Shoulder Injuries: MOI and S/Sx

Question 1

Clavicle Fracture S/Sx

Answer 1

• Patient supporting arm and tilting head toward injured side
• lowered clavicle on affected side
• step off deformity
• swelling, point tenderness, deformity

Question 2

Clavicle Fracture MOI

Answer 2

FOOSH,
Fall on tip of shoulder,
Direct impact
most occur in the middle 1/3

Question 3

Biceps Brachii Rupture S/Sx

Answer 3

loud snap, sudden intense pain, weakness, bulge near middle of biceps

Question 4

Biceps Brachii Rupture MOI

Answer 4

irritation of the transverse humeral ligament & degeneration of long head of the biceps tendon

Question 5

Biceps Brachii Tendinopathy

Answer 5

MIO: rotator cuff dysfunction, overuse of biceps brachia muscle, subacromial impingement

S&S: pain over bicipital groove, swelling, warmth, crepitus, snapping if tendon is subliming

Question 6

Sternoclavicular Joint Injury MOI

Answer 6

Longitudinal force on the clavicle
- FOOSH, hit on the lateral portion of the shoulder, or traction forces

Question 7

Glenohumeral Instability

Answer 7

Repetitive throwing, the anterior shear force that leads to stretching of static stabilizers, increased demands on dynamic stabilizers
Weakness, instability, excessive mobility

Question 8

Scapular Dyskinesis MOI

Answer 8

MOI: gradual onset due to poor scapular function due to abnormal motion, position, or stability. common in patients with other shoulder conditions.

Question 9

Scapular Dyskinesis S/Sx

Answer 9

S/Sx: pain localized over coracoid process, superior/medial border of scapula,
AC joint, subacromial space. abdnormal scapular positioning/movement, ex: scapular winging

Question 10

Sternoclavicular Joint Injury S/Sx

Answer 10

Pain with protraction, retraction, and joint play

Posterior dislocations = medical emergency!
- Threat to the subclavian artery and vein, trachea, and esophagus

Question 11

SLAP Lesions

Answer 11

MOI: Results from overhead throwing, acute or chronic, tears to the labrum anterior to posterior

S&S: Clinically inconsistent symptoms, pain between AC and coracoid during overhand movements, dead arm symptoms (loss of control and velocity)

Question 12

Brachial Plexus Injury MOI

Answer 12

Tension or compression of the brachial plexus

Tension – neck forced laterally to opposite side while the shoulder is depressed
Compression – common with tackling

Question 13

Brachial Plexus Injury S/Sx

Answer 13

Burning, numbness, tingling, and pain down the arm
May last seconds to several days

Question 14

Shoulder Subluxation MOI

Answer 14

Forced ER and ABD of humerus
excessive translation without complete separation from joint

Question 15

Primary Impingement MOI

Answer 15

Due to altered structure that increases compression

Question 16

Subacromial Impingement MOI (General)

Answer 16

• Compression of the structures under the coracoacromial arch
• Impingement most often occurs in repetitive overhead activities (↓ space creates compression)

Question 17

Anterior Dislocation MOI

Answer 17

Forced ER and ABD of humerus
translation of humeral head leading to complete joint separation

Question 18

Nontraumatic posterior instability

Question 19

Secondary Impingement MOI

Answer 19

• Closely related with shoulder instability
• Instability leads to excessive translation of humeral head that leads to increased compression

Question 20

Acromioclavicular sprain: MOI

Answer 20

FOOSH, blow to the superior acromion process

Question 21

Subacromial Impingement S/Sx

Answer 21

Pain when lifting arms above head or reaches backward. Pain over area

Question 22

Acromioclavicular sprain: S/Sx

Answer 22

Type I: Point tenderness over the AC joint; no laxity/deformity
Type II: Slight laxity and deformity & slight step deformity
Type III: Obvious dislocation of the distal end of the clavicle from the acromion process
Type IV: Posterior clavicle displacement into the insertion of the upper fibers of the traps
Type V: Displacement of the involved clavicle from the acromion & clavicle is posteriorly displaced
Type VI: Displacement of the clavicle inferiorly under the coracoid