Ch 22 The Shoulder Complex Flashcards
Muscles in the rotator cuff
supraspinatus, infraspinatus, teres minor, subscapularis
Other muscles in the shoulder region
latissimus dorsi, pectoralis major, teres major, coracobrachialis, rhomboids, deltoids
in what ways is the shoulder movable?
extension, flexion, rotation, circumduction
What makes the shoulder so unstable?
flat glenoid fossa, round humerus head. 50% of dislocations in body, esp vulnerable in overhead position
What helps provide additional stability?
glenoid labrum (similar to knee meniscus), and glenohumeral joint capsule
brachial plexus nerves
(C5,6,7,8,T1)
prevention of shoulder injuries
maintenance strengthening, tackling/falling correctly, correct biomechanics
Clavicle fracture
Mech: Foosh, direct hit. S&S: deformity, inability to raise arm, support of arm. MGMT: sling, refer to MD, Figure 8 brace, surgery
Scapular fracture
Mech: direct blow. S&S: inability to move shoulder, pain. MGMT: refer for x-rays, sling
humerus fracture
Mech: FOOSH, direct blow, dislocation. S&S: difficult to determine if there is no deformity, pain, swelling. MGMT: refer for x-rays, sling, surgery
Sternoclavicular joint sprain
Mech: FOOSH. S&S: pain with shoulder mvmt, point tender. MGMT: RICE, rehab
Acromioclavicular joint sprain
Mech: FOOSH, direct blow to shoulder. S&S: pain with overhead movement, step off deformity??, swelling. MGMT: RICE, rehab
Dislocation/Subluxation
Mech: abduction, external rotation, extension. It usually dislocates anteriorly. S&S: flattened deltoid, inability to move arm. MGMT: refer for reduction
Bankart lesion
Glenohumeral lig defect anteriorly
Hill-Sachs lesion
cartilage defect
SLAP lesion
labrum defect
anterior instability
seen in overhead athletes after dislocation/subluxation. mech: stretched capsule, torn/stretched ligaments, poor rotator cuff stretch. -> excessive mvmt of head of humerus, generalized shoulder pain, and loss of forceful mvmt. MGMT: strengthen rotator cuff, eccentric mvmts, scapular stabilizers, CORE, surgery.
shoulder impingement
Mech: compression of subacromial bursa, supraspinatus tendon, and the long head of the biceps tendon caused by overhead activity, recurrent instability. S&S: generalized shoulder pain in overhead activity. MGMT: Ice, avoid aggravating activities, strengthen rotator cuff and scapular stabilizers
adhesive capsulitis
Frozen shoulder. capsule around glenohumeral joint becomes stiff and fibrotic. Caused by: surgery with inadequate rehab, age, or a systemic disease such as diabetes or cardiopulmonary problems. MGMT: aggressive stretching
biceps brachii rupture
Mech: forceful contraction. S&S: snap, deformity in the muscle belly, weakness with elbow flexion. MGMT: ice, refer to MD, surgery.
throwing
wind up: prep for movement. cocking: shoulder reaches full extension. acceleration: concentric forward movement. deceleration: eccentric slowing of arm. follow through: regain balance
rehab
Some injuries/surgeries require immobilization. may begin easy conditioning, ROM, isometric strengthening. Early easy movement to avoid frozen shoulder, kept below 90/90 plane. strengthen: rotator cuff, scapular stabilizers, core. functional progressions for tennis, golf, and throwing
scapular stabilizer muscles
levator scapulae, trapezius, rhomboids, and the serratus anterior/posterior
with a sternoclavicular sprain the clavicle is generally displaced in what direction?
upward and anteriorly
winging of only one scapula indicates injury to which structure?
long thoracic nerve
the drop arm test is used to determine injury to which muscle?
supraspinatus
the most important and most commonly injured bursa in the shoulder is the__?
the subacromial bursa
