Term
3 bones of shoulder
1 articulation of shoulder |
|
Definition
Humerus
Scapula
Clavicle
Scapular articulation |
|
|
Term
| 3 joints of shoulder and what they connect |
|
Definition
Glenohumeral: ball joint connected head of humerus and scapula
Acromioclavicular: connects scupla and clavicle
Sternoclavicular: connects the clavicle, manubrium, and cartilage of the first rib |
|
|
Term
|
Definition
| Bony process of the scapula (shoulder blade) that hooks onto the clavicle. It is found as a bony notch on the very top of the shoulder. |
|
|
Term
Define rotator cuff
What the RC tendons in particular do |
|
Definition
A group of muscles and tendons that wraps around the joints of the shoulder and strengthens them
Reinforce the capsule of the glenohumeral joint |
|
|
Term
| Major anterior external landmarks of shoulder (4) |
|
Definition
Acromioclavicular notch: top of shoulder where clavicle meets scapula
Deltoi muscle
Clavicle
Sternoclavicular joint (suprasternal notch) |
|
|
Term
| 6 bony structures of shoulder you should be able to palpate |
|
Definition
SC joint
Clavicle
AC joint
Greater tuberosity
Coracoid process
Spine of scapula |
|
|
Term
What the ropy tendon on the shoulder that you can palpate is
What it means if it is painful |
|
Definition
Biceps tendon
Biceps tendonitis |
|
|
Term
Describe the subacromial space
Two structures in this space
Why this space is important |
|
Definition
Area under the acromion and above the glenohumeral joint
Supraspinatus
Subacromial/subdeltoid bursa
Is a small space, so can have impingement |
|
|
Term
Describe simple mechanics of subacromial bursa
What syndrome is called that causes pain
Describe it |
|
Definition
If bursa becomes inflamed due to injury, the supraspinatus tendon will get pressed on and become painful
Impingement syndrome
Activity that makes the space smaller and brings the acromion in, such as overhead work or lifting, will cause greater pain.
The acromion can press on it, causing pain. Anything that makes that space smaller also causes pain ( |
|
|
Term
Characteristic sign of subacromial bursitis
Pain lengths/degrees and what they mean |
|
Definition
Pain along front and side of shoulder
If pain doesn't resolve after treatment, can mean a tear that has to be looked at. |
|
|
Term
| 7 movements of the shoulder |
|
Definition
Abduction
Adduction
Extension
Flexion
Internal rotation
External rotation
Circumduction: combo of first 6 |
|
|
Term
Apley scratch test:
Describe how done
What first motion tests
What second motion tests |
|
Definition
Arm is raised and bent overhead so hand touches opposite scapula. Then hand is lower and bent upward to touch the scapula
Reaching overhead tests abduction and external rotation
Reaching under tests adduction and internal rotation |
|
|
Term
| 3 strength testing basics |
|
Definition
Compare to unaffected side
Differentiate b/w true weakness and weakness secondary to pain
Grade muscle strength |
|
|
Term
| Muscle strength grades with descriptions |
|
Definition
0=no movement
1=muscle belly moves but joint does not
2=joint moves without gravity
3=joint moves against gravity
4=joint moves against gravity and some resistance
5=full strength |
|
|
Term
| Describe muscle strength testing for the infraspinatus/ teres minor |
|
Definition
Pt's arm adducted at sides
Elbows flexed to 90 degrees
Pt attempts external rotation against examiner's resistance |
|
|
Term
| 3 tests to test strength of subscapularis |
|
Definition
Lift-off test
Belly press test
Bear hug test |
|
|
Term
Lift-test:
Muscle strength it tests
how to do it (3 steps) |
|
Definition
Tests subscapularis
Internally rotate shoulder
Put dorsal hand flat against lower back
Pt tries to push your hand away |
|
|
Term
Additional test to test subscapularis strength (2 names)
How to do (describe) |
|
Definition
Jobe's Test or Empty Can Test
Arms at 90 degree abduction and 30 degree forward flexion
Thumbs pointing downward
Pt attempts elevation against examiner's resistance |
|
|
Term
| 4 parts of neurovascular testing |
|
Definition
Distal pulses
Cap refill
Sensation
Reflexes |
|
|
Term
| 5 things tested with provocative shoulder testing |
|
Definition
Impingement
AC joint
Biceps tendon
Joint stability
Labrel signs |
|
|
Term
2 tests for impingement
1 test for AC joint |
|
Definition
Neer Test
Hawkins Test
Crossover test |
|
|
Term
2 provocative tests for Biceps tendon
1 provocative test for Labral signs |
|
Definition
Yergason's test
Speed's test
O'Brien test |
|
|
Term
| 3 provocative tests for joint stability |
|
Definition
Apprehension test
Relocation test
Sulcus sign |
|
|
Term
Describe Neer test
What positive is and means
Why it works |
|
Definition
Pt fully pronates arm. Examiner stabilizes scapula and brings shoulder to maximal forward flexion (straight up)
Positive is pain and means subacromial impingement
Humeral head is being forced toward the bursa |
|
|
Term
Describe a bursa
Describe what it does and how it does it |
|
Definition
A bursa is a small fluid-filled sac lined by synovial membrane with an inner capillary layer of viscous fluid.
It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement. Bursae are filled with synovial fluid and are found around most major joints of the body. |
|
|
Term
Describe Hawkin's test
Describe positive finding |
|
Definition
Pt's arm is flexed at 90 degrees and elbow is flex 90 degrees (like butler offering a towel).
Examiner internally rotates the shoulder (stabilizes shoulder and pushes arm down and out).
Pain means subacromial impingement. |
|
|
Term
Describe crossover test
Describe positive finding |
|
Definition
Pt flexes shoulder straight out (arm sticking straight out from body) and then adducts in across the body to the other side, keeping it level at shoulder's height
Pain indicates AC joint disorder |
|
|
Term
Describe an AC injury
Who often gets these |
|
Definition
Is a separation of place where clavicle meets the scapula; a separated shoulder.
Often found in football players who land on their shoulders. |
|
|
Term
Describe Yergason's teest
Describe positive finding |
|
Definition
Elbow flexed 90 degrees with thumb up; grasp hand like handshake
Pt supinates against resistance
Pain means biceps tendon injury |
|
|
Term
What is a labral tear?
Describe that location
Specific kind of labral tear
How usually injure it |
|
Definition
What is a labral tear?
Describe that location
Specific kind of labral tear
How usually injure it
Tear in glenoid labrum
Glenoid labrum is a cartilagenous ligament surrounding the glenoid cavity of the shoulder blade. The ball only fits into the bone about a third; the glenoid labrum extends the socket to cover more of the ball, like a sleeve.
SLAP: superior labrum anterior to posterior
Fall on an outstretched hand |
|
|
Term
Describe O'Briend's test
Describe positive finding |
|
Definition
Arm is flexed forward 90 degrees (sticking out straight ahead) and elbow is fully extended. Arm is adducted 10 to 15 degrees with thumb down.
Apply downward pressure, then retest with thumb sticking up.
More pain with thumb down indicates labral tear |
|
|
Term
Describe apprehension test
How can be performed
Two possible findings |
|
Definition
Apply slight anterior pressure to forearm and externally rotate.
Can be performed lying, sitting or stnading, but usually lying.
Apprehension may indicate anterior instability
Pain without apprehension is more likely impingement |
|
|
Term
Describe position for anterior instability test
Describe the test
Describe the finding |
|
Definition
Pt is supine.
Shoulder is abducted and externally rotated. Posteriorly directed force is applied to the shoulder.
Positive if apprehension decreases and indicates anterior instability |
|
|
Term
How to elicit sulcus sign
What to observe for and what is positive
What it indicates
How to follow up |
|
Definition
Arm in relaxed neutral position. Pull downward on elbow or wrist.
Observe for depression lateral or inferior to acromion. Is positive if >1 cm
Indicates inferior instability
Compare to other side |
|
|
Term
| Why it's important test the joints above and below shoulder |
|
Definition
| Can be referred pain. Neck problems can manifest as shoulder pain. |
|
|
Term
Part of body Spurling's maneuver is testing
Describe Spurling's maneuver
Describe positive sign
Two specific conditions specifically testing for |
|
Definition
Cervical spine
Head is rotated toward affected shoulder, and axial load is placed on cervical spine (press down on head)
Reproduction of pt's shoulder/arm pain indicates possible nerve root compression
Cervical rediculopathy or nerve impingement |
|
|
Term
3 processes involved in rotator cuff injury
What often elicits pain, and why
Rare occurrence |
|
Definition
Edema/hemorrhage, fibrosis/ tendonopathy, and tears
Overhead activities cause primary impingement of the supraspinatus against the anterior, inferior aspect of the acromion
Rarely, acute macrotraumatic injuries can cause rotator cuff injury |
|
|
