Shoulder review Flashcards
The GH joint has high _____ and low ______
The muscle provide _____ while the surrounding ligaments, labrum etc provide _____
mobility, stability
dynamic stability, static stability
What supports the capsule of the shoulder
SUP
INF
POST
ANT
s: supraspinatus
i: long head of triceps
p: tendons of infraspinatus and teres minor
a: subscapularis
The tendons of _____(4) blend with the fibrous capsule (rotator cuff) to provide active and dynamic stability
subscapularis, supraspinatus, infraspinatus, and teres minor
What are the humeral head depressors during abduction
pulls it upwards
subscapularis, infraspinatus, teres minor
deltoid
2 weak areas of the capsule
anterior and for passage of the biceps tendon
Clavicular dislocations are more common than
SC dislocations
Most frequently involved ligament in the rotator cuff muscles
supraspinatus
The 2 types of shoulder dyskinesia
winging
dysrhythmia
Actions of rhomboids, upper middle lower trap, pec minor, serratus anterior and lat
rhom: elevation, retraction
upper t: elevation
mid t: retraction
low t: depression, retraction
pec min: protraction, depression
serr: protraction
lat: depression
Subacromial vs internal impingement
S: entrapment of RTC tendons beneath arch
I: entrapment of undersurface of the tendon with glenoid labrum
SICK Scapula
Scapular malposition
Inferior medial border prominence
Coracoid pain and malposition
Dyskinesis of scapular movementq
What is GIRD
causes?
glenohumeral internal rotation deficit
- loss of IR of 20-25 degrees or more compared to opposite side
posterior capsule tightness, posterior rotator cuff muscle tightness, changes in humeral head orientation
Posterior capsule stretches
sleeper stretch
leaning forward with arms in dorm frame
cross body stretch
Posterior RTC muscle most likely to be able to decelerate arm motion during throwing
teres minor
What is the normal motion of the scapular during arm elevation?
upward rotation
Belly press test is used to
How is it performed
isolate the subscapularis muscle to test for dysfunction or tear
The patient sits or stands with the elbow flexed to 90 degrees, with the palm of the hand on the upper abdomen, just below the xyphoid process.
The patient is asked to press the palm of the hand against the abdomen, through shoulder internal rotation.
Empty can test is used to test
RTC lesion (supraspinatus)
Hawkins - Kennedy is used to test for
how is it done
Subacromial impingement
The examiner places the patient’s arm shoulder in 90 degrees of shoulder flexion with the elbow flexed to 90 degrees and then internally rotates the arm. The test is considered to be positive if the patient experiences pain with internal rotation
Neers tets is used for
how is it done
Subacromial impingement
The examiner should stabilize the patient’s scapula with one hand, while passively flexing the arm while it is internally rotated. If the patient reports pain in this position, then the result of the test is considered to be positive
Speed’s test is used for
how is it done
Superior labral tear/ bicipital tendontitis
To perform the Speed’s Test, the examiner places the patient’s arm in shoulder flexion, external rotation, full elbow extension, and forearm supination; manual resistance is then applied by the examiner in a downward direction.[1] The test is considered to be positive if pain in the bicipital tendon or bicipital groove is reproduced.
What does the scapular assistance/ repositioning test measure
how is it done
what makes the test positive
used to assess scapular motion which may be linked to shoulder pain, something around the scapula needs to change to improve movement
The examiner stands behind the patient, one hand on the superior border of the scapula of the involved shoulder with the fingers over the clavicle, and the other hand on the inferior angle of the scapula with the fingers wrapped laterally around the thorax.
The examiner assists the scapula’s upward rotation by pushing the inferior angle of the scapula upwards and laterally and assists posterior tipping of the scapula by pulling the superior angle posteriorly, while the patient actively elevates the arm
The test is positive if the symptoms of impingement decrease or abolish
What shoulder muscles tend to be hyper or hypo active?
hyper: the upper trapezius, pectoralis minor and latissimus
hypo: serratus and lower trapezius
Shoulder capsular pattern
ER>ABD>IR
What is the discrepancy between the painful arc and the actual occurrence of
potential impingement?
Painful arc is said to occur between 60 and 120 degrees, recent studies show subacromial impingement may occur at a lower ROM than that (between 30 and 90 degrees). Internal impingement occurs at higher ranges.
