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Pt Assess II Final > Shoulder Lecture > Flashcards

Shoulder Lecture Flashcards

1
Q

What is the most mobile joint in the body?

A

Shoulder

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2
Q

GH joint brings shoulder to what angle?

A

90 degrees

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3
Q

Shoulder is comprised of what joints?

A
  • GH (ball and socket synovial)
  • Sternoclavicular (cartilaginous)
  • AC (cartilaginous)
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4
Q

Muscles of shoulder girdle

A

3 groups:

  1. Rotator cuff (SITS)
  2. Trap, serrat anterior, rhomboids, lev scapulae
  3. Pec major and minor, lat dorsi
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5
Q

Rotator cuff muscles

A

SITS

  • Supraspinatus (superior most)
  • Infraspinatus (posterior)
  • Teres minor (posterior)
  • Subscapularis (anteiror)
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6
Q

Which muscles attach the scapula to the trunk and RAISE the scapula?

A
  • Trap
  • Serratus anterior
  • Rhomboids
  • Levator scapulae
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7
Q

Which muscles internally rotate the shoulder?

A
  • Pec major
  • Pec minor
  • Lat dorsi
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8
Q

Inspection of the shoulder:

A
  • Trauma or scars
  • Muscular symmetry
  • Clavicles for symmetry
  • Lumps over AC joint (previous AC separation)
  • Scapular winging (weakness in serrat anterior muscle)
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9
Q

What causes scapular winging?

A

Weakness in serratus anterior muscle (long thoracic nerve)

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10
Q

Bony palpation of shoulder:

A
  • Suprasternal notch (immediately lateral to this is SC joint)
  • Along the clavicle
  • Outer third of clavicle but before AC joint, lower finger and may be able to palpate coracoid process
  • Acromion
  • Proximal humerus
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11
Q

How to palpate proximal humerus?

A
  • Bicipital groove is here (long head of biceps tendon)
  • Pt ER arm to facilitate
  • Palpate tendon gently (it is sensitive)
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12
Q

How to palpate rotator cuff?

A
  • Stand behind pt
  • Passively extend shoulder (this moves supraspinatus out from under acromion for palpation)
  • Cup hand over top of shoulder to palpate subacromial bursa
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13
Q

The shoulder ROM includes:

A
  • Abduction (180 degrees)
  • Adduction (60 degrees)
  • Extension (60 degrees)
  • Flexion (160-180 degrees)
  • ER (75-90 degrees)
  • IR (60 degrees)
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14
Q

Easiest way to assess AROM of the shoulder?

A

Apley Scratch test

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15
Q

Describe Apley Scratch test

A
  • Used to test AROM of shoulder

- Pt touches opposite shoulder (adduction/IR), behind head (adduction/IR), and behind back

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16
Q

9 motions of the shoulder

A
  1. Flex
  2. Extension
  3. Abduction
  4. Adduction
  5. ER
  6. IR
  7. Scapular elevation
  8. Scapular retraction
  9. Scapular protraction
17
Q

Which muscles help flex the shoulder?

A

Coracobrachialis
Pec major
Anterior deltoid
Biceps

18
Q

Which muscles help extend the shoulder?

A

Lat dorsi
Teres major/minor
Posterior deltoid
Triceps

19
Q

Which muscles help abduct the shoulder?

A

Deltoid
Supraspinatus
Serratus anterior

20
Q

Which muscles help adduct the shoulder?

A

Pec major
Lat dorsi
Teres major
Deltoid

21
Q

Which muscles help ER the shoulder?

A

TIP
Teres minor
Infraspinatus
Posterior deltoid

22
Q

Which muscles help IR the shoulder?

A 
Subscapularis
Pec major
Lat dorsi
Teres major
Deltoid
23
Q

Which muscles help with scapular elevation?

A

Trap
Levator scapulae
Rhomboids

24
Q

Which muscles help with scapular retraction?

A

Rhomboids

Trapezius

25
Q

Which muscles help with scapular protraction?

A

Serratus anterior

26
Q

What is Speed’s test?

A
  • Test for bicipital tendinitis
  • Arm elevated to 90 degrees forward flex of shoulder w/elbow straight and arm supinated
  • Push down on pt palm
  • Positive: pain in anterior shoulder (bicipital groove)
27
Q

What is the empty can test?

A
  • Tests supraspinatus tendinitis/tear

- Pt puts arms out in front and “empties cans”

28
Q

What is the impingement sign?

A
  • Passively lift (forward flex) arm from 0 degrees up to 180
  • Positive: pain between 90 and 150 degrees
  • Sign of impingement from bursitis or chronic impingement
29
Q

What is the apprehension sign of the shoulder?

A
  • Bring pt’s arm up into throwing position (abducted/ER)
  • Watch for apprehension
  • Indicates instability due to torn labrum, Bankart lesion, or anterior dislocation of shoulder
30
Q

What is the relocation sign of the shoulder?

A
  • After establishing positive apprehension sign, lie pt prone on table
  • Reproduce apprehension sign
  • Reach underneath and push humeral head posteriorly
  • Bring back to apprehension position
  • If pt can tolerate this w/o apprehension, confirms anterior instability
31
Q

What is the point of the relocation sign of the shoulder?

A

Temporarily stabilize shoulder through manipulation (resolving apprehension)

Pt Assess II Final (17 decks)

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