Shoulder Ortho History/Inspection/Palpation Flashcards
15-35 YO typically present with
rotator cuff dysfunction
40+ YO typically present with
degenerative change in the shoulder
Frozen Shoulder typically presents bw ages of
40-60 YO
Gender percentage question - Frozen Shoulder more with _ . What is the ratio men/women?
Women - 70%
FOOSH injury means
Fall On Out-Stretched Hand
SLAP lesion means
Superior Labral Anterior Posterior lesion
FOOSH injury can cause a
SLAP lesion
What could create an AC separation
Landing on elbow & driving the humoral head up against the acromion.
Night pain & pain at rest may be likely relate to
Rotator cuff injuries
What movement creates pain to the patient with shoulder inflammation & instability?
Lifting arm over head
TOS
Thoracic Outlet Syndrome
What type of pain with TOS?
deep, boring, achy in neck & shoulder
When limb becomes tired after activity it could be an indicator of _______. What should be observed?
vascular involvement
Are fingers pale, cold, swollen?
Which is the lower shoulder, dominant or non-dominant?
Dominant
The shoulder with decreased ROM is the dominant or non-dominant shoulder?
Dominant (more musculature)
5 important pain questions to ask:
1) WHERE? (Location)
2) TYPE? boring, achy, deep, radiating, dull achy vs. electrical numbness & pins & needles
3) Limb TIRED after activity?
4) Any indication of NERVE injury?
5) Which HAND is dominant?
Step Deformity
(separated shoulder) AC dislocation, clavicle lying superior to acromion
What ligaments are torn w/ Step Deformity (2)
acromio-clavicular, coraco-clavicular
Sulcus Sign
gleno-humeral multidirectional instability
Causes for Sulcus Sign
loss of muscle control d/t nerve injury
Vertebral border of scapula moves away from the chest wall
‘Classic’ Winging
Muscles involved in ‘Classic’ Winging
weak/paralyzed serratus anterior
Nerves involved ‘Classic’ Winging
Long thoracic nerve injury (C5, C6, C7 nerve roots)
Trapezius nerves (C3, C4)
Rhomboids (C5)
Serratus anterior, Rhomboids (C7)
‘Scapular tilt’ aka
Inferior border winging
Most common type of scapular winging
‘Scapular tilt’
(4) Reasons for the ‘scapular tilt’
- **d/t weakness
a) lower trapezius
b) latissimus dorsi
c) serratus anterior - **d/t tightness
d) pectoralis minor, pulling on coracoid process
Palpation for shoulder, what should you palpate?
1) AC, SC joint tenderness
2) Is the biceps tendon of long head in groove?
3) Check LI-15 for supraspinatus injury
4) Check SI-10 for infraspinatus tendon/muscular junction
5) Rhomboids
