Shoulder review

Question 1

The GH joint has high _____ and low ______

The muscle provide _____ while the surrounding ligaments, labrum etc provide _____

Answer 1

mobility, stability

dynamic stability, static stability

Question 2

What supports the capsule of the shoulder
SUP
INF
POST
ANT

Answer 2

s: supraspinatus
i: long head of triceps
p: tendons of infraspinatus and teres minor
a: subscapularis

Question 3

The tendons of _____(4) blend with the fibrous capsule (rotator cuff) to provide active and dynamic stability

Answer 3

subscapularis, supraspinatus, infraspinatus, and teres minor

Question 3

What are the humeral head depressors during abduction

pulls it upwards

Answer 3

subscapularis, infraspinatus, teres minor

deltoid

Question 4

2 weak areas of the capsule

Answer 4

anterior and for passage of the biceps tendon

Question 5

Clavicular dislocations are more common than

Answer 5

SC dislocations

Question 6

Most frequently involved ligament in the rotator cuff muscles

Answer 6

supraspinatus

Question 7

The 2 types of shoulder dyskinesia

Answer 7

winging
dysrhythmia

Question 8

Actions of rhomboids, upper middle lower trap, pec minor, serratus anterior and lat

Answer 8

rhom: elevation, retraction
upper t: elevation
mid t: retraction
low t: depression, retraction
pec min: protraction, depression
serr: protraction
lat: depression

Question 9

Subacromial vs internal impingement

Answer 9

S: entrapment of RTC tendons beneath arch
I: entrapment of undersurface of the tendon with glenoid labrum

Question 10

SICK Scapula

Answer 10

Scapular malposition
Inferior medial border prominence
Coracoid pain and malposition
Dyskinesis of scapular movementq

Question 11

What is GIRD

causes?

Answer 11

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

Question 12

Posterior capsule stretches

Answer 12

sleeper stretch
leaning forward with arms in dorm frame
cross body stretch

Question 13

Posterior RTC muscle most likely to be able to decelerate arm motion during throwing

Answer 13

teres minor

Question 14

What is the normal motion of the scapular during arm elevation?

Answer 14

upward rotation

Question 15

Belly press test is used to

How is it performed

Answer 15

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.

Question 16

Empty can test is used to test

Answer 16

RTC lesion (supraspinatus)

Question 17

Hawkins - Kennedy is used to test for

how is it done

Answer 17

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

Question 18

Neers tets is used for

how is it done

Answer 18

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

Question 19

Speed’s test is used for

how is it done

Answer 19

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.

Question 20

What does the scapular assistance/ repositioning test measure

how is it done

what makes the test positive

Answer 20

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

Question 21

What shoulder muscles tend to be hyper or hypo active?

Answer 21

hyper: the upper trapezius, pectoralis minor and latissimus
hypo: serratus and lower trapezius

Question 22

Shoulder capsular pattern

Answer 22

ER>ABD>IR

Question 23

What is the discrepancy between the painful arc and the actual occurrence of
potential impingement?

Answer 23

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.

Question 24

What is the optimal test position for the serratus anterior?

Answer 24

Resisted shoulder elevation. Have the patient seated with no back support. The arm is flexed to 125
degrees, apply downward resistance just proximal to the elbow

Question 25

What are the implications of a tight pectoralis minor muscle?

Answer 25

Rounded shoulder posture, winging of the scapular, depressed shoulder girdle, excessive protraction of shoulder

Question 26

What are some general treatment options for managing scapular dyskinesis?

specifically?

we must consider?

Answer 26

strengthening, stretching with manual techniques, sometimes taping and bracing

• exercises to fascilitate lower and middle trap rather than upper to avoid premature elevation of scapula
• hip and trunk movements during functional activites
• single leg stance (or half kneeling) while performing a chop and lift movement to activate lower trap

kinetic chain!!!!

Question 27

What ligament is the primary means of maintain integrity of the AC joint?

Answer 27

The coracoclavicular ligament

Question 28

What is the most likely function of the coracoacromial ligament?

Answer 28

strong stabilizer of the AC Joint, preventing acromion from being driven inferiorly from clavicle (superior dislocation of the AC joint)