Comp 11 and OSCE Flashcards
what are the two functional joints of the shoulder?
- Suprahumeral
2. scapulothoracic
What are the two accessory joints of the shoulder?
- Costosternal
2. Costoverterbral
Which joints are involved in early shoulder abduction?
glenohumeral + suprahumeral
Which joints are involved in mid-late shoulder abduction?
scapulothoracic + sternoclavicular +acromioclavicular
When assessing the acromioclavicular ( AC) joint, internal rotation of the glenohumeral joint causes the AC joint to move in what direction and what is the normal ROM for the AC?
internal rotation, normal is about 10 degrees.
Explain how you’d test for sternoclavicular (SC) motion and are the normal motions when abducting and when during flexion.
Pt is supine and doc’s index finger is on clavicular head next to the sternum and ask patient to should shoulder for abduction. The distal end of the clavicle moves superiorly and proximal end moves inferiorly. Doc should feel an inferior movement at the SC joint. For adduction the motion would be opposite.
For flexion: doc places index finger on clavicular head next to sternum and pt flexes shoulder to 90 and reaches for ceiling forcefully. A posterior movement of clavicule should be palpated with normal motion at the SC joint. for Extension the motion is opposite.
when treating the scapulothoracic dysfunction, what is the patient’s and doc’s position?
pt is lateral recumbent, involved shoulder up, doc is facing the patient.
When treating the scapulothoracic dysfunciton using MFR, explain how a direct MFR would be treated.
Apply direct force toward restrictive barriers of the named motion pattern of the scapula and maintain force until tissue creep is felt. multiple restrictive barriers can be stacked.
Define what kind of technique the spencer’s technique is and what joint it treats.
Low velocity high amplitude springing articulatory technique that treats the GH joint involving the six motions: F, E, Ab, Ad, IR, ER).
When treating the GH using spencer’s technique, what is the patient’s and doc’s position?
Patient is lateral recumbent with affected shoulder up. Patient’s knee and hips are flexed, back straight and perpendicular to table, head supported by a pillow. Doc stands on the side of table facing patient.
Before performing spencer’s how do you prep the patient and what joints are locked?
Grab pt’s forearm with one hand flexing the pt’s elbow and the other hand is placed on top of shoulder to lock the shoulder girdle, limiting scapular movement.
What is the order of the spencer’s technique?
- Extension
- Flexion
- Circumduction
- Circumduction w/traction
- Abduction/adduction
- Internal rotation
- Traction stretch.
In the spencer’s technique, how is the circumduction technique performed?
Flex pt’s elbow sharply and abduct shoulder to 90. Lock patient’s shoulder in position and use pts elbow as pivot and rotate the shoulder in a circum fashion increasing diameter with each motion. start CW then CCW.
In Spencer’s technique, how is the internal rotation technique performed?
place pt’s hand behind their lower ribs with the elbow flexed. physician’s uses upper hand to lock scapula and lower hand to draw pt’s elbow forward and down (internal rotation).
(11c) ME tx for Flexion/Extension GH dysfunction
A. what is the normal ROM for Flexion and Extension?
B. When assessing these motion, where is linkage blocked?
C. What is the patient’s and doc’s position?
D. To tx flexion dysfunction, what is the patient’s activating force? during extension dysfunction?
A. Flexion 180; Extension 60
B. at the ipsilateral AC joint
C. Pt seated with doc standing behind pt.
D. For flexion tx patient’s activating force is towards flexion. For extension tx patient’s activating force is towards extension.
