MSK- Shoulder Flashcards
4 joints of the shoulder
Sternoclavicuar
AC
GH
Scapolothoracic (not a true joint
Capsular pattern of GH joint and loose pack
Loss of ER>ABD>IR
30 flex, 60 abd, slight IR (loose pack)
TOS borders
Ant: clavicle, crocodile process, pec minor
Post: UFT, scap
Medica: scalene ecusle, R1
Lateral: axial lateral
Contains (TOS)
Brachial plexus, subclavian artery and vein
Types of TOS
Neurogenic (true TOS) (anatomical abnormalities)
Nonspecific “symptomatic” neurogenic (diagnosed upon exclusion diagnosis )
Vascular- arterial (subclavian artery)
Vascular- venous
TOS S&S
Neurogenic
- weak grip, numbness, parathesisa
Vascular
- cool and pale extremities
Classifications of TOS
Scalene anterior syndrome
Costoclavicular
Hyperabduction
Cervical rib
TOS- special tests
Adson Maneuver
Costoclavicular syndrome test
Halstead maneuver
Wright test
Allen test
ROOS test (elevated arm stress test)
Shoulder girdle passive elevation
Shoulder separation (AC separation)
Trauma to the ligs of AC
Look for step deformity, tenderness, pain in add, elevation and HBB (hand behind back)
Shoulder seperation special test
Cross body (horizontal) adduction test
Glenohumeral jt stability- classifications
Direction
Degree
Etiology
Timing
What direction is more common for shoulder dislocation?
Anterior (in ortho)
Inferior for stroke populations
What position causes dislocation to occur?
Abduction and external rot
What other tissues can be damaged from ant dislocation
Sub scap, long head bicep (fill in more)
Potential complications of Shoulder dislocations
Auxiliary nerve
Auxiliary artery
Brachial plexus
Bankart lesion
Hill-Sach’s lesion
Spectrum of instability
AMBRI “born loose”
TUBS “torn loose”
Shoulder instability special tests
Anterior
- crank (apprehension relocation)
- apprehension release (surprise)
- load shift
Posterior instability
- jerk test
- load shift
- posterior apprehension
Inferior
- sulcus
Bankart lesion
Anterior tear of labrum (3-7 o’clock)
Sensation of clicking/ popping
Diffuse shoulder pain
Worse with HBB
Feeling insable
SLAP lesion
Superior labrum anterior and posterior (10-2 o’clock)
Long head bicep tendon pull
GIRD (decrease IR)
Pain overhead and laying on effected side
“Dead arm” syndrome
Labral special test
Clunk
Active compression of OBrien
Bicep load test
Adhesive Capsulitis (frozen shoulder)
Shoulder pain with progressive loss of ROM
Follows capsular pattern
Frozen SHoulder etiology
F>M
40-60
Non-dominant
Diabetics
Frzn shoulder etiology
Primary (idiopathic)
Secondary (trauma or long periods of immobile)
Correlation with anxiety
FRZN shoulder S&S
ER>ABD>IR
HBB, HBH, overhead
Reverse scapulohumeral rhythm
Progressive GHJ ROM restrictions
Stages of FRZN shoulder
1) Gradual onset of pain
2) Freezing
3) Fronzen
4) Thawing
Subacromial inpingement syndrome Structures
Subacromial bursa
Supraspinatus tendon
Long head
Cromioclavical lit
Capsule
Types of impingement
Primary (congenital or degenerative)
Secondary (functional)
Calcification tendinitis
Glenohumeral painful arc
60-120
Impingement special test
Hawkins Kennedy Impingement t
Needs impingement
Scapular assist test
Tendinitis
Inflammation of tendon
Tendinosis
Degeneration changes within tendon w/o inflammation
Repetitive stress/ overuse on the tendon
Tenosynovitis
Inflammation of the synovium
S&S of tendinopathy
Pain with muscle contraction
Tenderness upon palpating tendon
Biceps special test
Speed test
Yergasons (for the transverse lig)
Supraspinatus special test
Drop can, empty can
Sub scap special test
Belly pres
Lift off
External rotation lag sign
Infraspinatus special test
Infraspinatus test
Lateral rot lag test
Teres minor special test
Horn blowers sign
Scapular dyskinesia
Alteration in normal position of scap mvmt
Scap winging
Static
- winging at rest
Dynamic
- serratus anterior weakness, long thoracic nerve issue, C7
