Gross: Clinical Aspect Exam 2 Flashcards
Trapezius Palsy
- Weakening of Trapezium Muscle - shoulder drops on affected side
- Due to whiplash (hyperextension/flexion of neck)
- Damage to Cranial Nerve XI (Spinal Access. Nerve)
- Test: Shrug shoulders against resistance
Lumbar Triangle
- Common site of Posterior Abdominal Hernia
- Borders: Iliac Crest, Latissimus Dorsi, External Oblique
Triangle of Auscultation
- Used to take lungs to be heard
- Borders: Trapezius, Latissimus Dorsi, and Vertebral Border of Scapula
- Gets larger when scapula is abducted
Long Thoracic Nerve Palsy AKA Winged Scapula Syndrome
-Weakening of Serratus Anterior
-Hard to hold scapula flat to abdominal cavity
-Causes: Trama/sublux
Traction inj to shoulder (inc angle of neck and shoulder.
Recumbancy- laying back or side long pd time due to surgery
Crutch Paralysis
Weakening of Deltoid Muscle due to damage to Axillary Nerve.
- Weakened ABduction of humerus
- May have loss of sensation of lateral Arm
- Causes: Fraction of surgical neck of humerus
- Dislocation of shoulder joint
- Pressure of crutch in axilla.
Rotator Cuff Tendonitis aka shoulder Impingement Syndrome
- Most Common Shoulder pain/Inflammation of supraspinatus tendon.
- Pain in ant/lat aspect shoulder & arm.
- weaker than normal…Twinge in shoulder area –> Pain during/after activity..hot/burning…
- Causes: Born w/ hooked acromion Process
- Weakness around rotator cuff, humerus rides up and compresses tend.
- Stress/Repetition (athletes)
- Ca++ deposits in tendon in elderly
Rotator Cuff Tears
- Rupture of rotator cuff tendon at/near insertion.
- Symptoms similar to tendonitis BUT difficulty ABducting arm.
- Young: Single traumatic Injury (Shoulder dislocation)
- 50+: minor trauma
- Age, Repeated Trauma, Steroid = tear
- Drop Test: Slowly lower limb, drops quick last 30-40 due to supraspinatus
Drop Test
- Evaluates rotator cuff tears.
- Pt slowly lowers fully ABducted arm and it goes smooth until last 30-40 degrees where it quickly drops. Then tear indicated (supraspinatus)
Bursitis (rotator cuff)
Inflammation in deltoid and/or subacromial bursae. More common than rotator cuff tendonitis
Quadrilateral Space
- Axillary Nerve and Humeral Circumflex Arteries go through it.
- Borders: Teres Minor, Teres Major, Long Head of Triceps Brachii, Humerus
Triangular Space
- Circumflex Scapular branch of sub scapular Artery
- Teres Minor, Teres Major, Long head of Triceps Brachii
Shoulder Separation
- Dislocation at AC joint.
- Shoulder Pointer = common cause. blow to shoulder
- Contact Sports
- Grade III dis: both AC and Coracoclavicular ligs rupture and clavicle will sep. from scap.
- Lat. end of clavicle displaced easily palpable - Acromion Process more prominent (Acromion bump)
- Sometimes subclavian artery compromised and indicated by diminished brachial and radial pulse.
- Healed tear not as strong as log b4 injury
Shoulder Dislocation
- Dislocation of glenohumeral joint
- Anterior dislocation most common
- May damage Musculocutaneous and Axillary N
- Loss sensation lateral A/FA - Most common type:: Anterior Dislocation at inferior aspect of capsular lig. (moves medial and inferior) Caused by excessive extension and lateral rotation of humerus.
- Subcoracoid Dis: head humerus forced through ant part of capsular lig. and ends up lying below coracoid process.
- Shoulder Lose rounded appearance & greater tuberosity can’t be palpated normal position.
Bicipital Tendonitis
- Inflammation of Long head of Biceps Brachii with/in intertubercular groove.
- Causes: Wear/Tear = inflammation
- When lots flexion against resistance at elbow jt.
- Some narrow/rough groove…cracking called Creptis
- Pain proximal Arm/Shoulder
Rupture of Biceps Tendon
-Popeye Syndrome
-Rupture near supraglenoid attachment of biceps muscle.
-Detached muscle belly forms ball on distal/ant. arm = Popeye deformity
Causes: Wear and Tear = chronically inflame.
-Forceful Flexion FA against resistance and chronic tendonitis.
-Normally ruptures at Origin..If Insertion then trauma
Biceps Reflex
Tests segmental Innervation C5 & C6
Tendon of Insertion tap biceps tendon
Triceps Reflex
Tests Segmental Innervation C7 & C8
Cubital Fossa
From Medial and Lateral Epicondyles form sup. border...then brachioradialis and Pronator Teres. Contains: Median Nerve Brachial Artery Median Cubital Vein Biceps Tendon 1 of every structure
Carrying Angle
- Women (~12-15) have > angle than Men (~5)
- Lateral angle b/w ulna and humerus
Cubitus Valgus
Abnormal Increase in Carrying Angle