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OS1 Exam 1 > Shoulder > Flashcards

Shoulder Flashcards

1
Q

3 true synovial joints of the shoulder

A

glenohumeral (GH)
sternoclavicular (SC)
acromioclavicular (AC)

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2
Q

3 bones of shoulder girdle

A

clavicle, humerus, scapula (coracoid, acromion)

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3
Q

2 functional joints of shoulder girdle

A

suprahumeral, scapulothoracic

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4
Q

2 accessory joints of shoulder girdle

A

costosternal, costovertebral

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5
Q

What level is spine of scapula at?

A

T3

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6
Q

What level is the inferior border of scapula?

A

T7

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7
Q

shoulder flexion

A

180 degrees

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8
Q

shoulder extension

A

60 degrees

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9
Q

shoulder abduction

A

180 degrees

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10
Q

horizontal adduction

A

130-140 degrees

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11
Q

horizontal abduction

A

40-55 degrees

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12
Q

external rotation

A

90 degrees

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13
Q

internal rotation

A

90 degrees

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14
Q

scapula downward rotation

A

turning on A/P axis so that the scapula rotates in frontal/coronal plane to tilt the glenoid fossa downward

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15
Q

scapula upward rotation

A

turning on A/P axis so that the scapula rotates in frontal/coronal plane to tilt the glenoid fossa upward

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16
Q

scapula elevation

A

superior/cephalad glide in vertical direction along the frontal/coronal plane

17
Q

What muscles are involved in scapula elevation?

A

upper trapezius and levator scapula

18
Q

scapula depression

A

inferior/caudal glide in vertical direction along the frontal/coronal plane

19
Q

What muscles are involved in scapula depression?

A

lower trapezius and lower rhomboids

20
Q

scapula abduction/protraction

A

scapula moves away from the spine, combined with lateral tilt around thorax

21
Q

What muscles are involved in scapula abduction/protraction?

A

serratus anterior

22
Q

scapula adduction/retraction

A

scapula moves closer toward the spine

23
Q

What muscles are involved in scapula adduction/retraction?

A

rhomboids and middle trapezius

24
Q

scapula backward tilt

A

turning on a horizontal axis so that the posterior surface faces downward and the inferior angle is anterior

25
Q

scapula forward tilt

A

turning on a horizontal axis so that the posterior surface faces upward and the inferior angle protrudes posteriorly

26
Q

scapulothoracic treatment

A

pt lateral recumbent, involved shoulder up
physician faces pt front, contacting scapula with both hands
1. assess the ease and restrictions of scapular motions. apply direct or indirect MFR.
2. reassess motion

27
Q

stages of spencer’s technique

A
  1. extension
  2. flexion
  3. compression circumduction
  4. traction circumduction
    5A. adduction
    5B. abduction
  5. internal rotation
  6. traction with inferior glide
28
Q

glenohumeral joint MET flexion/extension SD

A

stabilize shoulder girdle with one hand, contact elbow with other
engage restrictive barrier in flexion/extension
apply MET
reassess

29
Q

SC joint abduction and adduction diagnosis

A
  1. pt supine; examiner index finger on clavicular head next to sternum
  2. pt shrugs (abduction)
  3. inferior/caudal movement should be palpated with normal motion at SC joint
  4. pt lowers shoulders downward (adduction)
  5. superior/cephalad movement should be palpated with normal motion at SC joint
30
Q

SC joint flexion/extension diagnosis

A
  1. pt supine; examiner index finger on clavicular head next to sternum; pt flexes shoulder 90 degrees and reaches for ceiling forcefully (flexion)
  2. posterior movement of clavicular head should be palpated
  3. pt lowers arms back toward table (extension)
  4. anterior movement of clavicular head should be palpated
31
Q

SC joint elevated adducted SD articulatory treatment

A

pt supine with neck fully flexed resting against physician’s chest who is seated at head of table

  1. physician thumb over sternal end of clavicle, exerting downward/caudal pressure on clavicle
  2. pt instructed to inhale and exhale fully. during exhalation, the physician springs the clavicle inferiorly/caudally to release restriction.
32
Q

SC joint elevated//adducted SD MET

A

pt supine, examiner on side of affected shoulder

  1. physician places one hand on sternal/proximal clavicular head. other hand grasps pt’s wrist and hold arm extended and internally rotated.
  2. pt is instructed to raise arm against physician’s hand toward ceiling (flexion at shoulder) for 3-5 seconds, then relax.
  3. bring joint into new barrier, repeating until no new barriers reached or full ROM restored
33
Q

SC horizontal extension SD MET

A

pt supine, examiner on side affected shoulder

  1. physician places one hand on the restricted clavicular head and other hand placed behind axilla to cover the scapula. pt holds physician’s shoulder with the hand of the affected shoulder.
  2. physician then flexes the clavicle toward the manubrium until movement is palpated in the SC joint by pulling scapula anteriorly.
  3. posterior force simultaneously applied to proximal clavicle from anterior to posterior to engage restrictive barrier.
  4. apply MET by having pt pull shoulder down toward table.
34
Q

SC clavicle anterior and superior glide SD

A

physician on contralateral side to SD

  1. pt assists in gapping the SC by adducting the opposite arm (ipsilateral to SD) Physician’s ipsilateral hand placed on the table under pt’s axilla to create fulcrum.
  2. articulatory springing applied laterally, posteriorly, and inferiorly over medial end of clavicle using hypothenar eminence of contralateral arm.
35
Q

cross-arm adduction test

A

physician monitors the posterior aspect of the AC joint
pt is instructed to start with arm flexed to 90 degrees and add adduction across body
motion should gap the joint posteriorly
+ if pt perceives pain at AC joint and/or increased tissue texture abnormality

36
Q

AC joint IR/ER

A

pt seated, physician standing behind pt
1 one hand contacts and stabilizes clavicular side of joint with index finger over AC joint noting tenderness
2 note assymmetry
3 flex, abduct 45 degrees to maximally engage AC component of GH rotation
4 IR and ER to assess for 90 degrees motion
5 note restriction and ease of motion
6 name somatic dysfunction based on direction of ease

37
Q

AC joint AC clavicle superior SD articulatory

A

pt supine, index fingerpad monitor AC joint and other fingers on superior aspect of clavicle; other hand grasps pt forearm proximal to wrist

  1. apply traction force in caudad direction to gap AC joint
  2. use enough force to register a change with the monitoring hand
  3. while maintaining the traction force maximally flex the arm
  4. reassess
38
Q

AC joint internal rotation SD

A

pt seated, physician stands behind pt

  1. physician places hand on clavicle just medial to AC joint while grasping wrist with the other hand
  2. add compressive force (blocking linkage) to stabilize clavicle/AC joint while flexing, abducting (45 degree) and externally rotate to restrictive barrier
  3. apply the principles of MET by having the pt internally rotate against physician’s resistance for 3-5 seconds
  4. repeat 3-5 times or until motion is fully restored
  5. reassess
39
Q

AC joint external rotation SD MET

A
  1. physician places hand on clavicle just medial to AC joint while grasping wrist with the other hand
  2. add compressive force (blocking linkage) to stabilize clavicle/AC joint while flexing, abducting (45 degree) and internally rotate to restrictive barrier
  3. apply the principles of MET by having the pt externally rotate against physician’s resistance for 3-5 seconds
  4. repeat 3-5 times or until motion is fully restored
  5. reassess

OS1 Exam 1 (8 decks)

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