Lab 6- Shoulder Flashcards
palpate coracoid process
- Horizontally adduct the patient’s arm
- Use 2 fingers and palpate inferior to the distal end
of the clavicle - Apply deep pressure to locate the coracoid
process
palpate deltoid tuberosity
1.Have the patient sit with their arm at their side,
elbow at 90 degrees
2. Instruct the patient to abduct their arm against
your pressure
3. Trace the deltoid muscle distally down the lateral
portion of the humerus
4. Where you feel the muscle end is where the
deltoid tuberosity is located
lower trap palpation
Instruct patient to clasp hands overhead
Resist pulling apart or extend arms
overhead/hyperflex
levator scap palpation
Instruct patient to place hand on small of back
Instruct patient to shrug shoulders upwards
against mild resistance
rhomboids palpation
- instruct patient to place hand on small of back
- “Lift hand off of back” against mild resistance
to scapular retraction and downward rotatio
to palpate the deltoid, the patient should abduct arm to ___ degrees
60
palpation of pec major patient position
supine with arm in 60 degrees of scaption
for pec major clavicular head, pt will perform _______
for pec major sternal head, pt will perform ________
pt will perform horizontal adduction and arm flexion
pt will perform horizontal adduction and extend arm (thumbs down!)
when palpating the latissimus dorsi, what motion does the pt perform?
adduction and extension
when palpating the trees major, what motion does the pt perform?
adduction and extension
the teres minor muscle belly is at the ________ of the lateral border of the scapular
midpoint
to palpate supraspinatus, the pt performs what motion?
abduction
to palpate the supraspinatus tendon, what does the pt do?
where do you palpate?
pt has arm being back sitting
palpate on superior surface of greater tubercle
what motion does the pt perform for subscap palpation?
internal rotation (you resist this)
to palpate the subscapularis, you should have the patient in __ degrees of abduction with arm _______
60 degrees of abduction with arm flexed
shoulder flexion goni landmarks
Stationary arm: Mid-axillary line
Axis of rotation: Greater tubercle of humerus
Movement arm: Lateral epicondyle
shoulder extension goni landmarks
Stationary arm: Mid-axillary line
Axis of rotation: Greater tubercle of humerus
Movement arm: Lateral epicondyle of humerus
shoulder abduction goni landmarks
Stationary arm :Parallel to sternum
Axis of rotation: Anterior acromion
Movement arm: Bisecting the condyles of humerus
shoulder IR goni landmarks
Stationary arm : perpendicular to floor
Axis of rotation: olecranon process
Movement arm: ulnar styloid process
shoulder ER and IR patient position (normal gravity)
supine with elbow flexion
shoulder flexion and extension MMT gravity reduced position
side lying
shoulder abduction MMT gravity reduced position (middle Delt, supraspinatus)
prone
scaption is __ degrees of flexion with __ degrees of horizontal adduction
90 degrees flexion with 30 degree of horizontal adduction
what main muscle is palpated in scaption?
supraspinatus
horizontal ad/abduction gravity reduced position
pt seated with humerus resting on table, 90 degree abduction 90 degrees elbow flexion
horizontal abduction (normal gravity) patient position (posterior deltoid)
prone, head turned to contralateral side
IR and ER gravity reduced position (IR: subscap, ER: Infraspinatus, teres minor)
prone, arm hanging off the edge, elbow extended to 0
normal shoulder IR and ER MMT pt position
prone, head turned contra laterally
shoulder abducted to 90, humerus supported on table
scapular elevation/depression gravity reduced position
prone, arms at side
scapular elevation normal pt position (upper trap, levator)
seated, head turned contralaterally
scapular ad/abduction gravity reduced position
sitting, shoulder adducted with ER
scapular adduction normal pt position (middle trap)
prone, head turns to contralateral side
lower trap MMT is
scapular adduction - depression
gravity reduced lower trap MMT pt position
prone, shoulder abducted to 130
normal MMT for lower trap pt position
prone, head turned to contralateral side, abduction to 130
(same as gravity reduced, just with head turn)
scapular adduction/downward rotation gravity reduced pt position (rhomboids)
sitting with hand resting on lumbar spine
pone with arm off edge of table, shoulder in neutral
pt position for normal scapular adduction MMT (rhomboids)
prone with dorm of hand on ipsilateral glutes
head turned contralaterally
or chicken arm
scapular abduction-upward rotation gravity reduced (serrates anterior)
patient seated
125-130 degrees shoulder flexion
what is the outcome measure/performance test for the shoulder?
closed kinetic chain upper extremity stability test
closed kinetic chain UE stability test:
two strips of tape __ inches apart
pt in ________ position
pt reaches across side to side
36 inches
pt in push up position
what is the cut off for the closed kinetic chain UE test?
less than 21= risk for injury
normal gravity pt position for serrates anterior MMT
pt seated, shoulder flexion to 125 degrees, apply resistance
apley scratch test
one arm into _____, ______ and ______ behind head
other arm in _____,______ and ______
then compare levels
abduction, flexion, ER
IR, extension, adduction
