Shoulder Flashcards
shoulder dislocations account for ___% of dislocations
50%
subacromial bursa
- lies in space under acromion
- cushions rotator cuff mm from acromion
- compressed during overhead arm action
common acute shoulder injuries
- fractures (clavicular, humeral)
- sprains (SC, AC, GH)
- strains (deltoid, biceps, triceps)
- ruptures (biceps)
- GH dislocations/subluxations
chronic common shoulder injuries
- rotator cuff impingement syndrome
- subacromial bursitis
- bicipital tendonitis
etiology - clavicular fracture
- FOOSH
- fall on tip of shoulder or direct impact
- occur primarily in mid-third
- greenstick #
S&S clavicular #
- generally presents with supporting of arm, head tilted towards injured side w/ chin turned away
- may appear lower
- palpation may reveal SHARP &/or deformity
fractures - clavicular - management
- treat for shock
- sling and swath
- transport to hospital
- will likely be braced 6-8 weeks
humeral fracture
- etiology
- S&S
- management
etiology: direct blow or FOOSH; proximal # may also be associated with dislocation
S&S: SHARP; neurovascular changes; may be mistaken for a contusion or dislocation
management: treat for shock, splint & sling prior to transport
acromioclavicuar sprain
- etiology
- S&S
- management
etiology: FOOSH, direct impact/falling on point of shoulder
- graded 1-6 depending on severity
S&S
- mild to severe pain, swelling, altered ROM, adduction/abduction; step deformity
management
- ice, stablization, and referral
- aggressive rehab is required with all grades
GH sprain
- etiology
- S&S
- management
etiology: forced abduction and/or external rotation or a direct blow
S&S; pain during movement, especially when recreating MOI, decreased ROM and pain w/ palpation
management RICE for 24-48 hours - sling - important to regain full ROM -> STR - must be aware of potential development of chronic conditions; (contractures, adhesions)
acute subluxation & dislocation etiology
- anterior dislocation associated with anterior force; forced abduction and ER
- additional structural damage
- may dislocate posteriorly or inferiorly (posterior accounts for 1-4%, inferior very rare)
S&S acute subluxation & dislocation
anteroinferior - flattened deltoid, head in axilla; arm carried in slight abduction and ER; moderate pain and disability
- posterior - severe pain and arm held in adduction and IR
management of acute subluxation and dislocation
- RICE
- reduction by a physician; immobilization sling and swathe
- perform isometrics while in sling
sprain - glenohumeral etiology
- forced abduction and/or external rotation or a direct blow
S&S GH sprain
- pain during movement; especially when recreating MOI
- decreased ROM and pain w/ palpation
GH sprain - management
- RICE 24-48 hours
- sling
- important to regain full ROM -> STR
- must be aware of potential development of chronic conditions (eg., contractures, adhesions)
shoulder impingement/subacromial bursitis
- etiology
- S&S
- management
etiology: mechanical compression; bursal or tendinous inflammation; contributing factors include joint laxity, postural malalignments, and repetitive overhead motions
S&S
diffuse pain around acromion; pain with OH activities; progresses in stages over time
management
active rest; correct biomechanics
bicipital tenosynovitis or tendinopathy - etiology
- repetitive overhead, ballistic activity that irritate the tendon & sheath; improper mechanics; impingement
S&S bicipital tenosynovitis or tendinopathy
- tenderness over bicipital groove, swelling, crepitus d/t inflammation
- pain when performing overhead activities
management - bicipital tenosynovitis or tendinopathy
- control inflammation followed by gradual program of strengthening and stretching
biceps brachii rupture
- etiology
- S&S
- management
etiology; results of powerful contraction; typically near mm origin
S&S
- pt hears a resounding snap; sudden and intense pain; deformity; weakness w/ elbow flexion and supination
management
- ice, sling, refer to physician
