Shoulder Flashcards
- General inspection
Discarded sling
Signs of pain
Systemically well
Body habitus
- Look
Alignment and symmetry Deformity Skin changes Wasting Swelling
- Deformity
Steps in clavicle
Dislocation
Winging of scapula (long thoracic nerve injury)
- Skin changes
Scars (arthroscopy, shoulder surgery)
Erythema
Bruising
- Wasting
Trapezius Deltoid Biceps Triceps Supraspinatus Infraspinatus
- Swelling
Inflammation
Bursitis
- Feel (12)
Temperature Sterno-clavicular joint Clavicle Arcromio-clavicular joint Acromion Greater tubercle of humerus Coracoid Deltoid Biceps tendon Boxers of scapula Supraspinatus Infraspinatus
- Function
Hands behind head
Hands behind back
Right hand left shoulder
Left hand right shoulder
- Move
Flexion
Extension
Abduction
-60°-120° mid arc pain (supraspinatus impingement)
>120° high arc pain (ACJ injury)
External rotation - elbows fixed (loss =frozen shoulder)
Internal rotation - hands behind back
- Special Tests
Empty beer can (supraspinatus) External rotation against resistance (teres minor and infraspinatus) Hands behind back, push (subscapularis) Scarf test Hawkins-Kennedy
- Scarf Test
Patient hand on opposite shoulder
Hand on elbow
Pain = ACJ injury
- Hawkins-Kennedy
Shoulder 70°, elbow 90°
Support elbow, push hand down
Pain = supraspinatus impingement
- Joint above
C spine
Flexion, extension
Lateral rotation
- Neurovascular
Radial pulse
Axillary nerve - deltoid