Term
| Shoulder pain is a common ______ complaint due to either _____ disorders or _____ pain. |
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Definition
musculoskeletal
intrinsic
referred |
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Term
| Intrinsic causes of shoulder pain |
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Definition
injuries
acute inflammation
chronic inflammation |
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Term
| the shoulder joint is the most ____ joint |
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Definition
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Term
| The joints of the shoulder |
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Definition
glenohumeral
acromioclavicular
sternoclavicular
scapulothoracic articulation |
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Term
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Definition
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Term
glenohumeral joint is the _____ articulation
only ____% of the humeral head makes contact with the glenoid. |
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Definition
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Term
| The clavicle is the only _____ connection between the ____ skeleton and the upper extremity. |
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Definition
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Term
| The bones of the shoulder are held in place by the ligaments at the ______and______ |
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Definition
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Term
| the shoulder overlies and protects the _____, _____, and ______ |
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Definition
brachial plexus
pleural cap
great vessels of the upper extremity |
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Term
| static joint stability is provided by... |
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Definition
| joint surfaces and the capsulolabral complex |
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Term
| Dynamic stability provided by.... |
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Definition
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Term
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Definition
| supraspinatus, infraspinatus, teres minor, and subscapularis |
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Term
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Definition
| trapezius, serratus anterior, rhomboids, levator scapulae |
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Term
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Definition
| diameter and depth of the glenoid (50%) |
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Term
| rotator cuff muscles have 3 functions |
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Definition
depress the humeral head against the glenoid
help maintain the humeral head position in the glenoid
assist with abduction and rotation of the humerus |
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Term
levator scapulae and upper trapezius support _____
trapezius and serratus anterior _____
trapezius and rhomboids do _____ |
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Definition
posture
rotate scapula upward
retraction |
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Term
history provides
exam serves to |
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Definition
most information
direct and confirm suspected diagnosis |
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Term
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Definition
aggravated by reaching
most common pain pattern
associated with impingement syndrome and rotator cuff tendonitis |
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Term
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Definition
much less common than lateral
conditions affecting the acromioclavicular joint, glenohumeral joint or anterior tendons |
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Term
| anterior tendons of the shoulder |
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Definition
| long head of the biceps, subscapularis, rarely the pectoralis major tendons are affected |
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Term
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Definition
least common pain pattern of conditions affecting shoulder
pain usually referred from the cervical spine
referred pain can also originate from chest and abdomen |
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Term
patients age and shoulder diseases:
shoulder instability -
rotator cuff disease -
adhesive capsulitis -
glenohumeral arthritis - |
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Definition
shoulder instability < 35
rotator cuff disease > 35
adhesive capsulitis > 50
glenohumeral arthritis > 50 |
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Term
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Definition
patients activity level
patients age
neck pain or injury
patients goals
dominant hand
acute or chronic
previous steroid injections
parasthesias
muscles qeakness
seizure
etiologies |
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Term
| etiologies of shoulder pain vary by... |
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Definition
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Term
| middle aged and older individuals develop shoulder pain from.. |
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Definition
rotator cuff lesions (supraspinatus tendonitis, partial of full tears)
frozen shoulder syndrome and symptomatic osteoarthritis |
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Term
| ___ % of shoulder injuries <30 yo are full rotator cuff tears |
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Definition
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Term
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Definition
overuse (strain, sprain)
subluxation of glenohumeral joint (adolescents) |
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Term
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Definition
subluxation or dislocation of the acromioclavicular joint
direct trauma on the point of the shoulder |
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Term
History of past disease related to shoulder injuries:
diabetes mellitus:
malignancy:
osteoporosis:
collagen disorder:
corticosteroids |
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Definition
diabetes - adhesive capsulitis
malignancy - metastatic disease
osteoporosis - fracture
collagen disorder - instability
corticosteroids - rotator cuff disease |
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Term
rotator cuff tears are see with
diagnosis is based on |
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Definition
pain and difficulty with abduction and external rotation of arm
history, exam and MRI |
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Term
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Definition
| deltoid and supraspinatus |
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Term
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Definition
| pectoralis major and latissimus dorsi |
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Term
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Definition
| deltoid and coracobrachialis |
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Term
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Definition
| teres major and latissimus dorsi |
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Term
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Definition
| teres major, latissimus dorsi, pectoralis major and subscapularis |
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Term
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Definition
| teres minor and infraspinatus |
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Term
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Definition
| overall shoulder range of motion and strength of abduction |
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Term
| full abduction of shoulder requires |
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Definition
| glenohumeral joint, rotator cuff tendons and functional AC joint, deltoid and rotator cuff muscles |
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Term
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Definition
like scratching your back
tests internal rotation |
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Term
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Definition
check external and internal rotation
resisted isometric movements
apply sufficient force to detect subtle weakness
note which movements cause pain
must compare with the unaffected side |
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Term
Manual Muscle Testing
arm adducted; elbow flexed
resisting forces inward and outward |
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Definition
external rotation - infraspinatus
internal rotation - subscapularis |
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Term
| infraspinatus/teres minor test |
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Definition
external rotation
pulling a rubberband apart |
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Term
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Definition
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Term
| muscle/tendon pathology tests |
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Definition
empty/full can test
lift off test
speeds test and yergasons test - biceps tests |
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Term
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Definition
| crossed arm adduction test |
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Term
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Definition
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Term
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Definition
supraspinatus
abducted arm with thumbs up
positive test is weaknesslift
without a healthy rotator cuff, the humerus floats upward and inflames the tnedons |
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Term
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Definition
hand at mid lumbar region; resist pushing toward back
subscapularis strength
positive test - weakness |
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Term
Impingement Syndrome
symptoms from...
caused by repetitive....
principle cause of... |
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Definition
compression of rotator cuff tendons and the subacromial bursa between the greater tubercle and lateral edge of acromion
caused by repetitive overhead reaching, pushing, pulling and lifting with arms outstretched
principle cause of rotator cuff tendonitis |
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Term
| impingement test is a diagnostic tool for determining if a limited range of motion is |
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Definition
| mechanical or secondary to pain from impingement |
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Term
to test impingement, ____ is injected into the _____ bursae
if _____ and ______ improve then impingement or RC tendonitis may be present |
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Definition
lidocaine into the subacromial bursae
range of motion and strength |
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Term
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Definition
assesses for a labral injury
apply axial compression to humerus |
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Term
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Definition
evaluates biceps tendon
pain with maneuver indicates biceps tendonitis |
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Term
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Definition
pain located to bicipital groove
suggestive of inflammation or lesions related to the long head of biceps or biceps/labral complex |
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Term
Instability Tests
Anterior:
Posterior:
Inferior: |
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Definition
anterior: apprehension test, Jobe's relocation maneuver
posterior: posterior apprehension
inferior: sulcus test |
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Term
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Definition
| tests for inferior laxity of the glenohumeral joint |
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Term
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Definition
common physical sign often asymptomatic
loss of serratus anterior muscle function - uncommon; damage to long thoracic nerve
loss of trapezius muscle function
weakness of all the scapula stabilizers
loss of the scapular suspensory mechanism
winging secondary to instability
secondary to pain
brachial plexus injury |
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Term
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Definition
axillary view - instability, dislocation
scapular Y view - dislocation
outlet view - shape of acromion
AC joint view - if suspicious of involvement |
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Term
| Differential Diagnoses of Shoulder Pain |
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Definition
impingement syndrome
RC tendonitis/ tear
bursitis
sprain/strain
fracure
dislocation/separation |
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