Shoulder Flashcards
What is the most sensitive indicator to joint disease
Range of motion
What are the ROM for shoulder
Flexion - 180
Extension - 60
Abduction - 180
Adduction - 50
Internal Rotation - 90
External Rotation - 90
Horizontal Abduction - 40-55
Horizontal Adduction - 130-140
Shoulder Horizontal Adduction
130-140
Shoulder Horizontal Abduction
40-55
Shoulder Extension
60
What is the most popular specialty test that indicates a Subacromial Bursa Impingement and/or Rotator Cuff Injury
Painful Arc Test
What makes the Painful Arc Test so important
Highest positive likelyhood ratio of all rotatory cuff maneuvers & lowest negative likelyhood ratio of all rotatory cuff maneuvers.
It’s the most sensitive & specific
What indicates a positive painful arc test?
Pain between 60-120. The other ROM in the arc is pain free.
What are the key upper extremity myotomes
C5 - Elbow flexers (biceps)
C6 - Wrist extensors
C7 - Elbow extensors
C8 - Finger flexors
T1 - Finger abductors
Where should pulses and/or capillary refill be checked after an injury?
distal to the site of the injury
What population is a clavicle fracture most common in
Kids
What group is a proximal humerus fracture most popular
Elderly
How does one typically get a scapular fracture
Blunt Trauma
What are the nerve roots for the UE DTR
Triceps (C6-7)
Biceps (C5-6)
Brachioradialis (C5-6)
What is the most common glenohumeral dislocation
Anterior dislocation
How does a AC joint injury typically occur
Direct trauma to the superior or lateral aspect of the shoulder (acromion) with the arm adducted
(Direct blow or falling onto the shoulder)
What are some extrinsic causes of shoulder pain
GI related, Upper lung disease & diaphragm irritation
These are also known as referred pain
What are some intrinsic causes of shoulder pain
Septic arthritis, overuse, bursitis & synovitis
Where does the most common Rotator Cuff Injury occure
Supraspinatus Tendon
Rotator Cuff diagnosis
X-rays are not helpful
Ultrasound &/or MRI are the tests of choice
Adduction of GH joint
Scapular motion - Depressed
Clavicle AC joint (distal) - Inferior glide
Clavicle SC joint (proximal) - Superior glide
Abduction GH joint motion
Scapular motion - Elevation
Clavicle AC joint (distal) - Superior glide
Clavicle SC joint (proximal) - Inferior glide
Flexion GH joint motion
Scapular motion - protraction
Clavicle AC joint (distal) - anterior glide
Clavicle SC joint (proximal) - posterior glide
Extension GH joint motion
Scapular motion - Retraction
Clavicle AC joint (distal) - Posterior glide
Clavicle SC joint (proximal) - Anterior glide
Internal Rotation GH joint motion
Scapular motion - none
Clavicle AC joint (distal) - Internal rotation
Clavicle SC joint (proximal) - none
External Rotation GH joint motion
Scapular motion - none
Clavicle AC joint (distal) - external rotation
Clavicle SC joint (proximal) - none
Apprehension Test
Test for - Glenohumeral Instability
(+) Test - Patient apprehension
Think how apprehensive you get when someone trying to bend your shoulder’s backward
Empty Can Test
Tests for Rotator Cuff Pathology specifically Supraspinatous Pathology
+ Test = pain or weakness
Think of motion when you pour out soda’s with both hands
Drop Arm Test
Rotator Cuff Pathology - Supraspinatous
+ Test = Uncontrolled arm drop
Painful Arc Test
Subacromial Bursa Impingement &/or Rotator Cuff injury
+ Test = pain btw 60-120 degrees of abduction
Neer Impingement
Subacromial Bursa Impingement &/or Rotator Cuff impingement
+ Test = Pain
Neer to the Ear
Hwakins Test
Subacromial Bursa Impingement &/or Rotator Cuff impingement
+ Test = Pain
Cross Arm Test
AC joint pathology
+ Test = AC joint pain or increased tissue texture abnormalities
What forces are used in a shoulder myofascial release?
distraction, compression, twist & shear
Spencer’s Technqiue
What does it treat
Direct or Indirect
How is the patient positioned
Glenohumeral joint
Direct/restrictive barrier - MFR and/or MET
Lateral recumbent with involved shoulder up
What are the steps of Spencer’s technique
Extension
Flexion
Compression Circumduction
Traction circumduction
ABduction w/ external rotation
ADduction
Internal Rotation
Traction w/ inferior glide
How are the AC and SC somatic disfunctions named
They are named after the direction the shoulder likes to go
