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ECOS > Approach to Shoulder Complaint > Flashcards

Approach to Shoulder Complaint Flashcards

1
Q

shoulder flexion ROM

A

180°

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2
Q

shoulder extension ROM

A

60°

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3
Q

shoulder abduction ROM

A

180°

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4
Q

shoulder internal/external ROM

A

90°

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5
Q

shoulder horizontal abduction ROM

A

40-55°

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6
Q

shoulder horizonal adduction ROM

A

130-140°

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7
Q

dermatome over the AC joint

A

C4

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8
Q

dermatome over the lateral aspect of the lower edge of the deltoid muscle moving into the anterior middle portion of arm and forearm

A

C5

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9
Q

dermatome of radial side of forearm and thumb

A

C6

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10
Q

dermatome of palmar side of middle finger and posterior middle portion of arm and forearm

A

C7

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11
Q

dermatome of the 5th digit and medial portion of arm and forearm

A

C8

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12
Q

dermatome of the medial aspect of antecubital fossa, proximal to the medial epicondyle of the humerus

A

T1

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13
Q

dermatomes of the biceps and brachioradialis Ms.

A

C5-6

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14
Q

dermatomes of the triceps M.

A

C6-7

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15
Q
  • patient: shoulder abducted to 90° and elbow flexed to 90°
  • stabalize shoulder and force arm into external rotation
  • (+) test: patient apprehension
  • indicates: glenohumeral instability
A

apprehension test

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16
Q
  • patient: flex shoulder to 90° and abduct to 45°
  • internally rotate arms so thumbs are pointed down, press down on forearms while patient resists
  • (+) test: pain or weakness
  • indicates: supraspinatus pathology
A

empty can test

17
Q
  • patient: abducts arm to 90°, then slowly drops arm to neutral, can also be down w/ gentle tap on the wrist
  • (+) test: uncontrolled arm drop
  • indicates: supraspinatus pathology
A

drop arm test

18
Q
  • patient: abducts arm starting at neutral
  • (+) test: pain between 60-120° of abduction
  • indicates: subacromial bursa impingement and/or rotator cuff injury
A

painful arc test

19
Q
  • stabalize shoulder and pronate forearm outward, passively flex shoulder into full flexion
  • (+) test: pain
  • indicates: subacromial bursa impingement or rotator cuff impingement
A

Neer’s Test or Neer’s Impingement

(“Neer to the Ear”)

20
Q
  • patient: flex shoulder to 90° and elbow to 90°
  • passively internally rotate shoulder
  • (+) test: pain
  • indicates: subacromial bursa impingement or rotator cuff impingement
A

Hawkin’s Test

21
Q
  • passively adduct arm across patient’s chest and rest patient’s hand on their opposite shoulder
  • monitor posterior aspect of AC joint
  • (+) test: AC joint pain or increased TTA’s
  • indicates: AC joint pathology
A

Cross Arm Test

22
Q

Most common type of shoulder dislocation:

A

anterior dislocation (95-97% of cases)

23
Q

Most common rotator cuff tendon to be injured:

A

supraspinatus

24
Q

Most common causes of shoulder pain:

A

rotator cuff injuries (acute) and myofascial injuries (acute)

25
Q

scapular depression causes distal clavicle (AC joint) to ______ ______ and proximal clavicle (SC joint) to ______ ______

A

scapular depression causes distal clavicle (AC joint) to inferior glide (clavicle inferior to acromion) and proximal clavicle (SC joint) to superior glide (clavicle superior to sternum)

*vice versa for scapular elevation*

26
Q
  • GH joint motion: adduction
  • scapular motion:
  • clavicle AC joint:
  • clavicle SC joint:
A
  • GH joint motion: adduction
  • scapular motion: depression
  • clavicle AC joint: inferior glide
  • clavicle SC joint: superior glide
27
Q
  • GH joint motion: abduction
  • scapular motion:
  • clavicle AC joint:
  • clavicle SC joint:
A
  • GH joint motion: abduction
  • scapular motion: elevation
  • clavicle AC joint: superior glide
  • clavicle SC joint: inferior glide
28
Q
  • GH joint motion: flexion
  • scapular motion:
  • clavicle AC joint:
  • clavicle SC joint:
A
  • GH joint motion: flexion
  • scapular motion: protraction
  • clavicle AC joint: anterior glide
  • clavicle SC joint: posterior glide
29
Q
  • GH joint motion: extension
  • scapular motion:
  • clavicle AC joint:
  • clavicle SC joint:
A
  • GH joint motion: extension
  • scapular motion: retraction
  • clavicle AC joint: posterior glide
  • clavicle SC joint: anterior glide
30
Q
  • GH joint motion: internal rotation
  • scapular motion:
  • clavicle AC joint:
  • clavicle SC joint:
A
  • GH joint motion: internal rotation
  • scapular motion: n/a
  • clavicle AC joint: internal rotation
  • clavicle SC joint: n/a
31
Q
  • GH joint motion: external rotation
  • scapular motion:
  • clavicle AC joint:
  • clavicle SC joint:
A
  • GH joint motion: external rotation
  • scapular motion: n/a
  • clavicle AC joint: external rotation
  • clavicle SC joint: n/a
32
Q
  • glenohumeral joint tx
  • patient lays prone w/ arm off table
  • grasp humeral head and assess ease and restriction by using distraction, compression, twist, and shear
  • engage either direct or indirect barrier until release is felt
A

shoulder myofascial release

33
Q
  • GH joint tx
  • engage 7 stages of articulatory movement of shoulder: ext/flex, compression circumduction, traction circumduction, abduction w/ ext rot, adduction, internal rot, traction w/ inferior glide
  • patient lays lateral recumbent w/ involved shoulder up
  • MET can be included once restrictive barrier has been engaged
A

Spencer’s Technique

34
Q
  • AC tx
  • doc: ipsilateral side or behind patient
  • grasp elbow or forearm and monitor clavicle between thumb and fingers
  • apply anterior/inferior pressure w/ thumb on lateral clavicle while flexing patient’s elbow; extending and adducting humerus (to gap AC joint)
  • shoulder is moved into a circulatory sweep, posterior, superior, then anteromedial
A

superior clavicle articulatory technique

35
Q
  • patient: supine w/ neck fully flexed by physician
  • doc: thumb over sternal end of clavicle, exerting a downward/caudal pressure on the clavicle
  • patient instructed to inhale and exhale fully, during exhalation, physician springs the clavicle inferiorly/caudally
  • tx: elevated SC joint = adducted SC joint
A

adducted SD articulatory technique

36
Q
  • patient: supine
  • doc: ipsilateral side
  • monitor at clavicular head and place other hand behind scapula, patient holds physician’s shoulder
  • physician flexes the clavicle toward the manubrium pulling scapula anteriorly
  • posterior force simultaneously applied to proximal clavicle from anterior to posterior to engage restrictive barrier
  • apply principles of MET
  • tx: anterior SC joint = extension SC joint
A

extension SD MET

37
Q
  • patient: supine
  • doc: ipsilateral side
  • monitor on the sternal clavicular head, place arm into extension and internal rotation
  • patient is instructed to raise arm against physician’s hand toward ceiling applying principles of MET
  • tx: elevated SC joint = adducted SC joint
A

adducted SD MET

38
Q
  • patient: supine
  • doc: contralateral side
  • patient gaps the SC joint by adducting th ipsilateral arm (using their contralateral hand to aid in the motion)
  • articulatory springing is applied laterally, posteriorly, and inferiorly over medial end of clavicle
  • tx: anterior SC joint = extension SC
A

extension SD articulatory technique

ECOS (6 decks)

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