Banner shoulder instability Flashcards
What is this:
Inability to maintain the humeral head centered in the glenoid fossa
instability
What is this:
Capacity of the humeral head to be translated or rotated from a reference position
Allows shoulder to attain full range of functional motion
laxity
What are two categories of stabilizers?
static
dynamic
What are the two types of static stabilizers?
articular anatomy
capsuloligamentous structures
What are the two types of dynamic stabilizers?
rotator cuff
long head biceps brachii
When do your shoulder muscles relax and ligaments relax and do not undergo tension, but the shoulder is still stable?
when you sleep
What is the glenohumeral stabilizing system?
- glenoid concavity
- scapula
- capsuloligamentous restraints
- muscles compress head into glenoid
- adhesion- cohesion of articular surface
What does the rotator cuff do?
compression of humeral head into glenoid and stears the humeral head into glenoid during arm movement
What does the long head of the biceps do for the shoulder?
stabilizes anterior and superior translation of humeral head
How does the deltoid help out the shoulder?
compesses proximal humerus into CA arch
What does the superior glenohumeral ligament do for the shoulder?
restraint against inferior forces when arm is adducted
What does the:
restraint to translation and rotation
in mid to low range of abduction
middle glenohumeral ligament
What does this:
thick anterior with thinner posterior band and a thin interposed axillary pouch. Causes restraint to translation and rotation. Such as arm abduction, extended, externally rotate
inferior glenohumeral ligament
The capsule of the shoulder gets tight anteriorly with what kind of rotation? tight posteriorly?
external rotation
internal rotation
What kind of shoulder instability is this:
manifesting as pain at the shoulder or upper arm with overhead activities
subtle
What kind of shoulder instability is this:
inability to perform overhead activities without apprehension (sense that the shoulder could dislocate)
mild to moderate
What kind of shoulder instability is this:
easily dislocate voluntarily or involuntarily during any activities, overhead or otherwise
severe
What are these: Demonstrate position & actions of instability and initial injury Observe Scapulothoracic Motion Provocative Tests Glenoid Cavity Competence Muscle Exam Laxity Tests Screening Cervical Spine Exam
physical exams to assess the shoulder
What are three provocative exam to compare shoulders?
apprehension test
relocation test
surprise test
Which test is this:
supine, shoulder abducted 90°, elbow flexed 90°
Examiners knee support elbow to prevent extension
extremity slowly externally rotated by 2 fingers on wrist
Positive = pain, stretch, apprehension
apprehension test
Which test is this:
Same starting position as apprehension test
Examiner puts posterior force on proximal humerus
External Rotation as above
Positive = relief of symptoms elicited with apprehension test
relocation test
Which test is this:
Hold final position of relocation test
Quickly remove force from proximal humerus
Positive = sudden return of symptoms
surprise test
How can you check on the supraspinatous?
check ability to resist forward flexion in internal rotation
How do you check on the infraspinatous
check ability to resist external rotation
How do you check on the subscapularis?
internal rotation with hand on stomach
What part of the glenohumeral joint has the most instability?
What nerve are you worried about here?
the anterior part (happens to pitchers)
axillary nerve
What tests tell you if you have anterior instability?
drawer and load-and-shift test, and apprehension and relocation tests positive
How can you tell if someone has a posterior instability?
present with arm externally rotated and a prominent humeral head on the posterior shoulder.
What is this:
Inherent elasticity in the connective tissues, and not a discreet injury
Athletes with congenital hyperlaxity of multiple joints in sports requiring overhead arm motions
Vague symptoms with activity
Usually rotator cuff weakness
Drawer and load-and-shift tests
anterior and posterior displacement without popping
Positive sulcus test with pain
Associated Scapulothoracic Dyskinesis
multidirectional instability
