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MSS - OPP Exam 2 > Shoulder Mechanisms and Counterstrain > Flashcards

Shoulder Mechanisms and Counterstrain Flashcards

1
Q

if you treat SD in T spine, upper ribs, lower C spine?

A

upper extremity dysfunction will frequently take care of itself

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2
Q

does shoulder motion involved just one joint or articulation?

A

no

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3
Q

shoulder motion?

A

dynamic interplay between scapulothoracic articulation and the glenohumeral, acromioclavicular and sternoclavicular joints

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4
Q

motions of shoulder

A

flex/extend
abduct/adduct
internal/external rotation

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5
Q

glenohumeral joint

A

designed for maximum motion at expense of decreased stability

very little osseous support
shallow glenoid cavity

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6
Q

scapulothoracic articulation?

A

scapula glides over ribcage with shoulder motion

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7
Q

scapulothoracic rhythm?

A

first 30 degrees of shoulder abduction occurs at glenohumeral joint (supraspinatus)

thereafter, for every 2 degrees of motion the glenohumeral joint, there is 1 degree of motion at scapulothracic articulation

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8
Q

scapulothoracic articulation restricted?

A

thoracic spine and rib dysfunction

glenohumeral joint compensates
-overuse to instability impingement rotator cuff tendonitis and tear

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9
Q

sternoclavicular joint

A

capable of anteroposterior, superoinferior rotational motions

injury, infections, and other can cause problems

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10
Q

posterior dislocation of sternoclavicular joint?

A

can compromise important neurovascular structures

ex/ seatbelt injury

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11
Q

acromioclavicular joint

A

allows anteroposterior, superoinferior, and rotational motion

frequently becomes separated

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12
Q

upper extremity innervation?

A

C5-T1 brachial plexus

between anterior and middle scalene
between first rib and clavicle
underneath pectoralis minor

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13
Q

SD in cervical spine, upper thoracic spine, upper ribs, scalene muscles, clavicle, pectoralis?

A

can have negative impact on brachial plexus and upper extremity dysfunction

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14
Q

primary flexors of glenohumeral?

A

pectoralis major
deltoid (anterior)
coracobrachialis

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15
Q

nerve of pectoralis major?

A

C5-T1

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16
Q

nerve of deltoid (anterior)

A

axillary nerve C5 C6

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17
Q

corachobrachialis innervation?

A

musculocutaneous nerve

C5, C6, C7

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18
Q

primary extensors of glenohumeral?

A

lat dorsi
teres major
deltoid (posterior)
long head triceps brachii

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19
Q

nerve of lat dorsi?

A

thoracodorsal (C6 7 8)

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20
Q

nerve of teres major

A

lower subscapular

C5 C6

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21
Q

deltoid muscle (posterior) nerve?

A

C5 C6 axillary

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22
Q

long head triceps muscle

A

radial nerve

C 6 7 8

23
Q

primary abductors of glenohumeral

A

deltoid

supraspinatus

24
Q

nerve of supraspinatus

A

suprascapular nerve

C4 5 6

25
Q

primary adductors of glenohumeral?

A

pec major
lat dorsi
teres major
long head triceps brachii

26
Q

primary external rotators of glenohumeral?

A

infraspinatus
teres minor
deltoid

27
Q

teres minor innervation?

A

C5 6 axillary nerve

28
Q

infraspinatus innervation?

A

suprascapular nerve C5 C6

29
Q

primary internal rotators glenohumeral?

A 
subscapularis
pec major
lat dorsi
deltoid
teres major
30
Q

subscapular nerve?

A

C5 6 7

upper and lower subscapular nerves

31
Q

SD and nerves?

A

can affect nerve roots

resulting in weakness of innervated muscles

32
Q

four muscles of rotator cuff?

A

supraspinatus
infraspinatus
teres minor
subscapularis

keep head of humerus centered in glenoid fossa
-move and stabilize glenohumeral joint

33
Q

arterial supply of glenohumeral joint?

A

left and right subclavian arteries

pass over top of first rib between anterior and middle scalene muscles

34
Q

upper extremity arterial supply?

A

may be affected by SD of anterior and middle scalenes, upper thoracic and cervical vertebrae, upper ribs, clavicles, and fascia of neck and upper extremity

35
Q

venous drainage of upper extremity?

A

subclavian and brachiocephalic veins

anterior to scalene muscles

SD in venous drainage - can lead to congestion of upper extremity

36
Q

lymphatic drainage of upper extremity?

A

drain through thoracic inlet

SD can produce mechanical restriction to lymph flow and congestion can occur
-slower healing

37
Q

sympathetics of upper extremity?

A

T2-T6
-cell bodies of preganglionic neurons concerned with upper extremity located in upper thoracic spinal segements

smooth muscles in walls of lymphatics contract when sympathetic stimulation

reduces size of lumen, thereby impairing lymphatic drainage

38
Q

upper thoracic SD?

A

increases sympathetic tone to upper extremity

decreased lymphatic dgainage

may lead to swelling, impaired function and recovery

39
Q

tensegrity and kinetic chain

A

entire body is interconnected by a vast network of connective tissue

one area is tight, whole system gets tight

40
Q

mechanics of throwing?

A

force transmitted from ground to upper extremity

41
Q

during overhead movements, what percentage of kinetic energy of upper extremity is generated by legs and trunk?

A

48%

42
Q

what stimulates scapular retraction?

A

ipsilateral hip and trunk extension

43
Q

what muscles decelerate glenohumeral joint when throwing

A

posterior shoulder muscles

posterior deltoid and teres minor

44
Q

lat dorsi tightness?

A

reduced shoulder flexion

45
Q

thoracolumbar junction

A

frequently find SD at T10-L2

psoas major, diaphragm, lat dorsi, thoracolumbar fascia

may also see somatovisceral reflex?
-adrenal glands

46
Q

posture imbalance?

A

sitting - kyphosis
protracts scapula
pec minor and biceps tighten
hamstring and psoas major also frequently tighten with prolonged sitting

47
Q

counterstrain

A

shoulder injuries frequently associated with tender points

supraspinatus, subscapularis, biceps are common

48
Q

supraspinatus tender point

A

in supraspinous fossa

49
Q

subscapularis tender point

A

in posterior axillary fold

50
Q

biceps tender point

A

along long head through bicipital groove

51
Q

principles of counterstrain?

A 
locate tender point
establish pain scale
find position reducing 70-100% of pain
hold position 90 seconds
slowly return to position
reassess
52
Q

shoulder problem slow or non-responsive to treatment?

A

think of systemic problems like diabetes or hypothyroidism

53
Q

nerve growth?

A

inch per month

MSS - OPP Exam 2 (10 decks)

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