OSPE - rotator cuff pain

Question 1

How would you measure ROM at the shoulder joint?

Answer 1

Goniometry
- axis on the centre of the humeral head
- stationary arm remains parallel to the trunk
- moving arm stays parallel to the humerus
ALWAYS COMPARE TO GOOD ARM

Question 2

How would you measure strength at the shoulder joint?

Answer 2

Oxford scale: graded 0-5, begin with 2
2 = full ROM, with gravity eliminated
3 = full ROM, against gravity
4 = full ROM, small resistance applied
5 = full ROM, full resistance applied

Question 3

Suggest some exercises for improving strength at the shoulder joint.

Answer 3

1. Crossover arm stretch: extend the injured arm out across the body, use the other arm to pull it towards the chest. Hold for 5 seconds.
2. Incline press: Wrap a resistance band around your back and stand in a partial lunge. Hold the band with both hands and straighten arms forwards against the resistance.
3. The sword: Stand on one end of the resistance band, maintain good posture as you bring the band up diagonally, keeping it in a straight line.

Question 4

Name the 4 rotator cuff muscles.

Answer 4

Subscapularis
Supraspinatus
Infraspinatus
Teres minor

Question 5

Name the origin, insertion, and action of the subscapularis

Answer 5

Origin: subscapular fossa of scapula
Insertion: lesser tubercle of the humerus
Action: rotates the arm medially

Question 6

Name the origin, insertion, and action of the supraspinatus

Answer 6

Origin: supraspinous fossa of scapula
Insertion: superior part of the greater tubercle of the humerus
Action: initiates abduction of the arm

Question 7

Name the origin, insertion, and action of the infraspinatus

Answer 7

Origin: infraspinous fossa of scapula
Insertion: inferior part of the greater tubercle of the humerus
Action: rotates arm laterally

Question 8

Name the origin, insertion, and action of the teres minor

Answer 8

Origin: posterior surface of the scapula, adjacent to its lateral border
Insertion: greater tubercle of the humerus, inferior to infraspinatous
Action: rotates arm laterally

Question 9

Name 3 other muscles, apart from the rotator cuff muscles that cross the shoulder joint

Answer 9

Pectoralis major, deltoid, latissimus dorsi

Question 10

Name the origin, insertion, and action of the pectoralis major

Answer 10

Origin: sternal end of the clavicle
Insertion: greater tubercle of the humerus
Action: adducts and medially rotates the arm

Question 11

Name the origin, insertion, and action of the deltoid

Answer 11

Origin: the lateral third of clavicle, acromion, and spine of the scapula
Insertion: deltoid tuberosity of humerus
Action: prime mover of arm abduction

Question 12

Name the origin, insertion, and action of the latissimus dorsi

Answer 12

Origin: iliac crest
Insertion: intertubercular sulcus of humerus (biciptal groove)
Action: prime mover of arm extension

Question 13

Describe how you would palpate the sternoclavicular joint

Answer 13

Located at the proximal end of the clavicle, forms a dip directly below the throat

Question 14

Describe how you would palpate the clavicle

Answer 14

Extends medially from sternoclavicular joint

Question 15

Describe how you would palpate the acromioclavicular joint

Answer 15

Located at the end of the clavicle

Question 16

Describe how you would palpate the coracoid process

Answer 16

Found in the infraclavicular fossa, roughly 2cm below the acromion. Moves when arm flexes forward.

Question 17

Describe how you would palpate the greater and lesser tubercle of the humerus

Answer 17

Anterior of humerus, prominent bony point. Bring the arm into lateral rotation to find the lesser tubercle

Question 18

Describe how you would palpate the spine of the scapula

Answer 18

Posterior aspect, medial and inferior to the tip of the acromion bone.

Question 19

Describe how you would palpate the bicipital groove

Answer 19

A deep groove that separates the greater and lesser tubercles.

Question 20

What pulse can be found around the shoulder joint

Answer 20

Brachial pulse

• slightly flex arm and face inside of arm to the ceiling
• tense muscles and place fingers between 2 bicep heads