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Clinical > Shoulder > Flashcards

Shoulder Flashcards

1
Q

What is inspected for in a shoulder anteriorily?

A
  • Slings?
  • Asymmetry of shoulder girdle
  • Scars
  • Deltoid wasting
  • Step deformity
  • Lump in antecubital fossa
  • Swelling
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2
Q

What is inspected for in a shoulder laterally?

A

Scars

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3
Q

What is inspected for in a shoulder posteriorly?

A
  • Winged scapula
  • Scoliosis
  • Tarpezius and deltoid wasting/bulk
  • Paravertebral muscles - swelling/wasting
  • Supra/infraspinatus fossa muscle wasting
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4
Q

c

A

c

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5
Q

c

A

c

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6
Q

c

A

c

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7
Q

c

A

c

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8
Q

c

A

c

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9
Q

c

A

c

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10
Q

What should be felt for in the shoulder?

A
  • Temperature

- Tenderness/swelling in shoulder girdle

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11
Q

What does temperature indicate in the shoulder?

A
  • Inflammatory arthropathy

- Infection

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12
Q

Palpation of shoulder girdle

A
  • Sterno-clavicular joint
  • Clavicle
  • Acromio-clavicular joint
  • Coracoid process – 2cm inferior and medial to the clavicular tip
  • Head of humerus
  • Greater tuberosity of humerus
  • Spine of scapula
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13
Q

Surface anatomy of coracoid process? 2 attachments?

A

2cm inferior and medial to the clavicular tip

  • Short head of biceps
  • Pec minor
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14
Q

What screening shoulder compound movements are used? (2)

A
  • Place hands behind head

- Move hands far up back

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15
Q

Put your hands behind your head - functions assessed? (2)

A
  • External rotation

- Abduction

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16
Q

Put your hands as far up your back as you can - function assessed?

A

Internal rotation

17
Q

What specific active shoulder movements should be assessed? And how? (6)

A
  • Lift arm backwards keeping them straight (extension)
  • Raise arms forwards until points upwards (flexion)
  • Lift arms away from sides as far as possible until top (abduction)
  • Bring arms across trunk to opposite sides (adduction)
  • Tuck elbows in like riding a bike then
    a) Bring elbows out (external rotation)
    b) Bring elbows in (internal rotation) then reach up back
18
Q

Normal ROM for shoulder flexion

A

150-180

19
Q

Normal ROM for shoulder extension

A

40

20
Q

Normal ROM for shoulder abduction

A

Up to 180

21
Q

Normal ROM for shoulder adduction

A

30-40

22
Q

Normal ROM for external rotation

A

80-90

23
Q

Normal ROM for internal rotation

A

T4-T8

24
Q

If aduction is painful 70-120 what is this a sign of?

A

Subacromial impingement

25
Q

If aduction is painful 140-170 what is this a sign of?

A

AC joint disruption

26
Q

What does passive movement assess for?

A

Crepitis

27
Q

What 2 shoulder conditions lead to generalised reducitions in passive as well as active range of movement? (other pathologies don’t restrict passive) (2)

A
  • Adhesive capsulitis

- Glenohumeral joint arthirtus

28
Q

Which movements are most effected by glenohumeral joint pathology (osteoarthiritus + adhesive capsulitus)? (2)

A
  • External rotation

- Abduction

29
Q

How is the scapula assessed? (3)

A
  • Ask patient to abduct shoulder
    • Palpage inferior pole of scapula (hand around armpit)
  • Assess degree and smoothness of scapular movement
30
Q

When does scapula dysfunction occur?

A

Impingement

31
Q

Name the special shoulder tests

A
  • Supraspinatus = “empty can”
  • Impingement of supraspinatus = “Painful arc”
  • Capsulitis/AC joint pathology = “scarf test
32
Q

What does a positive scarf test indicate?

A

Capsulitus/AC joint patholgy

33
Q

How to carry out scarf test? (2)

A

Get patient to stretch arm across to opposite shoulder and put hand on it
- Then push elbow in to opposite shoulder

34
Q

What is a positive scarf test?

A

Pain felt specifc to AC joint (lateral end of clavicle) during horizontal adduction

35
Q

How to carry out empty can test? (4)

A
  • Abduct arm by 90
  • Angle arm forward by 30 (shoulder in plane of scapula)
  • Internally rotate arm so thumb down to floor
  • Then push down on arm - patient resists pressure
36
Q

Weakness in empty can test?

A

Weakness/impingment in supraspinatus

Clinical (21 decks)

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