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kinesiology test > The Shoulder > Flashcards

The Shoulder Flashcards

1
Q

Objectives

9: Differentiate among ROM, AAROM, AROM and FROM
11: Perform PROM on the trunk, UEs and Cspine
12: Measure functional, active, and passive ROM with a goniometer and accurately record
13: Discuss manual muscle testing principles
14: Recognize a variety of muscle strength scales used in PT
15: Demonstrate accurate technique for performing manual muscle tests
16: Interpret results from a manual muscle test

A

fyi

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2
Q

ROM of the humerus on the glenoid cavity where motion at the scapula is STABILIZED
Think pure ROM of the GHJ

A

Glenohumeral motion

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3
Q

ROM of the humerus and the scapula moving together

  • Brings us to the 2:1 ratio of scapulohumeral rhythm
  • More of a functional motion of your patient or how your patient moves at home when you’re not there to cue or assist them
A

Shoulder complex motion

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4
Q

The scapula

Bones and Landmarks of the Shoulder Girdle

These make up the girdle (Scapula, Clavicle,& Sternum)

Name the landmarks of the Scapula

A
  1. Superior angle – levator scapula attaches here
  2. Inferior angle – determines scapular rotation
  3. Vertebral border – rhomboid, serratus anterior attaches here
  4. Axillary border – the lateral side between glenoid and inferior angle attachments of teres major/minor
  5. Spine of scapula – middle and lower trapezius attach here
  6. Coracoid process – attachment of pectoralis minor
  7. Acromion process – attachment of upper trapezius and attachment of middle deltoid
  8. Glenoidfossa – concave surface that articulates with the humerus
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5
Q

What are the landmarks of the clavicle?

A
  1. Sternal end – articulates on the medial end with the sternum
  2. Acromial end – attaches laterally to the scapula and provides attachment with the upper trapezius
  3. Body – Between the two ends
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6
Q

The Sternum- parts

A
  1. Manubrium – the superior end, providing attachment for the clavicle and first rib
  2. Body – the middle 2/3rds of the sternum, providing attachment for the ribs
  3. Xiphoid Process – the inferior tip
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7
Q

Sternoclavicular joint “SC joint” – name the ligaments

A
  1. Sternoclavicular ligament(capsular ligament)
  2. Costoclavicular ligament
  3. Interclavicular ligament
  4. Acromioclavicular ligament
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8
Q

Scapulohumeral Rhythm

explain The relationship between the shoulder girdle and the shoulder joint

A
  1. The first 30 degrees of shoulder motion are PURE shoulder motion (glenohumeral joint only)
  2. After the first 30 degrees, for every 2 degrees of shoulder flexion or abduction, the scapula must rotate upwardly 1 degree
  3. 2:1 ratio
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9
Q

This provides the shoulder girdle with its only direct attachment to the trunk.

This is a plane type, synovial joint and has a double gliding motion.

Motion occurs in 3 planes: elevation/depression, protraction/rectraction, and rotation

A

Sternoclavicular joint “SC joint”

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10
Q

what are the 4 scapular motions?

A
  1. Elevation/Depression
  2. Protraction/Retraction
  3. Upward/ Downward Rotation
  4. Tilt
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11
Q

These are Scapular companion motions of the shoulder girdle that occur with shoulder jt motions(i made seperate slides as well)

(think when you flex your shoulder, your shoulder blade does what…..)

These are the shoulder jt motions. Name what motions that are occuring in the shoulder girdle at the same time.

  1. Flexion –goes with number 1 on flipside
  2. Extension –
  3. Hyperextension –
  4. Abduction
  5. Adduction –
  6. Medial rotation –
  7. Lateral rotation –
  8. Horizontal abduction –
  9. Horizontal adduction –
A
  1. upward rotation, protraction
  2. donward rotation, retraction
  3. scapular tilt

4 upward rotation

  1. downward rotation
  2. protraction
  3. retraction
  4. retraction
  5. protraction
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12
Q

name the Scapular Muscles

TLRSP

(tell her (r) shes pretty =when she shimmies her shoulers)

A
  1. Trapezius – all divisions
  2. Levator Scapulae
  3. Rhomboids
  4. Serratus Anterior
  5. Pectoralis Minor
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13
Q

what is defined as muscles pulling in different directions to accomplish the same motion?

A

Force couples

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14
Q

what muscles are involved in a force couple of Upward rotation of the right scapula?

A
  1. Upper trapezius- up counter clockwise medially
  2. Lower trapezius- up counter clockwies laterally
  3. Serratus anterior- downward straight
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15
Q

What muscle are involve in force couple of Downward rotation of the Right scapula?

A
  1. Levator scapula- sraight up
  2. Rhomboids- up clockwise medially
  3. Pectoralis minor- down clockwise medially
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16
Q

Name the landmarks of the scapula when you are talking about the shoulder joint. pg 133

A
  1. Glenoid fossa- articulates wiht humerus
  2. Glenoid labrum – fibrocartilaginous ring attached to the GF rim, deepening the articular cavity
  3. Subscapular fossa – provides attachment of subscapularis
  4. Infraspinatous fossa – provides attachment of infraspinatous
  5. Supraspinatous fossa – provides attachment of supraspinatous
  6. Axillary Border- attacment for teres minor and major
  7. Acromion process- provides attacment for middle deltoid
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17
Q

Name the important landmarks of the Humerus when talking about the shoulder joint.

A
  1. Head – articulates with the scapula
  2. Surgical neck – just below the tubercles where the head meets the body
  3. Anatomical neck – the circumferential groove separating the head from the tubercle
  4. Shaft – the body of the humerus
  5. Greater tubercle – attachment for supraspinatous, infraspinatous, teres minor
  6. Lesser tubercle – attachment for subscapularis
  7. Deltoid tuberosity – on lateral side near tmidpoint but not well defined
  8. Biciptial groove - contains the tendon of the long head of the biceps
  9. Bicipital ridges-(lat & med lips of the bicipital groove)
    • Lateral – pectoralis major
    • Medial – latissimusdorsi and teres major
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18
Q

Fibrocartilaginous ring attached to the GH rim, deepening the articular cavity

A

Glenoid labrum

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19
Q

provides attachment of subscapularis on the scapula.

A

Subscapular fossa

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20
Q

provides attachment of infraspinatous on the scapula

A

Infraspinatous fossa

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21
Q

provides attachment of supraspinatous

A

Supraspinatous fossa

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22
Q

on the humerus it articulates with the scapula

A

Head

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23
Q

on the humerus just below the tubercles where the head meets the body

A

Surgical neck

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24
Q

On the humerus the circumferential groove separating the head from the tubercle

A

Anatomical neck

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25
Q

what is the body of the humerus known as?

A

The Shaft

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26
Q

name attachment on the humerus for supraspinatous, infraspinatous, teres minor

A

Greater tubercle

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27
Q

attachment for subscapularis on humerus

A

Lesser tubercle

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28
Q

on the humerus this is on the lateral side near the midpoint but not well defined

A

Deltoid tuberosity

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29
Q

on the humerus this contains the tendon of the long head of the biceps

A

Biciptial groove

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30
Q

where do these attach on the humerus?

Lateral – pectoralis major
Medial – latissimusdorsi and teres major

A

Bicipital ridges

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31
Q

These ligaments reinforce the anterior portion of the capsule. They are not well defined ligaments but acutally pleated folds of the capsule

A

The superior, middle, and inferior Glenohumeral ligaments

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32
Q

This attaches from the lateral side of the coracoid process and spans the joint anteriorly to the medial side of the greater tubercle. pg 134

It strengthens the upper part of the joint capsule.

A

Coracohumeral ligament

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33
Q

a fibrous ring that surrounds the fossa to deepen the cavity of the joint

A

Glenoid labrum

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34
Q

tendonous bands of the SITS muscles. What else is this called?

  1. Supraspinatous,
  2. infraspinatous,
  3. teres minor
  4. subscapularis
A

The Rotator cuff

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35
Q

On the trunk, this provides a broad attachment for the latissimusdorsi muscles

A

Thoracolumbar fascia

36
Q

name the Muscles of the Shoulder joint-there are 11

pg 134

BCDILPSSTTT

A
  1. Deltoid – anterior, middle and posterior
  2. Supraspinatus
  3. Infraspinatus
  4. Pectoralis major
  5. Latissimus dorsi
  6. Teres major
  7. Teres minor
  8. Subscapularis
  9. Coracobrachialis
  10. Biceps brachii
  11. Triceps – long head
37
Q

how do the Force Couple of the Deltoid/SITS work?

A

The deltoid and rotator cuff muscles rotate the humeral head in the glenoid fossa during shoulder abduction

38
Q

Did you know the shoulder is the only joint in the body that has _______degrees of motion?

A

360

39
Q

true or false

The shoulder joint is the most mobile joint in the body.

A

true

40
Q

The stability of the shoulder joint is maintained by the combined effort of the _______ muscles and the _______ ________muscles.
Force couples are two equal forces acting in opposite directions to rotate the bones of the girdle around an axis

A

deltoid muscle

rotator cuff

41
Q

A situation that occurs when the space between the humeral head below the acromion becomes narrowed

  • The bones then squeeze the structures that occupy the interval space.
    • Joint capsule
    • Bursa
    • Tendons of the rotator cuff
A

Impingement Syndrome

42
Q
  • Causes mechanical irritation of the cuff tendons resulting in hemorrhage and swelling
    • Tendonitis of the rotator cuff, usually the supraspinatous
  • This can also affect the bursa
    • Bursitis
A

Impingement Syndrome

43
Q
  • Most common cause: Repetitive overhead use
  • Common sports: baseball, tennis, swimming, volleyball
  • Impingement with rotator cuff tendonitis is one of the most common shoulder injuries seen in athletes
A

Impingement Syndrome

44
Q

S/S OF WHAT

  • Pain or tenderness in the glenohumeral area
  • Pain and/or weakness with active abduction in midrange
  • Limited internal rotation compared to the uninvolved side
  • Confirmation with special tests done by the PT
  • Tenderness to palpate in subacromial area
A

Impingement Syndrome

45
Q

Occur in both the young and the old

  • Younger athletes typically suffer a traumatic rupture (such as a fall on outstreched hand [FOOSH]) or by putting unusual demands on the shoulder
  • Tendons lose elasticity as people age and become more susceptible to tearing – often being injured while performing everyday activities
A

Rotator Cuff Tear

46
Q

In repetitive use injuries, an action will lead to chronic etiology and ultimately a tear

  • Partial thickness
  • Full thickness
    • Either can require surgery
A

Rotator Cuff Tear

47
Q

Signs and Symptoms: OF WHAT?

  • Pain but with Full/near full AROM
  • Vague pain
  • “Catching sensation” when the arm is moved
  • The larger the tear in the tendon, the more weakness a person will have
  • Inability to sleep on the affected side
  • Small to partial tears usually respond well to an outpatient rehabilitation program
A

Partial Thickness Tear - RTC

48
Q

Signs and Symptoms: OF WHAT?

  • Pain with inability to move the joint through a normal range of motion
    • Visible with a shoulder shrug or hike
  • “Catching sensation” with movement
  • Inability to sleep on the affected side
  • Diagnosed by MRI, sometimes confused with impingement syndrome
  • Surgical repair usually required
A

Full Thickness Tear - RTC

49
Q

Signs and Symptoms: OF WHAT?

Caused by overuse or traumatic injuries

  • Pain and tenderness in the area of the muscle belly
    • Provoked by direct palpation, stretch, contraction against resistance
  • Delayed onset muscles soreness (DOMS) can be seen a few days after the injury first occurs
A

Muscle Strains

50
Q

Signs and Symptoms: OF WHAT?
Discomfort in the front of the shoulder
Caused by impingement
Tender to palpation

A

Biceps (Long Head) Tendonitis

51
Q

Not common in athletics
Signs/Symptoms

  • “Pop” during activity
  • Drooping of the biceps muscle at the distal arm
  • Grade 3 – complete rupture of the biceps tendon to the long head
    • “Popeye” Muscle Deformity
  • Bruising/Ecchymosis in the anterior arm
A

Biceps Tendon Rupture

52
Q
  • Caused when the shoulder is abducted to the side with the elbow bent and a force is applied to the arm that causes external rotation
    • Anterior and posterior structures tear, allowing the humeral head to come out of the glenoidfossa resulting in a visual deformity
  • Extremely painful
  • Requires immediate medical care by a physician
A

Traumatic Anterior Dislocation

53
Q
  • Occurs with trauma or overuse/repetitive injury
  • Signs and Symptoms:
    • Pain
    • Catching/popping sensation
    • Limitation in use of the arm
  • Diagnosed by special tests and an MRI
A

Glenoid Labrum Injuries

54
Q

Often referred to as a “stinger” or “burner,” this a painful and debilitating injury when the head and neck are forcibly moved or hit to one side

  • Stretches the brachial plexus on the opposite side and sometimes compresses the brachial plexus on the same side
    • Irritating the nerves
A

Brachial Plexus Injury

55
Q

Signs and Symptoms: OF WHAT?

  • Causes intense pain from the neck down to the arm
  • Sensation of the arm on fire and/or a sensation of pins and needles
  • The arm or hand may be weak and numb with intense pain in the area of the brachial plexus in the shoulder
    • Can last from several minutes to several hours or more
    • Weakness can last for several days
A

Brachial Plexus Injury

56
Q

Signs and Symptoms: OF WHAT?

  • Easily recognized by visual deformity or exposed bone
  • Ecchymoses or bruising may be present
A

Fractures

57
Q

a wind up or prerelease phase of a softball pitch, a blowing delivery, or a racing dive in swimming are examples of what scapular motion?

A

scapilar tilt

58
Q

what motion happens when the inferior angle of the scapula rotates up and out, the superior angle moves down, and the glenoid fossa moves up and in?

A

scapular uppward rotation

59
Q

what muscels are involved in scapular uppward rotation?

A

upper traps, lower traps, and serratus anterior

60
Q

what muscles are involvled in scapular downward rotation?

A

levator scapula, rhomboids, and pectoralis major

61
Q

This shoulder jt motion goes with what shoulder girdle motion?

Horizontal adduction

A

protraction

62
Q

This shoulder jt motion goes with what shoulder girdle motion?

Horizontal ABduction

A

Retraction

63
Q

This shoulder jt motion goes with what shoulder girdle motion?

Lateral rotation

A

retraction

64
Q

This shoulder jt motion goes with what shoulder girdle motion?

medial rotation

A

protraction

65
Q

This shoulder jt motion goes with what shoulder girdle motion?

Adduction

A

downward rotation

66
Q

This shoulder jt motion goes with what shoulder girdle motion?

ABduction

A

upward rotation

67
Q

This shoulder jt motion goes with what shoulder girdle motion?

Hyperextension

A

Scapular tilt

68
Q

This shoulder jt motion goes with what shoulder girdle motion?

Extension

A

downward rotation and retraction

69
Q

This shoulder jt motion goes with what shoulder girdle motion?

Flexion

A

upward rotation and protraction

70
Q

Where do these each articulate?

shoulder girdle, the shoulder joint, and the shoulder complex.

A

Shoulder girdle- scapula and clavicle

Shoulder joint- scapula and humerus

Shoulder complex- scapula, clavicle, humerus,sternum, and rib cage

71
Q

Given the scapula is shaped somewhat like a triangle, what landmark is commonly used to determine the direction the scapula is rotating?

A

The inferior angle

72
Q

Given that the scapula is shaped somewhat like a triangle, what direction is the inferior angle moving if the scapula is rotating upwards or downwards?

A

Away from the vertebral border- upward rotation

Towards the vertebral border-downward rotation

73
Q

Which shoulder girdle motions are mostly linear?

A
  • Elevation/Depression
  • protraction/retraction
74
Q

Which shoulder girdle motions are mostly angular?

A

Upward/Downward rotation

75
Q

How is Shoulder joint motion affected by the absence of scapulohumeral rhythm?

A

One cannot normall and completely raise the arm above the head.

76
Q

From a functional perspective, why is the trapezius muscle referred to and separated into three muscles?

A

because the 3 different attachments of the trapezius muscle produce 3 different lines of pull, the 3 parts have different muscle action.

77
Q

From a functional perspective, why are the rhomboid muscles described as one?

A

The have the same line of pull and thus the same muscle action. There is no functioanl difference bwtween the rhomboid muscles.

78
Q

Raising your hand over your head requires the combined action of which 3 shoulder girdle muscles?

A

serratus anterior

upper trap

lower trap

79
Q

Starting at the inferior angle and going clockwise, name the shoulder girdle muscles that attach to the posterior surface of the right scapula.

A

Rhomboids

lower and middle traps

levator scapula

upper traps

80
Q

The pectoralis minor muscles is deep to what?

A

pectoralis major

81
Q

As you look at the lateral chest wall, the serratus anterior is deep to what two muscles?

A

Pectoralis major

Latissimus dorsi

82
Q

Identify the shoulder girdle motions that occur with the following actions. Accompanying shoulder joint motions are in parentheses.

Closing a window by pulling down shoulder girdle motion

(shoulder extension)

What type of contraction is occuring

A

Downward rotation

Concentric

83
Q

Identify the shoulder girdle motions that occur with the following actions. Accompanying shoulder joint motions are in parentheses.

Opening a window by pulling up

(shoulder flexion)

What type of contraction is occuring

A

upward rotation

concentric

84
Q

Identify the shoulder girdle motions that occur with the following actions. Accompanying shoulder joint motions are in parentheses.

Carrying a heavy suitcase

(no shoulder motion )

What type of contraction is occuring

A

Elevation

isometric

85
Q

Identify the shoulder girdle motions that occur with the following actions. Accompanying shoulder joint motions are in parentheses.

Combing your hair in the back

(shoulder flexion, lateral rotation)

What type of contraction is occuring

A

upward rotation and retraction

isometric

86
Q

Identify the shoulder girdle motions that occur with the following actions. Accompanying shoulder joint motions are in parentheses.

Reaching across the table

(shoulder flexion)

What type of contraction is occuring

A

prtotraction

concentric

kinesiology test (16 decks)

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