Shoulder Flashcards
impingement syndrome
can be mechanical or functional primarily
most commonly overhead activities over time produce impingement
orthos for impingement syndrome
neers
hawkin’s kennedy
painful arc
anterior pain associated with an impingement syndrome
subacromial bursitis
posterior pain associated with an impingement syndrome
infraspinatus/teres minor
if pain is under the AC joint
supraspinatus problem
coracoid pain associated with impingement syndrome
subcoracoid impingement of the subscapularis
traumatic instability
past history of shoulder dislocation
complains of pain or weakness when arm is placed in overhead position or apprehension position
stability is evaluated with what tests?
apprehension
load and shift
relaocation test
anterior release (surprise) test
not traumatic instability
may be asymptomatic
when symptoms occur often a result of sudden traction or difficulty working in overhead position due to fatigue
may have inherent looseness to their shoulder capsules
rotator cuff tears MC involve
supraspinatus
may involve injury to infraspinatus, subscapularis or teres minor tendons and muscles
pain with rotator cuff tear
overhead activities or weakness in lifting the arm
rotator cuff tears can be due to
trauma
secondary chronic degenerative change in the tendon
repetitive forces, degeneration, anatomic impingement
when might a patient be weak if they have a rotator cuff tear?
external rotation
supraspinatus
sprain/strain of the shoulder
over stretch or over contraction history
worse with specific ROM of the muscle/ligament that is strain/sprained
supraspinatus
empty can test
subscapularis
lift off test
infraspinaus/teres minor
lag sign
biceps
speed’s test
adhesive capsulitis
MC idiopathic
disuse
vascular insufficiency
acute phase of adhesive capsulitis
patient complains of moderate to severe pain taht limits all shoulder movement
middle phase of adhesive capsulitis
past history of the acute phase of 1 to 3 months
final phase of adhesive capsulitis
slower increase in ROM with significant reduction
subdeltoid bursitis
same as subacromial bursitis often been associated with impingement syndrome or as an isolated condition
findings of subdeltoid bursitis
palpation: tenderness found anterior to AC joint on passive extension of the shoulder
active ROM: most movements are painful in particular forward flexion
passive ROM: end range forward flexion and abduction are painful
HADD vs CPPD vs SOCM
HADD- calcification in the tendon
CPPD- thin linear calcifications near the joint
SOCM- multiple calcifications around the joint
SLAP tear
history of popping, clicking or catching may suggest labral tear
may be associated with atnerior dialocation or sudden contraction of bicepts or fall on a forward flexed arm
orthos for SLAP tear
crank
o’brien’s
anterior shoulder dislocation
usually due to indirect force on arm while in abducted and externally rotated position
95% of shoulder dislocations
bankart lesion
osseous fragmnt adjacent to the inferior aspect of the glenoid fossa
shoulder impingement
neers
hawkins
painful arc
instability
apprehension relocation surprise load and shift sulcus sign
labral tears
crank obriens bicep load II provocative test of mimori test of zaslov
rotator cuff
empty can infraspinatus muscle test palpation drop arm lift off hawkins
