Shoulder MET/ART Lab Flashcards
What 3 bones make up the shoulder?
Clavicle, humerus, and scapula (coracoid, acromion)
What are the 3 true synovial joints of the shoulder?
Glenohumeral, sternoclavicular, acromioclavicular
What are the functional joints of the shoulder?
Scapulothoracic (articulation of scapula on thoracic cage) and suprahumeral
What are the accessory joints of the shoulder?
Costosternal and costovertebral
What muscles are we evaluating in the shoulder region?
Upper trapezius, levator scapulae, supraspinatus, deltoids, pectoralis, rhomboids
Explain downward rotation of the scapula
Turning on an anterior/posterior axis so that the scapula rotates in the frontal plane to tilt the glenoid fossa downward
Explain upward rotation of the scapula
Turning on an anterior/posterior axis so that the scapula rotates in the frontal plane to tilt the glenoid fossa upward
What is scapulo-humeral rhythm?
A 1:2 ratio of scapular motion to humeral motion
Example: 180 degrees of abduction = 60 degrees of scapular motion and 120 degrees of humeral motion
What is elevation of the scapula and what muscles are involved?
Superior glide in a vertical direction along the coronal plane; upper trapezius and levator scapulae
What is depression of the scapula and what muscles are involved?
Inferior glide in a vertical direction along the coronal plane; lower trapezius and lower rhomboids
What is abduction (protraction) of the scapula and what muscles are involved?
Away from the spine, combined with a lateral tilt around the thorax; serratus anterior
What is adduction (retraction) of the scapula and what muscles are involved?
Moving closer to the spine; rhomboids and middle trapezius
What is backwards tilt of the scapula?
Turning on a horizontal axis so that the posterior surface faces downward and the inferior angle is anterior
What is forward tilt of the scapula?
Turning on a horizontal axis so that the posterior surface faces upward and the inferior angle protrudes
Describe muscle energy (MET)
- Engage the restrictive barrier and have the patient apply equal counterforce against the physician, maintaining an isometric contraction for 3-5 seconds
- Allow patient to relax 1-2 seconds for appropriate post isometric relaxation, then move into the next restrictive barrier
- Repeat 3-5 times or when motion is restored
Describe articulatory (ART)
- Engage the restrictive barrier applying a gentle but firm fore in short distance increments through the restrictive barrier (low velocity, high amplitude)
- Force is applied rhythmically for 1-2 seconds and then return joint away from the engaged restrictive barrier before moving into the next restrictive barrier
- Repeat until motion is restored
What does scapular elevation cause the SC joint to do and what is this called?
SC joint moves inferiorly; SC Abduction
What does scapular depression cause the SC joint to do and what is this called?
SC joint moves superiorly; SC Adduction
In 90 degrees shoulder flexion, protraction of the scapula causes the SC joint to do what and what is this called?
SC joint has posterior glide; SC Flexion
In 90 degrees shoulder flexion, retraction of the scapula causes the SC joint to do what and what is this called?
SC joint has anterior glide; SC Extension
Define extra-articular
Includes bones, muscles, tendons, bursa, and skin
Define dislocation
Complete lack of contact between 2 articulate surfaces
Define subluxation
Residual contact between 2 articulations surfaces
Define valgus deformity
Distal part of limb directed away from the midline
