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Rec and Care > Final - Shoulder > Flashcards

Final - Shoulder Flashcards

1
Q

3 bones of the shoulder

A

clavicle, scapula, humerus

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2
Q

4 joints of the shoulder

A

sternoclavicular
acromioclavicular
glenohumeral
scapulothoracic

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3
Q

clavicle - 3

A

slender s that limits shock to upper limb - distal part is the weakest (where it changes shape - #)
from sternum to acromion process
support ant aspect of shoulder

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4
Q

shoulder separation or SC SS - 3

MOI

A

ladder, cant abduct arm or move shoulder around

shoved into boards or fall

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5
Q

tests for shoulder seperation - 3

A

percussion, TOP, indirect pressure

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6
Q

scapula - 2
prominent projects - 3
fossas - 2
function

A

flat triangle - articular surface of humerus in glenoid fossa)
acromion, spine, coracoid process
infraspinatus and supraspinatus
site of attachment for muslces that move the shoulder - little midgits pulling on a floating iceberg

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7
Q

scapular resting position - 6

A 
arms at side, 
overlies ribs 2-7, 
vertebral border 2" lat to thoracic spinous processes, 
sup angle approx even with T1-T2
spine - T3
inf angle - T7/8
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8
Q

humeral head

A

spherical in glenoid fossa

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9
Q

humeral tuberosities

A

greater - lateal
lesser - medial
form bicipital groove for biceps tendon

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10
Q

sternoclavicular joint

A

plane joint formed by the larger medial end of clavicle that articulates with the manubrium of the sternum - compressed in dogpiles and strength depends on the lig

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11
Q

articular disc - 3

A

improves contact area on bony ends, enhances joint stability, prevent dislocation of clavicle

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12
Q

sternoclavicular lig - 3

A

ant SC lig

pos SC lig - reinforce ant and pos aspect of capsule

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13
Q

costoclavicular ligs - 2

A

inf surface of clavicle to sup surface of first rib - limit for elevation of pectoral girdle

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14
Q

interclavicular lig

A

attaches both clavicles across manubrium - strengthen sup capsule

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15
Q

AC joint

A

plane/gliding jt

clavicle and acromion that is covered by fibrocarilage

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16
Q

ac lig - 3

A

ac lig - reinforce sup aspect

cc lig - trapezoid and conoid

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17
Q

scapulothoracic jt - 3

A

not a true jt - shoulder blade on your rib cage
enables shoulder to function correctly
scapula and thoracic wall

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18
Q

larger shoulder blade

A

more force

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19
Q

3 types of movement of scapulothoracic jt

A

elevation/depression
protraction/retraction
lat/med rotation

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20
Q

glenohumeral jt - 6

A

synovial - ball and socket - multi axial
most movable jt in the body
active restraints of rotator cuff and deltoid, passive restraint of ligs and labrum
humeral head and glenoid fossa of scapula full with hyaline cartilage
incongruent becuase the head is too large

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21
Q

glenoid labrum

A

continuous with jt capsule
fibrocartilage ring
deepens the fossa and increases contact surface area and stability by 50%

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22
Q

purpose of lats and pec

A

movers of your arm - not biomechanically made to stablize your shoulder

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23
Q

ligs strengthening the ant capsule - 3

A

sup, mid and inf glenohumeral lig

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24
Q

ligs strengthening the sup capsule

A

coracohumeral lig

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25
Q

coracoacromial arch

prominent diseases - 5

A

coracoid process, acromion and coracoacromial lig
- impingement and tendinitis - cant lift it above your head
overlies the humeral head and limit the sup displacement of humerus, supraspinatus tendon passes through arch

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26
Q

External rotator cuff muscles

A

supraspinatus - from supraspinous fossa to greater tuberosity of humerus - abduction
infraspinatus - infraspinous process to greater tuberosity
teres minor - lateral border of scap to greater tuberosity

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27
Q

to avoid shoulder problems if you work out

A

stabilize your scapula before you start

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28
Q

subscapularis

A

subscapular fossa to lesser tuberosity - internal rotation

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29
Q

serratus ant

A

inside of ribcase ribs 2-9 and goes to medial border of scap - push up with a plus , scapula protraction, rotation and stabilize scap against thorax when pushing
weakness - scapular winging

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30
Q

rhomboids (maj and min)

A

spinous process of c7-t5 to medial border of scap from inf angle - scapular retraction and stabilize scap on thoracic wall, downward rotation
weakness - scap winging

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31
Q

thumbs down reverse fly would test

A

rhomboids

32
Q

thumbs up reverse fly would test

A

middle trap

33
Q

who does the rhomboids work against

A

serratus ant

34
Q

levator scapulae

A

transverse process of V1-4 to sup angle and med border of scap - elevates scap and extend head

35
Q

cervical genic headache

A

when you are typing all the time - tight levator scapulae, stretch - flex head and side flex

36
Q

trapezius

A

from occipital bone and lig nuchae and spinous processes of c7-12 to lat clavicle and spine of scap
upper fibers - scap elevation, lower fibres - scap depression and external lat rotation, all retract scap

37
Q

pec minor

A

ant rib 3-5 to coracoid
protraction, depression, and downward rotation
under the pec, ant and pos tilt
release by foam rolls

38
Q

how many muscles in the ST jt

A

5

39
Q

history of pain

A

activity level, contractile tissue? referred pain? chronic vs acute

40
Q

observation

A

resting posistion protracted? tilted? angulation in unilateral athlete

41
Q

all the movements of the shoulder

A

flex/ext, int/ex rotate, ad/adduction, elevation/depression, retraction/protraction

42
Q

functional movement of the shoulder

A

buckling - horizontal adduction

43
Q

3 ways to test strength

A

bilateral, isometrically and functionally

44
Q

apprehension test

A

dislocation/subluxation
abduct 90 degree flexed arm 90 degrees then gentaly externall rotate
- pos - spasm and tense up, apprehensive and watch for facial expressions - joint structure test for labral tear

45
Q

relocation

A

apprehensive in apprehensive test - push humeral back

pos - apprehension improved

46
Q

sulcus sign

A

GH instability
seated and grab the elbow and pull down
pos - depression under acromion for inf stability of labrum

47
Q

load and shift

A

ant shoulder instability

grab head ant and pos - push into glenoid fossa and push ant or pos - >25% movement is bad

48
Q

neers

A

shoulder impingement
passively internally rotate and flex
pos - pain at end ROM
ramming it into acromion

49
Q

hawkins kennedy

A

shoulder impingement
passively flexed to 90 and internally rotated
pos - pain at end range/with rotation

50
Q

painful arc

A

shoulder impingement
supraspinatus, subacromial bursa
raise arm into full abduction
pos - pain between 45-120 and 170-180

51
Q

empty can

A

supraspinatus
90 degree forward flexion and 30 degree adduction then internally rotated with slight downward pressure
pos - weakness and pain

52
Q

supraspinatus vs delt

A

externally rotate and primary abduction until delt kicks in

53
Q

scaption

A

30 degrees, where scap is sitting on your rib cage

54
Q

drop arm test

A

RC (supraspinatus) tendon tear (punching and catching)
abduct arm to 90 degrees - slowly lower
pos - drop and sharp pain

55
Q

why do we want to drop the arm?

A

delt will hold the arm in place

56
Q

lift off

A

subscapularis muslce
internal rotation - hand behind back and lift off against resistance
pos - weakness and unble

57
Q

door open test

A

SIT
external rotation
pos - cant

58
Q

speeds

A

long head of bicep/suspect rotator tendon
palpate bicipital groove - internal and external rotation
resisted supinated straight arm flexion
pos - pain over biceps tendon and weakness

59
Q

if your humerus constantly subluxes

A

long head of biceps starts to act as a lig and works too hard - wear out as a pulley

60
Q

sheer/AC compression test

A

fallen or jammed - AC stability/sprain should separation - cant sleep on your side or back
put palm at distal end clavicle with finders interlocked on top
pos - pain and laxity

61
Q

AC cross over test

A

AC stability/sprain shoulder separation
lift arm and horizontally adduct
pos - pain with movement and unable to perform

62
Q

hit the boards with their left shoulder, roll inward forcing his arm into cross flexion - pain on sup aspect of shoulder

A

AC jt sprain

63
Q 
AC joint sprain 
MOI
S&S
G1
G2
G3
management 
rehab
A

acromion goes down, back or inward and clavicle pushed against rib cage - foosh, landing on lat aspect of shoulder
step deformity
point tenderness and discomfort with movement of tip of clavicle/acromion, no deformity
tearing of AC and CC lig, slight prominence of clavicle, lose abduction, and pt tender
complete rupture of AC and CC, prominence of distal clavicle, more pain and loss of function
PIER, sling, MD for #, tape it down for healing by primary intention - scar in 3-5 days
jt ROM, stability, strength,

64
Q

trips and grabs onto rail, forcing his arm into hyperextension and rotation, - come to you supporting it and cant move

A

glenohumeral dislocation

65
Q 
glenohumeral dislocation 
MOI 
S&S
Management 
rehab
A

impact with shoulder abducted, externally rotate and extend, most often ant and downward - high chance of reoccurance - hitting someone about to throw a football
flatten delt contour
palpate axilla for prominence of humeral head
loss of function, ROM and pain
towel under arm and longitudinal traction
conservative
MD for reduction
PIER and sling
restore ROM, stability and strength
tape/brace for RTP
ROM - isometric scapular stability

66
Q 
instability of GH jt
MOI
SS
management 
rehab
A 
chronic instability of shoulder 
after recurrent subluxation/dislocation 
traumatic/congenital/repetitive overuse 
ant/pos instability or multidirectional 
pain, clicking, weakness, increased motion of humeral head, avoidance of positions due to pain/apprehension, impingement of rotator cuff because of poor stability 
conservative then surgical 
strengthen RC - sup, ant and pos 
strengthen scapular stabilization muslces and proprioception of the should - open and closed kinetic chain exercises - one hand on the mirror or hands and knees on a table cloth and slide - no pattern play with speeds
67
Q

Sports for ppl with GH instability

A

no throwing sports, not biomechanically great

68
Q

rotator cuff tear
MOI - 4
management
rehab

A

overuse or acute
poor blood supply - not adequate healing
begin with microtearing and impingement
older pop
pain, weakness, loss of ROM, partial can move with pain, full tear not normal ROM
vague pain in area and catching when arm is moved, cant sleep on the affected side
PIER, correct mechanics (muscle imbalance), prop up to 30 degress to give it room to heal
conservative
stretching to maintain and improve ROM, scap stabilization, strengthen, may be surgery.

69
Q

chronic shoulder pain - progressively worse with overhead strokes

A

shoulder impingement syndrome

70
Q 
shoulder impingement syndrome 
MOI
S&S
Management 
Rehab
A

repetitive overhead - swimming, tennis, postural abnormalities, loss of scap control, mechanical compression of bursa, supraspinatus of biceps tendon under coracoacromial arch - irritation and inflammation
generalized aching with abduction and flexion, pos painful arc and impingement
tender over RC tendons, decreased strength with resisted muscle testing
flexibility and rest
strengthen RC - below 90 degrees then progress to overhead, PIER

71
Q

increase weight for bicep curls, snap in front of shoulder, unable to lift, flatten bicpes muslce

A

biceps brachii rupture

72
Q

Biceps rupture
MOI
S&S
management

A

powerful concentric/eccentric contraction, often near the origin in the groove but can happen at distal end
audible snap and intense pain, weakness with elbow flexion and resisted biceps
PIER, sling, MD? surgery?

73
Q

fit 40 yr judo with worsening shoulder pain - known history of RC tear, no new trauma, constant pain, full strength but poor ROM

A

adhesive capsulitis - frozen shoulder

painful restriction of GH due to thickening and contracture of capsule

74
Q

adhesive capsulitis
MOI
S&S
management

A

no exact, may be synovial inflammation causing pain and disuse, >40yr, shoulder immob increase risk, diabetes, hyperthyroidism, hypertriglyceridemia increases risk
progressive onset, worse with movement and at night, decrease ROM
aggresive stretching and manipulation - cortisone may feel good but not in the long run

75
Q

jump to side with arms outstretched, lands hard on arm, immediate pain and hold on to support

A

clavicle fracture

76
Q 
clavicle fracture 
MOI 
S&S
management
rehab
A

FOOSH, fall on tip of shoulder or direct impact
support arm at the elbow, deformity, pain, swelling
sling up to 8 weeks, xrays
ROM, strength, surgery?

Rec and Care (11 decks)

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