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5 Ortho > L3 The Shoulder Exam > Flashcards

L3 The Shoulder Exam Flashcards

1
Q

AC Joint Symptoms

A

located over the joint itself
patient typically uses 1-2 fingers to point to joint
pain will be localized to the joint, ADD might hurt

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2
Q

GH Joint Symptoms

A

reproduced by rotation and compression of joint
PT reports S/S deep in joint, may radiate

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3
Q

Subacromial Symptoms

A

s/s at upper arm
may radiate down arm
pts may use entire hand to grasp the shoulder

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4
Q

Stiffness and GHJ

A

either frozen shoulder or arthritis, depending on capsular pattern

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5
Q

Intrinsic Factors for RCD

A

symptoms are caused by properties in the tendon itself

result of tension overload, tendon degeneration, etc

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6
Q

Extrinsic factors for RCD

A

Symptoms caused by properites outside of the tendon

Primary: angle of acromion, humeral head, AC joint deformity

Secondary: Instability

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7
Q

Posterior Impingement

A

occurs during ABD/ER

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8
Q

M vs F Shoulder Pathologies

A

M: trauma, osteolysis, OA
F: instability, frozen shoulder, arthritis

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9
Q

Calcific Tendonitis

A

Subacromial pathology
pain on ascending
usually no traumatic MOI
hot, burning pain

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10
Q

Adhesive Capsulitis

A

also known as frozen shoulder
GHJ impairment
presents with decreased abduction and ER
more common in females

has three stages of acuity

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11
Q

Thoracic Outlet Syndrome

A

deep, boring, pain in the neck or shoulder

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12
Q

Nerve injury

A

weakness, numbness, parethesia
placing arm above head provides relief
atrophy of muscles may indicate nerve palsy
MOI to long thoracic can cause winging

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13
Q

Things to observe

A

sulcus deformity
anterior dislocation
step deformity
ruptures or tears
lymphomas
cellulitis
winging
atrophy

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14
Q

Hands on hips position

A

allows you to see possible atrophy of muscles

may be due to a nerve injury

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15
Q

Inferior angle scapular dysfunction

A

inferior medial border is prominent at rest

results from anterior tipping of scapula

commonly seen in impingement

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16
Q

Medial border scapular dysfunction

A

entire medial border is posteriorly displaced

occurs from IR of scapula in transverse plane

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17
Q

Scapular True Winging

A

occurs with injury to long thoracic
penetrating force
stretch injury
compression
repetitive overhead use

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18
Q

Superior scapular dysfunction

A

early and excessive superior scapular elevation during arm elevation

results from RC weakness and force couple imbalances

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19
Q

Painful arc

A

pain from 45° to 120° of abduction

high spin, present in all impingements

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20
Q

Reverse scpulohumeral rhythm

A

scapula moves more than humerus

present in RCT, frozen shoulder, OA

21
Q

During elevation of arm, the scapula, clavicle, and humerus should do what?

A

Scapula: upwardly rotate and posteriorly tilt

Clavicle: elevates, retracts, posteriorly rotates

Humerus: elevates and ER

22
Q

Observation during arm elevation in symptomatic subjects

A

decreased scapular upward rotation
decreased posterior tilt
increased scapular IR
increased clavicular elevation/retraction
ant/sup translation of humeral head

23
Q

IR Loss and Pathologies

A

IR relates to GH jt posterior capsule tightness
relates to anterior and superior translation of head
increased subacromial contact of RC
decreased subacromial space

24
Q

Apley’s scratch test

A

lower shoulder is ext, add, ir
upper shoulder is flex, abd, er

25
Q

Decreased humeral head ER is b/c of

A

short pec major or lats
adhesive capsulitis

26
Q

Increased protraction of scapular is caused by

A

tight pect
weak lower trap
weak searratus anterior

27
Q

Increased depression on scap is caused by

A

weak upper trap

28
Q

Increased anterior tilting of scapula is caused by

A

tight pec minor, weak lower trap

29
Q

Motor patterns are produced by

A

learning
choice
adaptation
avoidance

30
Q

Levator scapulae referral

A

over muscle to posterior shoulder, along medial border of scapula

31
Q

Lats dorsi referral

A

inferior angle of scapula up to posterior and anterior shoulder into posterior arm. May refer to area above iliac crest

32
Q

Rhomboids referral of pain

A

medial border of scapula

33
Q

Supraspinatus referral of pain

A

over shoulder cap and above spine of scapula, sometimes down lateral aspect of arm to proximal forearm

34
Q

Infraspinatus referral of pain

A

anterolateral shoulder and medial border of scapula. may go to lateral aspect of arm

35
Q

Teres minor referral of pain

A

near deltoid insertion, up to shoulder cap, down lateral arm to elbow

36
Q

Subscapularis referral of pain

A

posterior shoulder to scapula and down posteromedial and anteromedial aspects of arm to elbow

37
Q

Teres major referral of pain

A

shoulder cap down lateral aspect of arm to elbow

38
Q

Deltoid referral of pain

A

over muscle and posterior GHJ

39
Q

Coracobrachialis referral of pain

A

anterior shoulder and down posterior arm

40
Q

Diagnostic Imaging

A

should be used in conjunction with a physical exam to determine a diagnosis
should not be used as sole method

41
Q

Scapula Dyskinesis and Pain

A

usually with scapular dyskinesis, athletes have a higher chance of developing shoulder pathologies

42
Q

Better outcome for shoulder pain

A

high expectation of recovery from PT interventions
higher pain self-efficacy
lower pain severity at rest
being employed or in education

43
Q

Poorer outcome for shoulder pain

A

resting shoulder pain not responding to meds
not currently employed or in education

44
Q

FOOSH

A

fracture or dislocation of the GHJ, possible RCT

45
Q

Fall onto tip of shoulder

A

can cause dislocation or subluxation of AC joint

46
Q

Calcium deposits

A

happen at 20 to 40

47
Q

Chondrosarcomas

A

occur for people older than 30

48
Q

Physical test values

A

clinical tests have limited use in informing diagnosis
emphasis on the management of dysfunction may be more appropriate

49
Q

Pain and Imaging

A

majority of studies report conflicting results between imaging and the detection of symptoms/pathologies/pain

structures and pain relationships are complex

5 Ortho (14 decks)

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