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MSc Physiotherapy > AROM, PROM & MMT of Shoulder > Flashcards

AROM, PROM & MMT of Shoulder Flashcards

1
Q

What movements are possible at the shoulder?

A 
Flexion/Extension
Abduction/Adduction
Medial/Lateral rotation
Elevation/Depression
Protraction/Retraction

Would evaluate these movements from anterior and posterior aspects

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2
Q

What functional movements could you ask them to do?

A 
Lifting something
Getting something from cupboard
Fastening bra
Washing hair
Taking off jacket
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3
Q

How would you conduct goniometry of flexion?

A

Pt - half lying or seated, arm at side, palm facing medially
PT - to side and back diagonally
Axis - lateral aspect of humeral head centre, 2.5cm inferior to lateral aspect of acromion
Stationary arm - parallel with midline of trunk
Moveable arm - lateral epicondyle of humerus
Command - keep elbow straight, move arm forwards and upwards as far as you can

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4
Q

How would you conduct goniometry of extension?

A

Pt - prone, arm rested on plinth, palm facing medially
PT - to side and back diagonally
Axis - lateral aspect of humeral head centre, 2.5cm inferior to lateral aspect of acromion
Stationary arm - parallel with midline of trunk
Moveable arm - lateral epicondyle of humerus
Command - keep elbow straight, move arm backwards as far as you can

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5
Q

How would you conduct goniometry of abduction?

A

Pt - supine on plinth, palm face medially
PT - to side and back diagonally
Axis - placed over anterior midpoint of GH joint, 1.5cm inferior and lateral to coracoid process
Stationary arm - parallel with mid sternal line
Moveable arm - lateral epicondyle of humerus
Command - keep elbow straight, move arm outwards and upwards toward your head as far as you can, keep your palm facing inwards

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6
Q

How would you conduct goniometry of adduction?

A

Pt - supine on plinth, palm face medially
PT - to side and back diagonally
Axis - placed over anterior midpoint of GH joint, 1.5cm inferior and lateral to coracoid process
Stationary arm - parallel with mid sternal line
Moveable arm - lateral epicondyle of humerus
Command - keep elbow straight, move arm inwards across body towards opposite side

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7
Q

How would you conduct goniometry of internal rotation?

A

Pt - supine on plinth, shoulder at 90degrees abduction, elbow flexed at 90 degrees, forearm pronated, towel under humerus
PT - to side
Axis - olecranon process of ulna
Stationary arm - parallel to floor
Moveable arm - parallel to ulna to styloid process
Command - move palm downwards towards floor

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8
Q

How would you conduct goniometry of external rotation?

A

Pt - supine on plinth, shoulder at 90degrees abduction, elbow flexed at 90 degrees, forearm pronated, towel under humerus
PT - to side
Axis - olecranon process of ulna
Stationary arm - parallel to floor
Moveable arm - parallel to ulna to styloid process
Command - move palm backwards towards plinth

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9
Q

Capsular pattern of shoulder

A

Active and passive movements restricted

External rotation > Abduction > Internal rotation

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10
Q

Prime movers of shoulder flexion

A 
Anterior deltoid
Pec major (clavicular part)
Coracobrachialis
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11
Q

Prime movers of shoulder extension

A

Posterior deltoid
Latissimus dorsi
Teres major

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12
Q

Prime movers of shoulder abduction

A

Deltoid

Supraspinatus

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13
Q

Prime movers of shoulder lateral rotation

A

Infraspinatus
Teres minor
Posterior deltoid

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14
Q

Prime movers of shoulder medial rotation

A

Latissimus dorsi
Anterior deltoid
Pec major
Subscapularis

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15
Q

Prime movers of horizontal adduction

A

Pec major

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16
Q

Expected ROM of shoulder extension

A

0-60

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17
Q

Expected ROM of shoulder internal rotation

A

0-70

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18
Q

Expected ROM of shoulder external rotation

A

0-90

19
Q

Expected ROM of horizontal adduction

A

0-135

20
Q

Expected ROM of flexion (elevation)

A

0-180 (0-60 GH)

21
Q

Expected ROM of abduction (elevation)

A

0-180 (0-30 GH)

22
Q

End feel of extension, int rotation, ext rotation and flexion

A

Firm

Tissue stretch

23
Q

End feel of horizontal adduction

A

Firm/Soft

Tissue stretch/apposition

24
Q

End feel of abduction

A

Firm/hard

Tissue stretch/bone

25
Q

How would you assess AROM of flexion?

A

Ask pt to have arms by side with thumbs facing forward
Ask pt to lift both arms, keeping them straight, out in front of them and all the way above their heads as far as they can go

26
Q

How would you assess AROM of extension?

A

Ask pt to have arms by side with thumbs facing forward
Ask pt to move arms back as far as possible
Ensure pt movement is in shoulder and does not compensate by leaning forward or rotating scapula

27
Q

How would you assess AROM of abduction?

A

Pt in anatomical position
Ask them to have arms by side with hands facing forward
Ask them to raise both arms up to the side of their head as far as they can

28
Q

How would you assess AROM of lateral rotation?

A

Ask pt to bend elbow to 90
Keep upper arm and elbow tight in to their side
Ask them to move wrist and hands out to the side as far as they can
Make sure they are not abducting arm

29
Q

How would you assess AROM of medial rotation?

A

Ask patient to reach as far up their back as possible with their thumb

Normal = reaching spinous processes of T5-T10

30
Q

How would you assess AROM of horizontal adduction?

A

Ask pt to bring arms out so they are in line with shoulders

Ask pt to bring arms across body as far as they can

31
Q

How would you assess AROM of protraction?

A

Ask pt to bring shoulders as far as they can to the front as if they are trying to make them touch in front of them

32
Q

How would you assess AROM of retraction?

A

Ask pt to squeeze shoulder blades together as if you are trying to make them touch behind you

33
Q

How would you assess AROM of elevation?

A

Ask pt to shrug shoulders bringing them up to their ears

34
Q

How would you assess AROM of depression?

A

Ask them to do the opposite of shrugging shoulders

Pushing them as far as possible towards the floor as they can

35
Q

How would you conduct resisted isometric testing of flexion?

A

PT to side of pt
One hand at middle of anterior arm pushing backwards
Ask pt to bring arms forward and meet your resistance

36
Q

How would you conduct resisted isometric testing of extension?

A

PT to side of pt
One hand at middle of posterior arm pushing forwards
Ask pt to move arms backwards and meet your resistance

37
Q

How would you conduct resisted isometric testing of abduction?

A

PT in front of pt
Place both hands on both arms
Ask pt to lift arms up and out to the side and meet your resistance

38
Q

How would you conduct resisted isometric testing of lateral rotation?

A

PT in front of pt
Ask pt to bend elbow, keeping arm and elbow in to their side
PT places hand on lateral arm and ask pt to move forearm out to the side to meet your resistance

39
Q

How would you conduct resisted isometric testing of medial rotation?

A

PT in front of pt
Ask pt to bend elbow, keeping arm and elbow in to their side
PT places hand on medial arm and ask pt to move forearm inwards to meet your resistance

40
Q

How would you clear the neck?

A

Do a full assessment of AROM of the joint to see if any movements replicate their symptoms

Flexion/Extension (bring chin to chest)
Rotation - turn head to left and right

41
Q

How would you clear the elbow?

A

Do a full assessment of AROM of the joint to see if any movements replicate their symptoms

Flexion/Extension
Supination/Pronation

42
Q

Prime mover of scapula elevation

A

Descending part of trapezius

43
Q

Prime mover of scapula protraction

A

Serratus anterior

44
Q

Prime mover of scapula retraction

A

Middle part of trapezius

MSc Physiotherapy (5 decks)

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