Shoulder Flashcards
The shoulder is susceptible to injury because _______
There is more mobility compromising the stability
This places great stress on the complex
Repetitive movements
Examples of repetitive movements
Throwing
Swimming
Serving in tenis or volleyball
FOOSHA
Falling on outstretched hand/arm
S shaped, 6 in long, supports anterior shoulder
Clavicle
Prone to fx because of shape and not protected
Clavicle
Flat, triangular, purpose is an articulating surface for the humerus
Scapula
Humerus structures
Head, neck, bicipital groove, greater and lesser tubercle and glenohumeral joint
Most frequent fracture
Clavicular
FOOSHA, direct impact, occurs in middle 3rd with athlete supporting arm, swelling deformity, point tenderness. They’ll often tip their head to the opposite side
Clavicular fracture
Direct blow or fall on arm with inability to move arm, swelling, point tenderness and discoloration
Humeral shaft fracture
Great danger to nerve and vessels, direct blow, discoloration, most likely at neck and can be mistaken for dislocation
Proximal humerus fracture
Young athlete 10 years and younger with a direct blow or indirect force applied to length of axis
Epiphyseal fracture
Brief translation of the humeral head without separation of the joint surfaces
Or in English, the joint comes out but goes back in
Subluxation
Most common dislocation
Anterior dislocation
Forced abduction, external rotation and extension, direct impact to the posterior or posteriolateral aspect with a flat deltoid, you can feel the humeral head and the athlete carries the affected arm in slight abduction and ER. They are unable to touch the opposite shoulder
Anterior dislocation
Forced adduction and IR or fall on outstretched and IR arm with labrum damage, severe pain and disability, limited ER and elevation
Posterior dislocation
Clavicle + manubrium of sternum, only direct connection between upper extremity and trunk
Sternoclavicular joint
Articulation disk that absorbs shock and allows movement
SC joint
Lateral end of clavicle and acromion process, weak junction
Acromioclavicular joint
Ball and socket joint, head of humerus and glenoid cavity of scapula held together by the glenoid labrum
Glenohumeral joint
Not a true joint, scapula + thoracic cage
Scapulathoracic joint
Pulls clavicle downward and toward sternum
Sternoclavicular ligament
What are you going to see in a grade 1 AC joint sprain
Mild point tenderness
Discomfort with movement
No deformity
Mild stretching of AC lig
What are you going to see in a grade 2 AC joint sprain
Moderate tearing or rupture of AC lig Stretching or tearing of coracoclavicular lig Displacement of distal end of clavicle Moderate pain Unable to abduct arm through full ROM
What are you going to see in a grade 3 AC joint sprain
Rupture of the AC and CC lig Dislocation of clavicle Gross deformity LOF Instability
Athlete is sitting or standing, push down on clavicle
Piano key
Piano key positive test
Movement of clavicle
Athlete sitting or standing
Heel of one hand on spine of scapula
Heel of other hand on clavicle
Squeeze
Compression/squeeze
Compression/squeeze positive test
Movement and pain
Forced abduction, external rotation, direct blow with pain w/movement and palpation, decreased ROM
Glenohumeral joint sprain
Athlete supine, stabilize the shoulder, hand around humerus, pull head anteriorly and push head posteriorly and inferiorly
GH glide/Load and shift
GH glide/Load and shift positive test
Laxity compared bilaterally
Athlete standing
Stabilize shoulder
Pull arm down
Eyes on middle deltoid watching for sulcus (sucking in)
Sulcus
Sulcus positive test
Observable gap
Athlete sitting or standing
Passively put into external rotation w/humerus parallel to ground
Apprehension crank
Apprehension crank positive test
Apprehension/resistance
Overuse in overhead activity with pain in the anterior upper arm over bicipital groove while performing overhead activity
Bicipital tenosynovitis
Athlete is sitting or standing
Elbow at 90 degrees and forearm pronated
Athlete attempts to move into supination against resistance
Yergason’s test
Positive test for yeragsons
Pain in bicipital groove
Athlete sitting or standing
One hand on bicipital groove
Other hand is resisting movement at forearm
Resist shoulder flexion
Speeds
Speeds positive test
Pain in bicipital groove