SHANKA SHOULDER CHAP PG 348 TO 363 Flashcards
What are the 3 main joints of the shoulder?
Glenohumeral
AC
sternoclavicuar
scapulothoracic
How many muscles directly or indirectly provide stabiltiy of the entire shoulder complex?
18
In this disorder the tendons of the rotator cuff are crowded, buttressed, or compressed under the coracoacromial arch, resulting in mechanical wear, stress and friction
subacromial rotator cuff impingement
this impingement refers to mechanical compression of the rotator cuff tendons, primarily the supraspinatus tendon as they pass under the coracoacromial ligament between the acromion and coracoid process
Primary
this impingement is related to glenohumeral instability that creates a reduced subacromial apace because the humeral head elevates and minimizes the area under the coracoacromial ligament
sencondary
This stage of rotator cuff impingement occurs in younger pts (younger than 25)
- edema
- hemorrhage
- pain w/ abd ^ than 90*
- reversible lesion
Stage I
This stage of rotator cuff impingement is the fibrosis and tendonitis stage. (25-40 yrs old).
- irreversilbe
- supraspinatus tendon, biceps tendon, and subacromia bursa become fibrotic
- pain sleeping
Stage II
This stage of rotator cuff impingement Affects pts more than 40 yrs.
- tendo degeneration
- rotator cuff tears
- rotator cuff ruptures
- from long term symptoms
- muscle weakness and atrophy
Stage III
two tests used to elicit an impingement sign
Neer painful arc test
Hawkins-Kennedy test
- Test for impingement in which pain is reported while the shoulder goes through elevation with internal rotation.
- impingement is secondary to compression of the rotator cuff against the coracoacromial arch
Neer painful arc test
- This test for impingement is performed by elevating the shoulder to 90* in the scapular plane with internal rotation over pressure.
- In most cases , elevation of more than 80* or 90* elicits pain.
Hawikins-Kenndy test
What are the scapular muscles
serratus anerior
upper, mid, lower traps
levator scapulae
rhomboids
What are the 3 phases of nonoperative treatment of impingement?
Phase I- pre functional
Phase II- return to function
Phase III- return to activity
This phase of non operative impingement tx concentrates of relief of symptoms and initiating exercises to improve or maintain motion
Phase I- pre functional
This phase of non operative impingement tx is progressed with advanced scapular stabilization exercises that are encouraged as part of a comprehensive glenohumeral and scapulothoracic strengthening program. It use PRE using OKC
Phase II- return to function
