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shoulderinjuries/ROM
| Question | Answer |
|---|---|
| Scapulothoracic rhythm and humeral motion | for the humerus to be elevated to its maximal 180 degrees, the GH joint and the scapulothoracic articulation must work closely together |
| ___ratio of GH:ST motion hence, 120 degrees GH joint motion and 60 degrees scapulothoracic motion- this ratio is not smooth or consistent | 2:1 |
| early ROM is all __joint and scapula provides base of support | GH |
| intermediate ROM is more like ___ratio | 1:1 |
| extreme ROM occurs at ___ | GH joint |
| ONCE YOU GET ABOVE___DEGREES, CLAVICLE ROTATES A DEGREE FOR EVERY DEGREE YOU RAISE YOUR ARM | 30-40 |
| Passive ROM Abduction | inferior capsule- impingement |
| Passive ROM flexion | posterior capsule- impingement |
| Passive ROM extension | anterior capsule |
| Passive ROM Internal / external rotation | infraspinatus, teres minor / subscapularis |
| Passive ROM Horizontal adduction | posterior capsule, posterior rotator cuff/ anterior capsule, pects |
| MOI AC joint sprain | fall on outstretched hand/arm or direct trauma to the tip of the shoulder driving the scapula under the clavicle |
| ac joint sprain occur as Type I-VI joint sprains which is described___ | by which and how much of each ligament tears as well as deformity |
| ac joint sprain; S&S: deformity, point tenderness over the AC joint; pain with AROM above ___; positive __test Tx: referral; ____brace/sling | 90 degreesSpring figure eight |
| grade 1 ac joint sprain | partial tear of AC ligament and capsule |
| grade 2 ac joint sprain | complete tear of AC lig and partial CC lig |
| grade 3 ac joint sprain | complete tear of both AC and CC ligamentsPossible involvement of the trapezius and deltoid muscles |
| SC Joint sprain mechanism | fall on outstretched hand/arm or direct trauma |
| SC Joint sprain tx | referral; figure eight brace/sling |
| SC Joint sprain s/s | point tenderness over the SC joint; pain with AROM above 90 degrees; positive Spring test |
| GH Joint sprain moi | typically occur when forces are exerted at the end of ROM and often results in a Subluxation/dislocation |
| GH Joint sprain s/s | general complaint of shoulder soreness; if labrum torn there is more localized pain with movement |
| GH Joint sprain tx | treat symptomatically, rest, strengthening, referral prn |
| shoulder stains cause | due to the mobility of the joint-capsule and ligamentous structures are comparatively lax – provide little stability |
| __provide most of the stability (primarily the rotator cuff) and any of them can be injured | muscles |
| 2. Rotator Cuff SITS muscles muscle test to see which is injured treat symptomatically and __ | rehabilitate |
| Clavicle: fractures typically occur at the ___where the bone changes contour | distal one-third |
| clavical fracture S&S: point tenderness; deformity; crepitus; positive ___ | compression |
| clavical fracture tx | TX: stabilize and refer |
| humerus fracture possible MOI | possible spiral fracture of the humeral shaft when torsional stress added |
| humerus fracture s/s | S&S: severe pain and point tenderness; swelling, disability; deformity |
| potential complication of humeral shaft fractures is ____ | possible involvement and injury to the radial nerve |
| anterior dislocation | humeral head lodges between the anterior glenoid rim and the coracoid process |
| s/s anteior dislocation | arm slightly abducted and supporting the injured arm: the acromion process will be prominent; flattened deltoid appearance; possible palpation of the humeral head in the in the axilla; unwillingness of the athlete to move the extremity |
| concern w/ anterior dislocation | concern with the axillary nerve |
| Posterior: -less frequent than anterior- occur when : | the arm is forward flexed and a posterior force is applied along the length of the humerus which drives the humeral head through the posterior capsule |
| S&S of posterior dislocation | less obvious; often times spontaneously reduce themselves; arm adducted and internally rotated; coracoid process may be more prominent; unwillingness to move the extremity |
| Inferior dislocaiton- occurs as a result of | forced abduction with stress applied to the inferior capsule -fairly uncommon and more often it is anterior-inferior |
| Chronic Instabilities/ GH dislocation/subluxation: - may have a multidirectional instability- commonly seen in physically active people with inherent instability and weak ___often seen in athletes who perform a lot of __ | muscular stabilizing structuresoverhead activities |
| Management of GH dislocation | do not reduce-stabilize and refer-evaluate distal pulses and sensations- loss of either constitutes a medical emergency-proper communication with emergency personnel and/or physician |
| Bankart Lesion | tear of labrum associated with inferior GH ligament |
| Bankart lesion often occus with__ | anterior glenohumeral dislocations |
| bnakart lesion difficult to identify clinically with the primary complaints being__ | paoin and crepitus as the shoulder is evaluated |
| s/s of bankart lesion | a sense of instability, repeat dislocations, catching sensations, aching of the shoulder |
| Hill-Sachs Lesion | defect in the posterior humeral head’s articular cartilage caused by the impact of the humeral head on the glenoid fossa as the humerus attempts to relocate |
| hill-sachs lesion often found with ____ | anterior GH dislocations |
| Reverse Hill-Sachs Lesion | -same as above, except the lesion is found on the anterior aspect of the humeral head due to a posterior dislocation |
| Slap Lesion | superior labrum torn anterior to posterior |
| associated nerve injuries are more common than __injuries | vascular |
| always need to assess __with injuries | sensation, tingling, numbness, pulses, nail bed refill |
| Thoracic Outlet Syndrome: | the thoracic outlet is marked by the anterior scalene muscle anteriorly; the middle scalene posteriorly; and the first rib inferiorly - the brachial plexus and subclavian artery exit through the outlet |
| tos s/s | symptoms can very considerably due to location of the compression; pain can occur anywhere between the neck, face, occipital region or into the chest, shoulder and/or upper extremity; complaint of weakness, fatigue or heaviness of the arm and hand |
| TOS pain with overhead movements especially ____ | abduction and external rotation |
| . Impingement-encroachment in the subacromial space that decreases the space through which the ___and ___pass (LH biceps) | supraspinatus and subacromial bursa |
| impingement may occur as the result of chromic ____ or in conjunction with acute trauma; individuals may also have chronic glenohumeral instabilities or multidirectional instabilities | inflammation |
| 3 stages of impingment | 1. edema and hemorrhage within the rotator cuff 2. thickening and fibrosis of subacromial bursa and supraspinatus tendon – typically not reversible with conservative treatment 3. degeneration has progressed to a partial or full thickness tear of r.c. |
| • Scapular dyskinesis | trapped on thorax and cannot move correctly |
| Causes OF impingment | Irregularly shaped acromion, bone spurs• Coracoarcormial ligament Enlarged- inflamed bursa• Thickened rotator cuff tendons, rotator cuff weakness/fatigue• GH instability/laxity• Repetitive overhead movements/overload |
| s/s impingment | pain during overhead movement, pain/weakness with rotator cuff/LH biceps, pain at night, shoulder feeling tired, positive impingement special tests |
Created by:
jocbutch