Approach to Shoulder Complaint Flashcards
what is unique about the shoulder joint?
It is the only joint where tendons pass between bones
what is the most sensitive indicator of joint disease?
range of motion
where should you check the neurovascular status at?
distal to the site of the injury
what is the painful arc test used to test?
subacromial impingement and rotator cuff tendon injury
what is the cross arm test used to test?
acromioclavicular joint/ ligament injury
what is unique about the painful arc test compared to all of the rotator cuff maneuvers?
it has the highest positive LR and the lowest negative LR
what is a positive painful arc test?
shoulder pain from 60-120 degrees
what is the triceps reflex testing?
C6-C7
what is the biceps reflex testing?
C5-C6
what is the brachioradialis reflex testing?
C5-C6
what is the normal grade for a reflex?
2/4
what is the normal grade for a pulse?
2/3
where should you always check the pulse/ capillary refill?
distal to the site of the injury
clavicle fractures most often occur in what demographic?
kids and young adults
proximal humerus fractures most often occur in what demographic?
in the elderly
what are scapular fractures associated with?
blunt trauma
what is the most common type of glenohumeral dislocation?
anterior dislocation
what do acromioclavicular joint injuries usually occur from?
direct trauma to the superior or lateral aspect of the shoulder with the arm adducted (direct blow or falling onto the shoulder)
what type of painful ROM is associated with acromioclavicular joint injuries?
pain with abduction
what tendons make up the rotator cuff?
supraspinatus, infraspinatus, teres minor, and subscapularis
what tendon is most often injured in rotator cuff injuries?
supraspinatus tendon
What are the symptoms of a rotator cuff injury?
shoulder pain over the lateral deltoid more prevalent with overhead activity and at night
what diagnostic tests are of choice for a rotator cuff injury?
ultrasound and/or MRI
what are the life threatening causes of shoulder pain?
septic arthritis, referred pain from an acute MI, intraperitoneal hemorrhage, and a lung pathology
what does the scapula joint motion require?
clavicle motion
what does the distal clavicle articulate with?
acromion
what does the proximal clavicle articulate with?
the sternum
what happens to the distal clavicle when the scapula depresses?
inferior glide (of the AC joint)
what happens to the proximal clavicle when the scapula depresses?
superior glide (of the SC joint)
what happens to the clavicle when the glenohumeral joint externally rotates?
the clavicle will externally rotate at the AC joint
what happens to the clavicle when the glenohumeral joint internally rotates?
the clavicle will internally rotate at the AC joint
what happens to the GH joint when the scapula depresses?
adduction
what happens to the GH joint when the scapula elevates?
abduction
what happens to the scapula when the GH joint flexes?
protraction
what happens to the scapula when the GH joint extends?
retraction
if you have a superior AC joint somatic dysfunction, where is the direct barrier?
inferior pressure to the distal clavicle
if you have an internal rotation somatic dysfunction, where is the direct barrier?
GH external rotation
if you have an inferior glide somatic dysfunction of the SC joint, where is the GH direct barrier?
GH adduction
if you have a superior glide somatic dysfunction of the SC joint, where is the GH direct barrier?
GH abduction
if you have an anterior glide somatic dysfunction of the SC joint, where is the GH direct barrier?
GH flexion
if you have a posterior glide somatic dysfunction of the SC joint, where is the GH direct barrier?
GH extension
