Shoulder Flashcards

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1
Q

The shoulder is susceptible to injury because _______

A

There is more mobility compromising the stability

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2
Q

This places great stress on the complex

A

Repetitive movements

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3
Q

Examples of repetitive movements

A

Throwing
Swimming
Serving in tenis or volleyball

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4
Q

FOOSHA

A

Falling on outstretched hand/arm

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5
Q

S shaped, 6 in long, supports anterior shoulder

A

Clavicle

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6
Q

Prone to fx because of shape and not protected

A

Clavicle

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7
Q

Flat, triangular, purpose is an articulating surface for the humerus

A

Scapula

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8
Q

Humerus structures

A

Head, neck, bicipital groove, greater and lesser tubercle and glenohumeral joint

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9
Q

Most frequent fracture

A

Clavicular

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10
Q

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

A

Clavicular fracture

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11
Q

Direct blow or fall on arm with inability to move arm, swelling, point tenderness and discoloration

A

Humeral shaft fracture

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12
Q

Great danger to nerve and vessels, direct blow, discoloration, most likely at neck and can be mistaken for dislocation

A

Proximal humerus fracture

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13
Q

Young athlete 10 years and younger with a direct blow or indirect force applied to length of axis

A

Epiphyseal fracture

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14
Q

Brief translation of the humeral head without separation of the joint surfaces

Or in English, the joint comes out but goes back in

A

Subluxation

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15
Q

Most common dislocation

A

Anterior dislocation

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16
Q

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

A

Anterior dislocation

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17
Q

Forced adduction and IR or fall on outstretched and IR arm with labrum damage, severe pain and disability, limited ER and elevation

A

Posterior dislocation

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18
Q

Clavicle + manubrium of sternum, only direct connection between upper extremity and trunk

A

Sternoclavicular joint

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19
Q

Articulation disk that absorbs shock and allows movement

A

SC joint

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20
Q

Lateral end of clavicle and acromion process, weak junction

A

Acromioclavicular joint

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21
Q

Ball and socket joint, head of humerus and glenoid cavity of scapula held together by the glenoid labrum

A

Glenohumeral joint

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22
Q

Not a true joint, scapula + thoracic cage

A

Scapulathoracic joint

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23
Q

Pulls clavicle downward and toward sternum

A

Sternoclavicular ligament

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24
Q

What are you going to see in a grade 1 AC joint sprain

A

Mild point tenderness
Discomfort with movement
No deformity
Mild stretching of AC lig

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25
Q

What are you going to see in a grade 2 AC joint sprain

A
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
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26
Q

What are you going to see in a grade 3 AC joint sprain

A
Rupture of the AC and CC lig
Dislocation of clavicle 
Gross deformity
LOF 
Instability
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27
Q

Athlete is sitting or standing, push down on clavicle

A

Piano key

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28
Q

Piano key positive test

A

Movement of clavicle

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29
Q

Athlete sitting or standing
Heel of one hand on spine of scapula
Heel of other hand on clavicle
Squeeze

A

Compression/squeeze

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30
Q

Compression/squeeze positive test

A

Movement and pain

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31
Q

Forced abduction, external rotation, direct blow with pain w/movement and palpation, decreased ROM

A

Glenohumeral joint sprain

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32
Q

Athlete supine, stabilize the shoulder, hand around humerus, pull head anteriorly and push head posteriorly and inferiorly

A

GH glide/Load and shift

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33
Q

GH glide/Load and shift positive test

A

Laxity compared bilaterally

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34
Q

Athlete standing
Stabilize shoulder
Pull arm down
Eyes on middle deltoid watching for sulcus (sucking in)

A

Sulcus

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35
Q

Sulcus positive test

A

Observable gap

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36
Q

Athlete sitting or standing

Passively put into external rotation w/humerus parallel to ground

A

Apprehension crank

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37
Q

Apprehension crank positive test

A

Apprehension/resistance

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38
Q

Overuse in overhead activity with pain in the anterior upper arm over bicipital groove while performing overhead activity

A

Bicipital tenosynovitis

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39
Q

Athlete is sitting or standing
Elbow at 90 degrees and forearm pronated
Athlete attempts to move into supination against resistance

A

Yergason’s test

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40
Q

Positive test for yeragsons

A

Pain in bicipital groove

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41
Q

Athlete sitting or standing
One hand on bicipital groove
Other hand is resisting movement at forearm
Resist shoulder flexion

A

Speeds

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42
Q

Speeds positive test

A

Pain in bicipital groove

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43
Q

Athlete sitting or standing
Bring both arms up to 90 degree flexion and 30 degrees of horizontal abduction
Tell athlete to hold position and push down on arms

A

Empty can

44
Q

Empty can positive test

A

Weakness or pain in shoulder

45
Q

Athlete sitting or standing
Athlete activity goes into full abduction
Then drops down and holds at a 90 degree position

A

Drop arm

46
Q

Positive test for drop arm

A

Athlete cannot hold a 90 degree position

47
Q

Complains of diffuse pain, overhead activities increase pain, painful arc, pain in insertion of supraspinatus

A

Shoulder impingement

48
Q

Athlete stands/sits or supine

Passively put into IR and bring shoulder into flexion

A

Neer

49
Q

Neer’s positive test

A

Pain at AC joint

50
Q

Athlete sitting or standing
Passively put into shoulder flexion with elbow bent
Passively IR the arm

A

Hawkins Kennedy

51
Q

Hawkins Kennedy positive test

A

Pain at the AC joint

52
Q

Buildup of fluid caused by chronic inflammation, overuse, or a direct impact and there is pain with movement and tenderness

A

Shoulder bursitis

53
Q

What bursa is most inflamed with shoulder bursitis

A

Subacromial

54
Q

Subjected to trauma with overhead positions compressing the bursa under the coracoarcemia arch; most important

A

Subacromial bursa

55
Q

Subacromial nerve supply

A

Brachial plexus (C5-T1)

56
Q

Subacromial blood supply

A

Subclavian, brachial and axillary arteries

57
Q

Compression of brachial plexus and or subclavian artery with pain and paresthesia

A

TOCS “stingers”

58
Q

Serratus anterior weakness means

A

2 scapula wing

59
Q

Thoracic nerve injury means

A

One scapula wings

60
Q

Describes the movement of the scapula relative to the movement of the humerus through a full range of movement

A

Scapulohumeral rhythm

61
Q

How do you prevent a shoulder injury

A
  1. Proper total physical training through full ROM
  2. Proper warm up
  3. Instruction on how to properly fall
  4. Appropriate techniques must be taught
62
Q

How do you fall

A

Shoulder pads
Shoulder roll
Not without stretched hand/arm

63
Q

History

A

Type of pain

Specific movements that cause pain

64
Q

Pins and needles

A

Radiating pain from cervical pathology

65
Q

Sharp pain

A

Acute inflammation

66
Q

Dull, aching, sense of heaviness

A

Chronic rotator cuff

67
Q

Deep, aching pain in the neck, shoulder region

A

TOCS

68
Q

Night pain

A

Rotator cuff tear

69
Q

Burning pain

A

Acute tendinitis

70
Q

Weakness, numbness

A

Nerve pathology

71
Q

Pain with movement of the neck may mean

A

Cervical spine injury

72
Q

Pain with shoulder external rotation may mean

A

Dislocation/subluxation

73
Q

Pain with movement above 90 degrees

A

ACJ

74
Q

Observations should be done

A

From all sides
Anteriorly
Posteriorly
Laterally

75
Q

When observing from all sides look for

A
Symmetry 
Hypertrophy
Deformity 
Discoloration 
Swelling
How is the shoulder carried
76
Q

When observing from the anterior side look for

A

Step deformity at the ACJ

Flat deltoid

77
Q

When observing from the lateral side look for

A

Kyphosis

Scoliosis

78
Q

Shoulders slumped forward

A

Kyphosis

79
Q

Forward or backward arm hang

A

Scoliosis

80
Q

When observing from the posterior side look for

A

Muscle definition
Scapulohumeral rhythm
Scapular winging during flexion and abduction

81
Q

Anterior bony palpations

A
Clavicle
SC joint
AC joint
Coracoid process
Humeral head
Sternum
Bicipital groove
82
Q

Posterior bony palpation

A
Scapula
Spine of scapula
Medial border of scapula 
Inferior angle
Lateral border
83
Q

Anterior soft tissue palpation

A
AC and SC joint ligaments
Deltoid
Rotator cuff tendon
Sternoclediomastoid 
Biceps muscle and tendon
84
Q

Posterior soft tissue palpation

A
Rhomboids
Levator scapulae
Trapezius
Supraspinatus
Infraspinatus
Teres minor/major
Latissimus dorsi
85
Q

Phase 1 Rehab

A

Wall walks
Tubing
Strengthening
Pendulum

86
Q

What do wall walks do

A

Regains ROM in flexion and abduction

87
Q

What does tubing do?

A

Helps strengthen scapular stabilization

88
Q

Types of strengthening for phase 1 rehab

A

I’s Y’s and T’s
Rhomboids
Wall pushups
Ceiling punches

89
Q

What is the purpose of the pendulum

A

Regains ROM

90
Q

Phase 2 ROM

A
Stabilization
Balancing
Pushups
Tubing
Stretching
Strengthening
91
Q

Types of balancing for phase 2 rehab

A

Vibe plate

Dot drill

92
Q

Types of stretching for phase 2 rehab

A

Corner (pec maj)
Sleeper
Posterior/anterior deltoid
Triceps

93
Q

Types of strengthening for phase 2

A

I’s, Y’s and T’s with weight
Ceiling punch with weight
Rhomboid row with weight

94
Q

Phase 3 rehab

A
Plyometrics
Strengthening
Pushups
Tubing
Balancing
95
Q

Examples of plyometrics

A

Pushups
Trampoline
Catch and throw medicine ball

96
Q

Strengthening for phase 3 rehab

A

I’s, Y’s, and T’s on ball with weight

97
Q

Shoulder PNF

A

Ceiling punch
Pitching
Shrugs
Shiver

98
Q

Ceiling punch

A

Resist protection and retraction

99
Q

Pitching

A

Extended fingers, wrist, elbow, arm

Flex fingers, wrist and horizontal adduction across the chest

100
Q

Shrugs

A

Athlete does a shoulder shrug up and down with arm in 90 degrees of elbow flexion, examiner resists

101
Q

Shiver

A

Athlete is supine with elbow in 90 degrees of flexion and moved their arm in flexion and extension while examiner resists

102
Q

Throwing analysis steps

A
Windup
Cocking
Acceleration 
Release-Deceleration 
Follow through
103
Q

Prepares the body posture and balance in preparation of the cocking phase
Phase starts when the ball leaves the glove
Key concept is balance

A

Windup

104
Q

Shoulder abduction and extension, scapula retracted
Throwing arms is fully externally rotated
Humerus parallel to the ground
Shoulder is still pointed at partner

A

Cocking

105
Q

Very fast, explosive, short phase
Body brought forward with arm following behind
Opposite leg strides forwards
Elbow at or slightly above parallel

A

Acceleration

106
Q

Majority of posterior shoulder pain comes from this phase
Elbow extends upon release
Arm 45 degree angle to body
Striding foot on the ground pointing at partner

A

Release-deceleration

107
Q

Throwing shoulder goes across body

Full torso rotation over foot stride

A

Follow through