Shoulder and elbow tidbits Flashcards
sprengel’s deformity
in utero deformation of scapulae, scapulae sit high on chest wall
scapular winging is a problem with what N and what M?
long thoracic N
serratus anterior
in general, what are the shoulder impingement categories?
external or internal,
then external broken down into primary or secondary?
Dx? shoulder pain with max ER? caused by supraspinatus and infraspinatus tendons ribbing on glenoid and becoming frayed. Pt says “my shoulder never feels loose”, they have an IR limitation
internal impingement
impingement that throwers get in late cocking phase.
internal impingement
what is GIRD?
glenohumeral internal rotation deficit- happens in throwing shoulders
limitations with GIRD?
most loss of IR, loss of total arc of motion tho
tx for GIRD?
post. capsule stretching
which type of impingement has to do with the type of acromion, like if it is hooked or not.
external… leads to impingement and eventually torn RC
what type of impingement is due to decreased subacromial space and often requires a SAD with or w/o a DCE/mumford sx?
primary external imingement
dx? ant. shoulder pain, lateral shoulder pain, limited IR and horizontal abduction, the pt says “I can’t fasten my bra, take off my shirt or put on my seatbelt”
primary external impingement
what type of impingement is caused by GHJ instability or RC weakness which leads to humeral head migration?
secondary external impingement
symps of secondary external impingement
ER/IR ratio is off
humeral head instable (pos. load and shift test),
pain with ER and abduction
(positive aprehension relocation test)
who gets secondary external impingement?
OH athletes
types of instability
inferior- hurts when i carry grocery bags
posterior- football lineman
anterior- pitchers
multi-directional- ligamentous laxity
scapular _______ increases loads on labrum, so u should work into __________.
protraction inc. load on labrum, retraction dec. load on labrum
horizontal abduction hurts worst with what dx?
acromioclavicular joint probs
Best shoulder exercises: Reinold Study! supraspinatus infraspinatus/teres minor subscapularis serratus anterior lower trap mid trap upper trap rhomboids/levator
supra- full can
infra/tm- SLER with towel
subscap: IR at 0
SA: pushup plus
lower trap: prone full can in scaption, (thumb up is key!)
middle trap- prone row, hand neutral, shoulder at 90
upper trap- shrug
rhomboids/levator- prone rob at neutral for rhomboid, 45 deg. for levator, and 90 degrees for mid trap!
3 Fs of adhesive capsulitis
fat, female, 40
9 Constitutional symptoms!
fever fatigue nausea night sweats dizziness diaphoresis diarrhea pallor weight loss
systemic causes of shoulder pain?
pleural pain
bacterial endocarditis
pericarditis
how do u know its pleural pain and not heart pain?
decreases when laying on affected side, worse with respiration
how do u know if its bac. endocarditis?
1-2 joints have warmth or redness
how do u know if its pericarditis?
substernal pain, coughing, pain radiates to shoulder
