

supraspinatus

A

O: supraspinatus fossa of scapula
I: greater tubercle of humerus
A: abducts and slight external rotation
N: suprascapular

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12
Q

infraspinatus

A

O: infraspinatus fossa of scapula
I: greater tubercle of humerus
A: external rotation and slight adduction
N: suprascapular

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13
Q

subscapularis

A

O: subscapular fossa of scapula
I: lesser tubercle of humerus
A: internal rotation
N: suprascapular

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14
Q

teres major

A

O: dorsal surface of inferior angle of scapula
I: lesser tubercle of the humerus
A: adduction, extension and internal rotation
N: subscapular

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15
Q

teres minor

A

O: axillary border of scapula
I: greater tubercle of humerus
A: external rotation
N: axilary

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16
Q

coracobrachialis

A

O: coracoid process of scapula
I: middle of humerus, medial surface
A: adduction, flexion of GH
N: musculocutaneous (c5-7)

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17
Q

trapezius

A

O: occipital bone, ligamentum nuchae, SP of the c7 and all tspine
I: lateral third of clavicle, acromion process and spine of scapula
A: upper: elevation; lower: depression, rotate, adducts and stabilizes the scapula; middle retraction and downward rotation
N: spinal accessory nerve CN11

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18
Q

rhomboid major

A

O: sp of 7 cervical and first thoracic vertebrae
I: vertebral border of scapula below the spine
A: rotates and retracts scapula, stabilizes and adducts
N: dorsal scapular

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19
Q

rhomboid minor

A

O: sp of 2-5 thoracic vertebrae
I: vertebral border of the scapula at the base of the spine of the scapula
A: adducts, stabilizes, rotates scapular, lowering its lateral angle
N: dorsal scapular

20
Q

nerve supply to the shoulder

A

brachial plexus

branches to axillary, musculocutaneous, subscap, supra, dorsal scap, pectoral, and radial

21
Q

blood supply to shoulder

A

subclavian and axillary arteries

brachial artery

22
Q

levator scapulae

A

O: tp of c1-c4
I: vertebral border of scapula, above the spine of the scapula
A: elevates and adducts scapular, side bends neck when scap is fixed
N: dorsal scapular

23
Q

pectoralis minor

A

O: anterior surface of rib 3-5
I: coracoid process of scapula
A: draws scapular anteriorly and downward rotation
N: medial pectoral

  • would cause tilt to scapula if in dysfunction*
  • not to be confused with serratus anterior which would cause winging*
24
Q

serratus anterior

A

O: outer surface of ribs 1-9
I: entire length of vertebral border of scapula
A: protracts, and rotates scapula, stabilizes
N: long thoracic nerve

25
Q

scaption

A

movement of the humerus away from the body in the scapular plane
glenohumeral abduction in a plane 30 to 45 degrees between the sagittal and front planes

26
Q

load and shift test

A
  • grasp shoulder w one hand to stabilize
  • grasp humeral head with thumb over posterior head and fingers over anterior head with other hand
  • load the head by compressing into shoulder and translate forward P-A
  • load the head by compressing into shoulder and translate backward A-P
  • bilateral

-pos: excessive translation in the fossa

-ind:
Grade 1: translation up to 50% of the diameter of the head or up to rim of glenoid
Grade 2: head is pushed beyond rim by >50% of diameter of head, reduces spontaneously
Grade 3: head remains dislocated after translation

27
Q

anterior drawer for shoulder

A

check anterior glenohumeral stability
pt supine
arm abducted 45degrees, horizontal abduction 10degrees, and 10 degrees of external rotation
scapula is stabilized and the umeral head is glided anteriorly white slight distraction is applied to the glenohumeral joint.

a positive test indicated insufficiency of the anterior joint capsule and the integrity of the anterior labrum

28
Q

posterior drawer for shoulder

A

check posterior glenohumeral instability
pt supine 90 abduction, 20 horizontal adduction and 90 elbow flexion
scapula stabilized, humerus internally rotated as the humeral head is glided poteriorly.

a postive test indicates insufficency of the posterior capsule and possible damage to the posterior labrum

29
Q

sulcus test

A

TESTING: Inferior instability (indicative of global instability)
POSITION: Grasp humerus, pull down, look at acromion for sulcus (+) TEST: Gap at sulcus and pain

30
Q

clunk test

A

pt in supine. PT places one hand on the posterior aspect of the pt’s humeral head and other hand stabilizes the humerus proximal to the elbow. PT passively fully ABD and ER the arm f/b applying an anterior directed force to the humerus. (+) audible “clunk” or grinding while performing test. Identifies a glenoid labrum tear.

31
Q

obriens test

A

Patient position: seated or standing
GH joint flexed to 90º and Hz adducted 15º from front
Full humeral internal rotation and pronated forearm
Examiner position: anterior to patient
One hand place over superior aspect of patient’s distal forearm
Patient Action: resists examiner’s downward force
Examiner Action
Pushes downward on forearm
Test repeated with humerus externally rotated and forearm supinated
Positive: Pain experienced with arm in internal rotation but is decreased during external rotation
Pathology: SLAP lesion
Be aware of “popping” at AC Joint
Rotator cuff pathology may give false positive

32
Q

apprehension test

A

pt supine
arm abduct 90
shoulder is passively and gently moved into external rotation as far as patient will allow
watch face

33
Q

relocation test

A

supine
shoulder 90 elbow 90
as shoulder is externally rotated pressure is applied posteriorly to stabilize the humeral head which allows for greater degree of external rotation

test is positive if apprehension or pain is relieved with his maneuver

34
Q

neers test

A

forced flexion of the humerus in overhead position, impingement of structures between humeral head and coracoacromial arch

35
Q

hawkins kennedy test

A

horizontal adduction with forced internal rotation of the humerus which prouduces impingement

a positive sign is pain or reaction with a grimace

36
Q

drop arm

A

rotator cuff
patient abducts the arm as far as possible adn then slowly lowers it to 90
from this the pt with a torn supraspinatus muscle will be unable to lower the arm with control

if patient can hold arm at 90, pressure on on the wrist will cause the arm to drop

37
Q

empty can

A

flexion 90 horizontal abduction 30 (scaption)
arm is internally rotated as far as possible
thumb pointing downward
pressure is applied inferior

weakness and pain can be detected

38
Q

yergasons

A

TESTING: Stability of long head of biceps, integrity of transverse ligament, may identify biceps tendonitis
POSITION: Elbow flexed to 90˚ and tucked into side; forearm pronated, pt tries to supinate and flex while therapist resists
(+) TEST: Inability to hold original position and pain indicates bicep tendon irritation

39
Q

speeds test

A

elbow extended, supinated and resistance applied as the humerus elevates to 60 (or whole ROM- above head)

test is positive if pt feels pain in the region of the bicipital groove- it may sublux out of groove

40
Q

luddingtons

A

Hands interlocked behind head, have patient push against head, palpate the long head of biceps and note any deformity. Stand behind subject (Biceps tendonitis)

41
Q

adsons maneuver test

A

thoracic outlet syndrome
subclavian artery between anterior and middle scalenes

pt standing
check radial pulse first when arm relaxed and then extended while patient elevates the chin and turn toward the extended hand and hold breath

positive is decreased or stopped pulse

42
Q

hyperabduction

A

allen test
compressed behind pec minor and coracoid process

radial pulse
elbow flexed to 90 and shoulder extended and abducted and external rotation
rotate head away from arm
positive if pulse disappears

43
Q

military brace test

A

Position:
patient standing
examiner palpates the patients radial pulse
patient retracts and depresses the shoulders as if coming to military attention, and extends the shoulder
(+) test:
diminished or disappearance of radial pulse
Indication:
thoracic outlet syndrome

44
Q

costoclavicular syndrome test

A

compression between first rib and clavicle

both arms abducted to 90 and externally rotated
pt open and closes hands and fingers, making fists for 3 minutes
loss of strength in hand or loss of sensation is a positive test

45
Q

phase of throw

A 
wind up
cocking
acceleration
deceleration
follow through
46
Q

deceleration phase

A

lasts from ball release until max shoulder IR, ERs of rotator cuff contract eccentrically to decelerate humerus, rhomboids contract eccentrically to decelerate scapula

most dangerous phase of through due to repetitive nature how difficult/dangerous it is to deceleration such force so quickly and controlled as it does so often

Athletic Therapy (23 decks)

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