Shoulder Complex Exam and Eval Flashcards
adhesive capsulitis vs frozen sholder
adhesive capsulitis is an inflammatory response
adhesive capsulitis
2 year process
age 40-60
females>males
capsular pattern
capsular pattern of shoulder
first loss is ER
second loss is flexion and abduction (equal losses in both)
frozen shoulder
capsular pattern may or may not be present
often limitations greater in IR than ER
if more ROM loss in IR rather than ER, think what diagnosis?
frozen shoulder (rather than adhesive capsulitis)
causes of IR position of arms at rest
- tight pecs, lat, teres major, subscap
- weak traps
- IR can be due to position of scapula, not tight muscles
most commonly used UE outcome measurement tool
quick dash
GROC
global rating of change
measures the patient’s perception of it theya re getting better or worse (can use with any joint, 7 pt scale)
pattern 4 of scapulohumeral rhythm
normal
C3-C4 referred pain
SC joint
C4
AC joint innervation
C5
lateral shoulder referred pain
C5-C6
GHJ structure innervation
getting coat on: what arm positions and what disorder?
abduction and ER: classic adhesive capsulitis if painful
pain with arms overhead and with putting on seatbelt
impingment
pattern 1 scapulohumeral rhythm
inferior medial angle of scapula is displaced posteriorly from the posterior thorax
pattern 2 scapulohumeral rhythm
entire medial border of scapula is displaced posteriorly from the psoterior thorax
pattern 3 scapulohumeral rhythm
early scapular elevation or excessive/insufficient scapular upward rotation
which muscles attach to the coracoid?
coracobrachialis, pec minor, short head of biceps
palpate subacromion space
fall laterally off of AC joint
how to palpate teres major
feel by asking for IR, it will pop out
teres major and lat close to inferior angle of scapula
order from sup to inferior: infraspinatus, teres minor, teres major, lat
IR vs ER for palpating tuberosities of humerus
IR = greater tuberosity ER = lesser tuberosity
SA palpation
below inferior angle of scapula
arm in flexed position above head, resist extension to feel
weak SA will compensate with pecs
origin/insertion of triceps
infraglenoid tubercle of scapula and olecranon
subscapularis palpation
palpate in supine
armpit
inferior/anterior surface of scapula
Position of patient when assessing the scapulothoracic joint
sidelying facing the therapist
Sternoclavicular joint becomes unstable after: (2)
- trauma such as a car accident
2. open heart surgery: sternum heals as cartilage and not bone
anterior inferior glide of SCJ assesses which 3 ligaments?
- anterior sternoclavicular
- costochondral
- costoclavicular
Superior posterior glide of SCJ assesses what lgiament?
asesseses the posterior SC ligament, restricted by superior joint capsule and interclavicular ligament
When the GHJ has limited motion, the most common place to compensation/substitute from to get the motion is where?
scapulothoracic joint
anterior and posterior glide of the ACJ: two methods of stabilization
- stabilize humerus and move clavicle (pt faces away from therapist)
- stabilize scapula/thorax with your body and move the clavicle (pt faces you)
limited inferior glide of GHJ = textbook what disorder?
adhesive capsulitis
inferior glide of GHJ: stabilize what and palpate what?
stablize scapula, palpate subacromial space!
good inhibition, relaxation technique
if a patient is restricted in posterior glide, what happens to the head of the humerus?
it is pushed anteriorly, which decreases the subacromial space during elevation of the arm
position of patient during both posterior and anterior glides of GHJ
supine (however, an anterior glide can also be done in prone!)
if anterior glide of the GHJ is limited, what function/action is limited?
humeral ER will be limited, which is needed for glenohumeral elevation
patients who classically have a tight posterior capsule and would benefit from a posterior glide of the GHJ?
baseball pitchers (because anterior capsule is hypermobile) also - those with impingement
an anterior glide goes from ___ to ___
posterior to anterior
a posterior glide goes from ___ to ____
anterior to posterior ( stretches posterior capsule)
limited anterior and inferior glides = what condition?
adhesive capsulitis
capuslar pattern of GHJ
ER, abduction, flexion
how do you stabilize the scapula when doing a prone anterior glide to the GHJ?
place towel under arm
