Shoulder

Question 1

Which way does the humeral head face?

• A) medial, posterior, superior
• B) medial, anterior, superior
• C) medial, posterior, inferior
• D) medial, anterior, inferior

Answer 1

A) Medial, Posterior, Superior

Question 2

What is the purpose of the glenoid labrum in the shoulder joint?

Answer 2

Deepen the fossa, Create a negative intraarticular vacuum, and assist with stability

Question 3

The Superior Glenohumeral Ligament restrains what motion in the shoulder?

Answer 3

Inferior Translation

Question 4

The Middle Glenohumeral Ligament restrains what motion in the shoulder?

Answer 4

Anterior translation and External rotation

Question 5

The Inferior Glenohumeral Ligament restrains what motion in the shoulder?

Answer 5

Anterior and posterior translation

Question 6

The medial border of the scapula should be approximately how far from the vertebral column at rest?

Answer 6

Approximately 5 cm

Question 7

Which ligament in the Sternoclavicular Joint if damaged results in the greatest amount of instability?

Answer 7

Posterior Sternoclavicular Ligament

Question 8

The Conoid Ligament resists what motion in the shoulder complex?

Answer 8

Clavicle elevation and protraction

Question 9

The Trapezoid Ligament resists what motion in the shoulder complex?

Answer 9

Compression of the Acromioclavicular Joint

Question 10

Explain the general concept of the Deltoid-Rotator Cuff Force Couple.

Answer 10

The superior directed force of the deltoid is counteracted by the inferior and medially directed force creasted by the infraspinatus, sbuscapularis, and teres minor.

*The supraspinatus provides a direct compression force into the humeral head*

Question 11

What force couple is provided the main rotation of the scapula during elevation of the arm below 90degrees.

Answer 11

Upper Trapezius and Levator Scapula

Question 12

What force couple provides the primary upward rotation when the arm is elevated above 90degrees?

Answer 12

Serratus Anterior and Lower Trapezius

*Serratus Anterior is found to be impaired in patients with impingement.*

Question 13

How should you position the patient to help define the peri-scapular muscles while assessing for muscle atrophy?

Answer 13

Have patient place their hands on their hips (iliac crest).

Question 14

Describe the Kibler Scapular Slide Test as is assesses scapula dyskinesia.

Answer 14

Measure the distance from the Thoracic Spinous Process to the Inferior angle of the scapula with the arm first positioned at neutral and elevated at 90deg.

*Difference > 1.5cm is considered abnormal*

Question 15

An Inferior Angle Scapular Dysfunction as described by Kibler is most commonly seen in what shoulder diagnosis?

Answer 15

Rotator Cuff Impingement

(Anterior tipping of the scapula)

Question 16

A Medial Border Scapular Dysfunction as described by Kibler is most commonly seen in what shoulder diagnosis?

Answer 16

Glenhumeral joint instability

(especially anteriorly)

Question 17

A Superior Scapular Dysfunction as described by Kibler is most commonly seen in what shoulder diagnosis?

Answer 17

Rotator Cuff weakness and fource couple imbalances?

Question 18

How do you perform the Scapular Assistance Test (SAT) to assess for scapula dyskinesia?

Answer 18

Therapist stands behind the patient and helps guide the scapula as the pt actively elevates the arm.

*Positive = ROM increase or pain decreases

Question 19

How do you perform the Scapular Retraction Test (SRT) to assess for scapula dyskinesia?

Answer 19

Therapist manually retracts the scapula while the patient actively internally and externally rotates the arm at 90deg of abduction.

*Positive = Increased ROM or decreased pain

**Often seen in posterior impingement and RTC pathology

Question 20

How do you perform the “Flip Sign” Test and what does a positive test indicate?

Answer 20

Resist arm external rotation at the side.

*Positive = medial border comes off the thorax

**Indicates need to work on serratus anterior and trapezius force couple.

Question 21

According to EMG studies, which position of the arm activates the Supraspinatus the best?

Answer 21

Champagne Toast Position

Arm abducted 30deg, Slight ER, Flexion 30deg