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Eshe 201 > Exam 3- Shoulder > Flashcards

Exam 3- Shoulder Flashcards

1
Q

Apprehension of shoulder- positive sign

A

Apprehension displayed by the athlete

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2
Q

Apprehension of shoulder- how to perform

A

Grab the arm, place one hand on the scapula and tries to push the shoulder into external rotation

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3
Q

Drop arm- structure/condition

A

Integrity of the supaspinatus

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4
Q

Drop arm- positive sign

A

Increased pain or unable to hold up arm

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5
Q

Drop arm- how to perform

A

Individual takes arm all the way above, from 0 to 180 degrees. Drops them down to 90 degrees and pauses

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6
Q

Empty can- structure/condition

A

Integrity of the supraspinatus

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7
Q

Empty can- positive sign

A

Pain in the affected area, inability to hold up arm

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8
Q

Empty can- how to perform

A

Raise arms to 180 degrees, then down to 90, internal rotate 30 degrees, then “empty out cans.” Can add pressure if needed.

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9
Q

Hawkins-Kennedy impingement test- structure/condition

A

Impingement of the supraspinatus or the bicep tendon

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10
Q

Hawkins-Kennedy impingement test- positive sign

A

Increased pain

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11
Q

Hawkins-Kennedy impingement test- how to perform

A

Pick the arm up and internally rotate it (hawk, bird, motion)

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12
Q

Yergasons- structure/condition

A

Integrity of the bicep tendon

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13
Q

Yergasons- positive test

A

Pain or the tendon popping out of the bicepital groove where the athlete palates

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14
Q

Yergasons- how to perform

A

Resist supinations with external rotation

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15
Q

Neer shoulder impingement- structure/condition

A

Impingement of supraspinatus

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16
Q

Neer shoulder impingement- positive sign

A

Pain

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17
Q

Neer shoulder impingement- how to perform

A

Passively abduct the shoulder near the ear

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18
Q

Sternoclavical (SC) joint

A

Joint between the sternum and clavicle

Allows for rotation during movements like shrugging the shoulders and reaching above the head

Supported by:
Anterior and posterior SC ligaments
Costoclavicular ligament
Interclavicular ligament

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19
Q

Acromioclavicular (AC) joint

A

Lies between the acromion process and the clavicle

Has limited motion

Primary ligament: AC ligament
Secondary ligaments: coracoacromial ligament, coracoclavicular ligament

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20
Q

Glenohumeral (GH) joint

A

True shoulder joint

Glen kid fossa of the scapula
Very shallow

Head of the humerus (3/4 times larger than glenoid (VB/plunger)

Lacking in bony stability

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21
Q

GH joint (continued)

A

Joint is deepened by a meniscus like structure called the glenoid labrum
Functions to add stability

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22
Q

GH joint stabilizers

A 
Stabilized by 2 types of stabilizers 
     Static stabilizers
         Joint capsule
         Several Glenohumeral ligaments
     Dynamic stabilizers
         Rotator cuff muscles (supraspinatus, infraspinatus, teres minor, subscapularis)
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23
Q

Bursa

A

Subacromial (clinically most important)

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24
Q

Nerve supply

A

Brachial plexus (C5-T1)

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25
Q

Blood supply

A

Subclavian, axillary artery

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26
Q

Shoulder movements

A 
Flexion (180) & extension (80-90)
Abduction (180) and adduction 
Horizontal adduction/flexion (180)
Horizontal abduction/flexion (60)
External rotation (90)
Internal rotation (90)
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27
Q

ROM/ muscle testing

Shoulder flexion

A

Anterior delt/pec major

28
Q

ROM/ muscle testing

Shoulder extension

A

Posterior delt

29
Q

ROM/ muscle testing

Shoulder abduction

A

Supraspinatus/ middle delt

30
Q

ROM/ muscle testing

Shoulder adduction

A

Pec major/ lats

31
Q

ROM/ muscle testing

Shoulder internal rotation

A

Ant. Delt/ subscapularis

32
Q

ROM/ muscle testing

Shoulder external rotation

A

Infraspinatus/ teres minor

33
Q

ROM/ muscle testing

Horizontal ADD/flex

A

Anterior delt

34
Q

ROM/ muscle testing

Horizontal ABD/ ext

A

Posterior delt

35
Q

ROM/ muscle testing

A

Scapula elevation
Depression
Protraction
Retraction

36
Q

Prevention of shoulder injuries

A 
Proper physical conditioning is key
Develops body specific regions relative to sport 
Warm up
Proper falling tactic for some sports
Correct equipment 
Mechanics vs overuse injuries
37
Q

Preventing shoulder problems

A

General muscle strengthening
Stretch for shoulder capsule
Strengthen rotator cuff muscles
Strengthen scapular stabilizers (push/press ups)

38
Q

Throwing mechanics: windup phase

A

First movement until ball leaves glove hand

Lead leg strides forward while both shoulders abduct, externally rotate and horizontally abduct

39
Q

Throwing mechanics: cocking phase

A

Hands separate (achieve max. External rotation) while lead foot comes in contact with ground

40
Q

Throwing mechanics: acceleration

A

Max external rotation until ball release (humerus adducts, horizontally adducts and internally rotates)

Scapula elevates and abducts and rotates upward

41
Q

Throwing mechanics: deceleration phase

A

Ball release until max shoulder internal rotation

Eccentric contraction of ext. rotators to decelerate humerus while rhomboids decelerate scapula

42
Q

Throwing mechanics: follow-through phase

A

End of motion when athlete is in a balanced position

43
Q

Clavicle fractures: cause of injury

A

Fallen on outstretched hand (FOOSH), fall on tip of shoulder or direct impact

Occur primarily in middle third (greenstick fracture often occurs in young athletes)

44
Q

Clavicle fractures: signs of injury

A

Generally presents with supporting of arm, head tilted towards injured side with chin turned away

Clavicle may appear lower

Palpation reveals pain, swelling, deformity and point tenderness

45
Q

Clavicle fractures: care

A

Closed reduction: sling and swathe, immobilize w/ figure 8 brace for 6-8 weeks

Removal of brace should be followed with joint ,mobes, isometrics and use of a sling for 3-4 weeks

Occasionally requires operative management

46
Q

Sternoclvicular sprain: cause of injury

A

Indirect force, blunt trauma (may cause displacement)

47
Q

Sternoclvicular sprain: signs of injury

A

Grade 1: pain and slight disability
Grade 2: pain, subluxation w/ deformity, swelling and point tenderness and decreased ROM
Grade 3: gross deformity (dislocation), pain, swelling , decreased ROM
-possibly life threatening if dislocates posteriorly

48
Q

Sternoclvicular sprain: care

A

PRICE, immobilization

Immobilize for 3-5 weeks followed by graded reconditioning

49
Q

Apprehension of shoulder- structure/condition

A

Possible shoulder subluxations

50
Q

Acromioclavicular sprain: cause of injury

A

Result of direct blow (from any direction), upward force from humerus, FOOSH

51
Q

Acromioclavicular sprain: signs of injury

A

Grade 1: point tenderness and pain w/movement; no disruption of AC joint
Grade 2: tear or rupture of AC ligament, partial displacement of lateral end of clavicle; pain, point tenderness and decreased ROM
Grade 3: rupture of AC and CC ligaments with dislocation of clavicle; gross deformity (step deformity) pain loss of function and instability

52
Q

Acromioclavicular sprain: care

A

Ice, stabilization, referral to physician
Grades 1-3 (non-operative) will require 3-4 days (grade 1) and two weeks of immobilization (grade 3)

Aggressive rehab is required with all grades

53
Q

Glenohumeral dislocations: cause of injury

A

Head of humerus is forced out of the joint

Anterior dislocation is the result

54
Q

Glenohumeral dislocations: sighs of injury

A

Flattened deltoid, prominent numeral head in axilla, arm carried in slight abduction and external rotation, moderate/severe pain and disability

55
Q

Glenohumeral dislocations: care

A

RICE, immobilization and reduction by a physician
Begin muscle re-conditioning ASAP
Use of sling should continue for 1 week
Progress to resistance exercises as pain allows

56
Q

Shoulder impingement syndrome: cause of injury

A

Mechanical compression of supraspinatus tendon, glenoid labrum, subacromial bursa and long head of biceps tendon due to decreased space under coroacromial ligament

Seen in over head repetitive activities; painful arc 70-120 degrees of AB

57
Q

Shoulder impingement syndrome: Signs of injury

A

Diffuse pain, pain on palpation of subacromial space
Decreased strength of external rotators compared to internal rotators; tightness in posterior and inferior capsule
Positive impingement

58
Q

Shoulder impingement syndrome: Care

A

Restore normal biomechanics in order to maintain space
Strengthening of rotator cuff and scapula stabilizing muscles
Stretching of posterior and inferior joint capsule
Modify activity

59
Q

Rotator cuff tear: cause of injury

A

Involves supraspinatus or rupture if other rotator cuff tendons
Primary mechanism- acute trauma (high velocity rotation)
Occurs near insertion on greater tuberosity
Full thickness tears usually occur in those athletes w/ a long history of impingement or instability

60
Q

Rotator cuff tear: signs of injury

A

Present with pain with muscle contraction
Tenderness on palpation and loss of strength due to pain
Loss of function, swelling
With complete tear impingement and empty can test are positive

61
Q

Rotator cuff tear: care

A

RICE for modulation of pain
Progressive strengthening of rotator cuff
Reduce frequency and level of activity initially with a gradual and progressive increase of intensity

62
Q

Shoulder bursitis: etiology

A

Chronic inflammatory condition due to trauma of overuse

May develope from direct impact or fall on tip of shoulder

63
Q

Shoulder bursitis: signs of injury

A

Pain with motion and tenderness during palpation in subacromial space; positive impingement tests

64
Q

Shoulder bursitis: management

A

Cold packs and NSAIDs to reduce inflammation
Remove mechanisms precipitating condition
Maintain full ROM to reduce chances of contracture and adhesions from forming

65
Q

Bicepital tendinitis: cause of injury

A

Repetitive overhead athlete- ballisitic activity that involves repeated stretching of bicep tendon and sheath

66
Q

Bicepital tendinitis: signs of injury

A

Tenderness over bicipital groove, swelling, crepitus due to inflammation
Pain with performing overhead activities
Pain with yergusons test

67
Q

Bicepital tendinitis: care

A

Rest and ice
NSAIDs
Gradual program of strengthening and stretching

Eshe 201 (1 decks)

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