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-msk > shoulder > Flashcards

shoulder Flashcards

1
Q

shoulder GH ROM

A 
flexion 180
abduction 180
IR 90
ER 90
extension 60
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2
Q

GH joint open pack

A

55 deg abduction
30 deg horizontal adduction
neutral rotation

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3
Q

GH joint closed pack

A

max abduction, ER

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4
Q

scapulohumeral rhythm

A

first 30-60deg elevation GH

then 2:1 = 120 GH:60 scapulothoracic

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5
Q

scapular upward rotation muscles

A

upper and lower trap

serratus anterior

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6
Q

scapular downward rotation muscles

A

rhomboids
levator scapulae
pectoralis minor

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7
Q

joint mobilization for ER

A

anterior glide

adhesive capsulitis - posterior glide

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8
Q

shoulder labrum special tests

A

o’briens - slap lesion
speeds - Superior labral tear or tendinitis
yergason’s - Torn transverse humeral ligament, bicipital tendonitis or tendinosis
crank - labral instability
clunk - glenoid labrum tear

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9
Q

instability tests

A

anterior instability

posterior instability

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10
Q

shoulder GH capsular pattern

A

ER, Abduction, IR

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11
Q

shoulder SC and AC capsular pattern

A

pain at extremes of ROM

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12
Q

shoulder SC and AC open and closed pack

A

open: arm resting by side
SC closed: max shoulder elevation
AC closed: arm abducted 90deg

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13
Q

painful arc in 60-120 degrees of shoulder flexion

what special test next? suspect?

A 
impingement:
Neers
Hawkins Kennedy
Infraspinatus MMT
Empty Can (Jobe)
- Supraspinatus tendonitis, impingement, partial tear
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14
Q

treatment program for adhesive capsulitis

A

primary treatment: gentle progressive stretching exercises with the focus on increased active range of motion.

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15
Q

O’Brien’s test for?

A

SLAP tears, Superior labral tear

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16
Q

interventions:

  • subacromial bursitis
  • difficulty with overhead activities
A

Shoulder rotation, esp ER, strengthening the rotator cuff, which will be the MOST helpful at treating subacromial bursitis.

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17
Q

what pathology?
pain with extreme flexion and internal rotation,
passive range of motion WNL

A

Subacromial bursitis

18
Q

what pathology?

pain with cross-body movements

A

Acromioclavicular joint lesion

19
Q

most common cause Hill-Sach’s lesion

A

most likely to occur with anterior shoulder dislocation which creates a divot in the cortex of the humeral head.

20
Q

primary or secondary impingement?

  • Worsening pain with overhead activity
  • rotator cuff weakness
A

secondary

21
Q 
primary or secondary impingement?
mechanically narrow the subacromial space such as 
- osteophytes, 
- hooked acromion, 
- malposition after fracture, 
- increased subacromial soft tissue
A

primary

22
Q

adhesive capsulitis end feel

A

firm

capsule shrinks and sticks

23
Q 
what test(s)?
Rotator cuff pathology
A

external rotation lag sign

resisted external/internal rotation/supraspinatus.

24
Q 
what test(s)?
crossover test
A

Acromioclavicular joint pathology

25
Q 
what test(s)?
bicep tendon pathology
A

Speed’s Test
yergasons
biceps load
ludington

26
Q

what pathology?

  • Gross symptomatic instability in more than one direction
  • caused by hyperlaxity in ligaments and GH joint capsule, symptomatic instability
A

glenohumeral multidirectional instability

27
Q

pivot shift test
which way is leg rotated?
what does it test for?

A

medial rotation of the leg

ACL

28
Q

reverse pivot shift test
which way is leg rotated?
what does it test for?

A

lateral rotation

PCL

29
Q

what test? + indicates what pathology?

arm in 90 degrees of abduction and 30 degrees of horizontal adduction with the thumb pointing downward.

A

supraspinatus test

+ supraspinatus tendon tear, impingement, suprascapular nerve pathology

30
Q

what test? + indicates what pathology?

arm in 90 degrees of abduction and external rotation with the elbow also flexed to 90 degrees

A

Roos test

+ thoracic outlet syndrome

31
Q

what test? + indicates what pathology?

arm in 90 degrees of flexion before being medially rotated

A

Hawkins-Kennedy impingement test

+ shoulder impingement specifically involving the supraspinatus tendon

32
Q

what test? + indicates what pathology?

positioned with the arm in a resting position at their side with the elbow flexed to 90 degrees and the forearm pronated

A

Yergason’s test

+ bicipital tendonitis

33
Q

what test? + indicates what pathology?

  • Patient’s arm is placed in 90 degrees of flexion in the scapular plane and 90 degrees of elbow flexion.
  • Therapist then laterally rotates the shoulder to end range and asks the patient to hold the position.
  • Positive: inability to hold the test position (i.e., hand springing back toward midline)
A

lateral rotation lag sign
infraspinatus or teres minor lesion
- both ER

34
Q

what test? + indicates what pathology?

  • patient to medially rotate the arm behind the back with the dorsum of the hand resting in the mid-lumbar region.
  • Therapist then instructs the patient to attempt to lift the hand off the back.
  • Positive: unable to lift hand off back
A

lift-off sign
lesion of the subscapularis muscle
- shoulder IR, innervated by the subscapular nerve (C5-C6).

35
Q

what pathology?

  • drop arm test was positive,
  • magnetic resonance imaging confirmed that the rotator cuff was not torn.
A

Axillary nerve palsy

deltoid acts as a primary abductor of the shoulder, innervated by the axillary nerve (C5-C6)

36
Q

what pathology?

generalized weakness, sensory disturbances and pain in the shoulder, arm, and hand.

A

thoracic outlet syndrome

37
Q

shoulder arthrokinematics

Flexion and medial rotation

A

humeral head rolls anterior, slides posterior

38
Q

shoulder arthrokinematics

Extension and lateral rotation

A

humeral head rolls posterior, slides anterior

if adhesive capsulitis glide posterior for ER

39
Q

shoulder arthrokinematics

Abduction

A

humeral head roll superiorly, slides inferiorly

40
Q

shoulder arthrokinematics

Adduction

A

humeral head rolls inferiorly, slides superiorly

-msk (28 decks)

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