Quiz #1: Intro & Shoulder Flashcards
What are the 11 Principles of Examination?
- test the uninvolved side first
- active mm first , then passive, then resisted iso.
- painful mm are last
- apply pressure with care
- repeat or sustain mm if history indicates
- do resisted isometric mm in resting position
- with passive and ligamentous testing, both the degree and quality (end feel) of opening are important
- with ligamentous testing, repeat with increasing stress
- with myotome (groups of muscles supplied by the single nerve root) contractions must be held for 5 seconds
- warn of possible exacerbations
- refer if necessary
What are the 5 elements of patient/client management?
- Examination
- Evaluation
- Diagnosis
- Prognosis
- Intervention
Define contractile, nervous and inert tissues
Contractile: includes muscles, their tendons, and their attachments into bone
Nervous: nerves and their associated sheaths
Inert: include all structures not considered contractile or neurological such as, joint capsules, ligaments, bursae, blood vessels, cartilage and dura mater.
What are the 3 classic normal end feels? Explain.
Bone-to-bone or hard: unyielding sensation that is painless
Soft tissue approximation or soft: yielding compression that stops further mm due to compression of soft tissue
Tissue stretch or firm: springy or firm type of mm with a slight give.
What are the 5 classic abnormal end feels?
- Muscle spasm: painful mm and end feel is sudden and hard.
- Capsular: hard capsular has thick quality to it and a soft capsular has a boggy feel to it.
- Bony block: restriction occurs before the end of the ROM
- Empty: the ROM is stopped by the patient due to pain
- Springy block: occurs when you wouldn’t expect it to, usually in joints with Menisci
- Laxity: hyper mobility
What is the grading scale?
5: normal: max resistance applied by the examiner
4: good: mod resistance
3: fair: against gravity-no resistance
2: poor: gravity minimal
1: trace: evidence of muscle contraction
0: zero: no contraction
What are the 4 joints of the shoulder?
Glenohumeral
Sternoclavicular
Acromioclavicular
Scapularthoracic - functional joint
What type of joint is the Glenohumeral? And what is the capsular pattern?
Synovial ball and socket
Lateral rotation, abduction, medial rotation
What type of joint is the sternoclavicular?
Synovial joint, saddle shaped joint surface
What type of joint is the acromioclavicular joint?
Synovial
What type of joint is the Scapulothoracic?
Considered a functional rather than an anatomical joint.
What muscles are being tested during MMT of shoulder flexion? What nerve?
Anterior Deltoid- Axillary nerve (C5,C6)
Coracobrachialis- Musculocutaneous (C5,C6,C7)
What muscles are being tested during MMT of shoulder extension? What nerve?
Latissimus Dorsi- Thoracodorsal (Long Subscapular
Posterior Deltoid- Axillary
Teres Major- Subscapular
What muscles are being tested during MMT of shoulder scaption? What nerve?
Anterior Deltoid- Axillary
Middle Deltoid- Axillary
Supraspinatus- Suprascapular
What muscles are being tested during MMT of shoulder abduction? What nerve?
Middle Deltoid- Axillary
Supraspinatus- Suprascapular
What muscles are being tested during MMT of shoulder horizontal abduction? What nerve?
Posterior Deltoid- Axillary
What muscles are being tested during MMT of shoulder horizontal adduction? What nerve?
Pectoralis Major- Lateral Pectoral and Medial Pectoral (C5, C6)
What muscles are being tested during MMT of shoulder external rotation? What nerve?
Infraspinatus- Suprascapular
Teres Minor- Axillary
What muscles are being tested during MMT of shoulder internal rotation? What nerve?
Subscapularis- Subscapular
What muscles are being tested during MMT of scapular ABD and upward rotation? What nerve?
Serratus Anterior- Long thoracic
What muscles are being tested during MMT of scapular elevation? What nerve?
Upper trapezius- Accessory, Cervical Spinal (C3, C4)