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KIN 440 > Shoulder > Flashcards

Shoulder Flashcards

1
Q

The shoulder complex is a coordinated function of:

A
  • glenohumeral (scapulo-humeral)
  • acromioclavicular
  • sternoclavicular
  • scapulothoracic
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2
Q

3 Joints of the shoulder complex:

A
  • sternoclavicular joint
  • acromioclavicular joint
  • glenohumeral (GH) joint
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3
Q

Sternoclavicular joint is a direct connection between ____ and _____.

A
  • UE

- trunk

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4
Q

Sternoclavicular joint is what type of joint?

A

weak synovial plane joint

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5
Q

Sternoclavicular joint is stabilized by…

A

strong ligaments and articular disc

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6
Q

Sternoclavicular joint moves with….

A
  • scapula

- actions of shoulder cause motion at this articulation

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7
Q

Acromioclavicular joint is a connection between ____ and ____.

A
  • scapula

- clavicle

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8
Q

Acromioclavicular joint is what type of joint?

A

weak synovial gliding joint

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9
Q

Acromioclavicular joint is stabilized by…

A

multiple strong ligaments

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10
Q

Acromioclavicular joint moves with…

A
  • UE

- actions of shoulder cause motion at this articulation

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11
Q

Scapulothoracic pseudo-articulation is …

A

not a true joint

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12
Q

Scapulothoracic pseudo-articulation movement pattern:

A
  • between the scapula and across the thoracic cage (ribs)
  • elevation, depression
  • protraction, retraction
  • rotation
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13
Q

Scapulothoracic pseudo-articulation dysfunction often results in…

A

stress or injury to shoulder joint from repetition of movement

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14
Q

With contraction of _____ stabilization muscles, a strong base for high level ___ ____ mobility of ____ is achieved.

A
  • scapular
  • GH joint
  • UE
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15
Q

GH joint:

A
  • ball and socket joint
  • multiaxial joint, mobile joint
  • articulation of head of the humerus with glenoid fossa or cavity of scapula
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16
Q

ROM of GH joint:

A
  • flexion, extension
  • abduction, adduction
  • medial rotation, lateral rotation
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17
Q

Labrum of the GH joint is called:

A

glenoid laburm

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18
Q

Functions of the glenoid labrum:

A
  • joint stability
  • deepens and increases glenoid depth approximately 2x
  • protects bone
  • lubricate joint synovial fluid
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19
Q

Glenoid labrum is continuous with …

A

tendon of long head of the biceps brachii

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20
Q

Injury to glenoid labrum:

A
  • labral stress
  • load
  • rotations with stress
  • extreme ROMs (past end ROM)
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21
Q

Capsule of the GH joint:

A
  • assists in joint stability

- rotator cuff tendons blend in for a dynamic capsular tightening (restricts extreme ROM)

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22
Q

Capsular injury of the GH joint can be…

A

acute or chronic injury

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23
Q

Functions of bursa of the shoulder:

A
  • aids mobility

- increases ROM

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24
Q

4 bursae in the shoulder:

A
  • subacromial bursa
  • subdeltoid bursa
  • subcoracoid bursa
  • subscapular bursa
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25
Q

Bursae of the shoulder injury MOI:

A
  • compression

- contusion/contact

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26
Q

Most common bursae injuries:

A
  • subacromial bursa

- impingement

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27
Q

GH ligaments are the primary check against…

A

anterior and posterior dislocations

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28
Q

GH ligaments are critical structures for…

A
  • joint stabilization

- overhead activities

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29
Q

Ligamentous support of …

A
  • GH joint

- AC joint, SC joint

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30
Q

If there is injury to the ligaments of the GH joint, there will be…

A

pain with ROM

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31
Q

3 components of neurovascular structures of shoulder joint and complex:

A
  • arteries
  • veins
  • nerves
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32
Q

Important neuro structures of shoulder:

A
  • brachial plexus
  • auxillary nerve
  • musculocutaneous n.
  • radial n.
  • scapula ulnar n.
  • median n.
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33
Q

Important vascular structures of shoulder:

A
  • subclavian artery
  • axillary artery
  • brachial artery
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34
Q

DOI questions for shoulder:

A
  • acute

- chronic (repetitive movements of arm)

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35
Q

MOI questions for shoulder:

A
  • understand tissues under stress (fall on point, or repetitive motion)
  • not position of arm relative to joint (ie. FOOSH, at side, forcefully abducted and extended)
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36
Q

Pain questions for shoulder:

A
  • region, referred or radiates (if yes, quadrant scan)
  • establish relationship with function and the pain
  • ADL, sleep (affected, positions of pain)
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37
Q

Unusual sounds and sensations questions for shoulder:

A
  • crepitus
  • catching or clicking
  • give way
  • pop out
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38
Q

Function questions for shoulder:

A
  • notable weakness

- affect function of the wrist and hand

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39
Q

Previous injury questions for shoulder:

A
  • dislocations
  • MVA
  • whiplash
  • injury to neck or spine
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40
Q

Changes in sensations (unusual sensations) questions for shoulder:

A
  • numbness
  • tingling
  • stabbing
  • any circulation changes (cold)
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41
Q

Activity/sport history questions for shoulder:

A
  • any OH activities in sport, ADL, occupation (positions of pain)
  • changes to activity, training, strength training
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42
Q

Key observations to consider for the GH joint:

A
  • all view points
  • scapular posture
  • position of shape of clavicle
  • muscle asymmetry
  • spinal alignment
  • scapulo-humeral rhythm
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43
Q

All view points includes:

A
  • anterior
  • posterior
  • lateral
  • landmarks
44
Q

What to look for with scapular posture:

A
  • resting position of the scapula
  • bilateral position
  • scapular elevation
  • protraction position
  • winging
  • scapular deviations
45
Q

Position and shape of clavicle:

A
  • acromion process (height of, deformity of)
  • observe notable or remarkable postures
  • bony prominences
46
Q

What to look for with muscle asymmetry:

A
  • shape
  • girth
  • atrophy
47
Q

What to look for with spinal alignment:

A
  • position of head
  • t-spine
  • position of UE
48
Q

Scapular dyskinesis:

A
  • noting border prominences that are remarkable
  • protracted, retracted
  • rotated, tilted
  • winging
49
Q

Acromion process deformity:

A
  • AC joint

- piano key (sign for a sprain of AC ligaments)

50
Q

Impact of spinal alignment with shoulder pain:

A
  • CC: pain in ant. aspect of shoulder
  • observe thoracic spine (kyphotic posture)
  • impact on shoulder pain
51
Q

Scapulo-humeral rhythm:

A

observation of a pattern or rhythm of the movement of the humerus (UE) in relation to the scapula

52
Q

Full ROM at the shoulder is a combination of…

A
  • complex
  • GH joint
  • SC joint
  • AC joint
  • scapulothoracic movement along with the spine
53
Q

Full ROM movement can be compromised by…

A
  • anything that changes the position of the scapula

- such as muscle imbalances

54
Q

Purpose for effective movement pattern:

A
  • to achieve full and functional ROM in a pain free ROM

- for efficient and effective strength and power in movement

55
Q

Movement pattern for first ___ degrees abduction or first ____ degrees flexion:

A
  • 30
  • 45
  • humerus moves
  • scapula is fixed to a position of stability on thorax
56
Q

Movement pattern for beyond the initial range:

A
  • the ratio of humerus to scapular movements is a 2:1 ratio

- scapular rotation facilitates GH movement

57
Q

Degree of ROM is an assessment relative to…

A

positioning of the UE

58
Q

How to assess degree of ROM:

A
  • direct rotation of UE or observe for it
  • evaluate with elbow straight or bent elbow
  • can assess internal/external GH ROM in any degree of abduction or of flexion (ie rotation at 90/90)
  • transverse or horizontal abduction
59
Q

When assessing ROM, we should assess _____ for …

A
  • bilaterally
  • pain
  • strength
  • degree of range
60
Q

Notable or remarkable observations in ROM:

A
  • painful arc pattern
  • starting positions for initiating movement
  • observation of the scapulo-humeral rhythm
61
Q

Painful arc pattern describes a syndrome where there is…

A
  • a common painful range of 60-120 degrees for flexion and abduction
  • painful at end of the ROM
62
Q

Painful arc pattern IOS:

A
  • subacromial dysfunction

- inflamed tendon presses against acromium

63
Q

Structure of painful arc pattern:

A
  • compressed, pinching

- AC joint, RTC tendon, subacromial bursa

64
Q

Glenohumeral painful arc:

A

60-120 degrees

65
Q

Acromioclavicular painful arc:

A

170+ degrees

66
Q

MMT using UE positioning: deltoid:

A
  • anterior, lateral, posterior

- flexion, abduction, extension

67
Q

MMT using UE positioning: supraspinatus:

A
  • abduction

- deltoid

68
Q

MMT using UE positioning: biceps long head:

A
  • flexion
  • 2 joint muscle (TJM)
  • anterior deltoid
69
Q

Impingement positions are…

A

unwanted compression of soft tissue between 2 or more harder unyielding structures

70
Q

Impingement positions leads to…

A
  • pressure
  • inflammation
  • pain
  • loss of function
71
Q

MOI for impingement positions:

A

typically repetitive OH actions

72
Q

Impingement positions are evaluated in ….

A
  • end range of AROM and PROM

- sign and a symptom

73
Q

How to conduct a impingement test:

A
  • position the UE to stress structures of the GH joint

- pinch, impinge, compress

74
Q

Coracoacromial arch is made up of:

A
  • acromion
  • coracoacromial ligament
  • coracoid process
75
Q

Common impingement structures at the GH joint:

A

under coracoacromial arch

76
Q

Apprehension test assesses…

A
  • the integrity of stabilizing structures of the joint

- the client’s feeling of instability in ROMs

77
Q

Anterior apprehension test:

A
  • positive test illicit apprehension in putting the humeral head into a position to stress the joint
  • leads to an IOS of GH joint instability (subluxation, dislocation)
78
Q

Movements of function:

A
  • in OH activities; as a weight-bearing joint

- load, compress, stress the joint and the shoulder complex (stress to structures; symptoms)

79
Q

Movement of shoulder complex in combination of

A
  • SC joint
  • AC joint
  • scapula: movement to positions of stability
  • GH joint
  • spine
80
Q

Maintaining ____ while allowing for a high degree of _____ is critical for effective and full shoulder function.

A
  • stability

- mobility

81
Q

___ joint instability is often the cause of many specific shoulder injuries like…

A
  • GH

- tendinitis, dislocation, subluxation

82
Q

GH joint injuries result from…

A
  • structural vulnerability
  • extensive freedom of movement
  • poor correlation between articular surfaces
  • great strength of surrounding musculature
83
Q

While the GH joint is inherently _____, the coordinated and synchronous actions of the ____ and _____ structures provide joint stability.

A
  • unstable
  • static
  • dynamic
84
Q

GH joint has integrated function of ____ structures and _____ (____) structures such as….

A
  • inert
  • contractile (dynamic)
  • joint
  • scapular stabilizing muscles
  • RTC muscles
  • joint capsule labrum and ligaments
85
Q

What originates on axial skeleton to humerus?

A
  • latissimus dorsi

- pec major

86
Q

What originates from the scapula to humerus?

A
  • deltoid, teres major, corochobrachialis

- subscapularis, teres minor, supraspinatus, infraspinatus

87
Q

RTC in conjunction with biceps provide dynamic stability through…

A
  • minimizing excessive humeral head displacement

- creates force couples to compress humeral head into glenoid fossa

88
Q

_____ imbalances cause _____ mechanics.

A
  • dynamic

- abnormal

89
Q

Stability: which muscles go from axial skeleton/spine to scapula?

A
  • pecs
  • lats
  • levator scap
  • rhomboids
  • serratus anterior
  • trapezius
90
Q

____ stability aids _____ mobility of GH joint.

A
  • scapular

- functional

91
Q

Scapular muscles produce ….

A
  • scapular motion

- dynamically position the glenoid for humeral motion

92
Q

Collectively, scapular muscles work to ….

A

maintain consistent length-tension relationships with the glenohumeral musculature

93
Q

Scapular muscles sustain _____ _____ through a larger portion of the ROM.

A

force production

94
Q

Scapular muscles prevents _____ between the _____ and the _____ (____).

A
  • impingement
  • humerus
  • acromion (scapula)
  • movement between the humerus and scapula is limited
95
Q

Key scapular stabilizers:

A
  • spinal posture

- scapular posture

96
Q

What provides strength for the shoulder?

A
  • scapular stabilizers

- RTC

97
Q

At the shoulder, we are palpating for …

A
  • pain
  • TICS
  • integrity of the joint (AC, SC joints)
  • instability of the bones (clavicle, acromian, humerus)
  • soft tissue structures (muscles, tendons, ligaments, bursa)
  • pain (specific site = location of structure)
98
Q

Structures in the shoulder:

A
  • bone
  • joint
  • ligament
  • muscular
  • nerve
  • meniscus
  • bursa
  • capsule
99
Q

Types of potential injuries:

A
  • sprain
  • strain, tendonitis
  • bursitis
  • fracture
  • dislocation, subluxation
  • labral injury
  • brachial plexus/nerve injury
  • thoracic outlet syndrome
100
Q

Severity is ranked by….

A

grade

101
Q

Rehab considerations: ____ response to _____ controlled.

A
  • tissues

- trauma

102
Q

Rehab considerations: injured part should be ____/____.

A

rested/supported

103
Q

Rehab considerations: restore…

A
  • scapulothoracic control
  • ROM
  • rotator cuff function and endurance
104
Q

Rehab considerations: assess…

A
  • scapulohumeral rhythm

- posture

105
Q

Rehab considerations: _____ control.

A

proprioceptive

106
Q

Rehab considerations: how to have progressive return to function:

A
  • activity modification

- equipment modification

KIN 440 (10 decks)

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