OMM approach to the shoulder Flashcards

1
Q

How many joints comprise the shoulder joint? What are they?

A
4:
Sternoclavicular joint
Acromioclavicular joint
Scapulothoracic joint
Glenohumeral joint
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2
Q

What are the three bones that comprise the shoulder?

A

Clavicle
Scapula
Humerus

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3
Q

What are the ligaments that surround the shoulder joint?

A

Ligament capsule

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4
Q

What is Wolf’s* law?

A

Areas of bone stress will cause new bone deposition to reinforce that area

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5
Q

What are the areas of the diagnosis and treatment for OMM of the shoulder?

A
  • Axial skeleton
  • S/CS tender points
  • Specific SDs of the GHJ, SCJ, ACJ
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6
Q

What are the five areas of the axial skeleton that should be treated with shoulder SDs?

A
  • Thoracic vertebrae
  • Ribs
  • Inlet
  • Neck (AA joint)
  • Head (OA joint)
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7
Q

Diaphragmatic irritation may refer pain to where? What are the spinal nerves that are involved in this?

A
Shoulder
Phrenic nerve (C3, C4, C5)
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8
Q

What are some of the syndromes that arise from the abdomen, can irritate the diaphragm, and thus cause subsequent shoulder pain? (5)

A
  • Liver abscesses
  • General peritonitis
  • Gallbladder disease
  • Splenic rupture
  • Perforated peptic ulcer
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9
Q

Pancoast tumors may impinge on what nerve plexus to cause pain in the cervical distribution? What trunk is affected? What peripheral nerve, then, would be affected?

A

Brachial plexus

Lower trunk

Ulnar nerve

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10
Q

What are the three main joint restrictions that are amenable to OMM treatment?

A
  • Glenohumeral joint
  • Sternoclavicular joint
  • Acromioclavicular joint
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11
Q

What are the ssx of sternoclavicular joint restrictions (usually)?

A

Usually adducted and extended

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12
Q

What are the two main forms of OMM that are used to treat the scapulothoracic joint?

A

Scapular lift

Shoulder mobilization

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13
Q

What are the major SDs of the glenohumeral joint?

A

Tight shoulder capsule

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14
Q

What are the 7 stages of Spencer? (in order)?

A
  1. Extension
  2. Flexion
  3. Circumduction
  4. Circumduction with traction
  5. Abduction/adduction
  6. Internal rotation
  7. Abduction with traction
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15
Q

What is the use of the 7 stages of spence?

A

Order of articulatory techniques, in order of progressing difficulty with movement

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16
Q

What is Boas’s sign?

A

Right shoulder pain secondary to cholecystitis

17
Q

What is the relationship between the movements of the distal and proximal ends of the clavicle?

A

Inverse relation (e.g. Anterior/superior motion at the distal end, results in posterior/inferior motion at the proximal end)

18
Q

What is the movement of the ACJ and clavicle with abduction of the shoulder?

A

ACJ moves upward

Medial clavicle moves downward

19
Q

What is the movement of the ACJ and clavicle with adduction of the shoulder?

A

ACJ moves downward

Medial clavicle moves upward

20
Q

What is the movement of the ACJ and clavicle with extension of the shoulder?

A

ACJ moves posteriorly

Medial clavicle moves anteriorly

21
Q

What is the movement of the ACJ and clavicle with flexion of the shoulder?

A

ACJ moves anteriorly

Medial clavicle moves posteriorly

22
Q

What are the two primary dysfunction of the SCJ?

A

Adducted clavicle

Extended clavicle

23
Q

True or false: patient may have pain at the ACJ with movement of the arm, or the scapula, but not usually both

A

False- can be both

24
Q

What causes the glenohumeral joint pain (outside of a fracture), when falling on an outstretched arm?

A

Folding of the fascia in and around the glenohumeral joint

25
Q

What is the absolute contraindication (outside of fractures) to treating the glenohumeral joint with overfolding the mis-compressed fascia?

A

If patient has pain when compressing the shoulder

26
Q

How do you do a generalized treatment of the ACJ and the SCJ?

A

Circumducting one way, and then the opposite

Move the clavicle while using the humerus as a lever and moving it in abduction/adduction and internal/external rotation

27
Q

What axis is being utilized with generalized mobilization of the clavicle?

A

Long axis

28
Q

What are the areas outside of the shoulder that should be addressed for their neurological tie to the shoulder?

A
  • C5-T1 d/t brachial plexus

- T2-T8

29
Q

What are the areas of the body that should be treated for the vascular concerns of the shoulder?

A
  • Thoracic inlet
  • Clavicle
  • Ribs
  • Axillary folds
30
Q

Which ribs affect scapular movement?

A

1-8

31
Q

Which ribs affect clavicular movement?

A

1-2