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Shoulder

QuestionAnswer
Components of the Humerus include: Humoral head, greater tubercle, leader tubercle, bicipital groove, deltoid tuberosity
What compresses the humeral head Supraspinatus muscle
What depresses the humeral head during overhead motion Rotator cuff muscles
Muscles of the Rotator Cuff Supraspinatus, Infraspinatus, Subscapularis, Teres Minor
Initial 30° of GH ABD that does not include scapular motion is called what? The setting phase
After the initial 30° of GH ABD, what is the ratio between GH and scapulothoracic joint motion? 2:1
Movement of the scapula relative to the humerus is called what? Scapulohumeral Rhythm
FOOSH, fall on tip of shoulder or direct impact, occurs primarily in middle third (Greenstick in young patients) Etiology of Clavicular Fractures
Presents w/ supporting of arm, head tilted towards injured side w/ chin turned away, clavicle May appear lower, palpation reveals swelling, deformity, and point tenderness, sling & swathe w/ brace for 6-8 wks to manage S & S of Clavicular Fractures
Result of direct impact or force transmitted up thru humerus Etiology of Scapular Fractures
Pain during shoulder movement, swelling, and point tenderness S & S of Scapular Fractures
Result of direct blow or FOOSH (shaft); direct blow, dislocation, FOOSH, or indirect blow traveling along long axis (proximal) - may pose danger to nerve & blood supply Etiology of Humeral Fractures
Main Vascular Arteries of Shoulder Subclavian, Axillary, Brachial
Immediate application of splint, treat for shock, and refer Management of Humeral Fractures
Humeral Shaft Fracture - remove from activity for? 3-4 months
Proximal Humeral Fracture - incapacitation for? 2-6 months
Epiphyses Humeral Fracture - quick healing takes how long? 3 weeks
Indirect force, blunt trauma (may cause displacement) Etiology of a Sternoclavicular Sprain
Grade I - pn & slight disability; Grade II - pn, subluxation w/ deformity, swelling, point tenderness, decreased ROM; Grade III - gross deformity (dislocation), pn, swelling, decreased ROM, possibly life threatening if dislocated posteriorly S & S of Sternoclavicular Sprain
Result of direct blow (from any direction), upward force from humerus Etiology of an Acromioclavicular Sprain
Grades I - VI from pn w/ mvmt & point tenderness to displacement of clavicle behind coracobrachialis S & S of an Acromioclavicular sprain
Excessive translation of humeral head w/out complete separation from joint Etiology of Acute Shoulder Subluxation
Anterior - result of ant force on shoulder, forced ABD & ER; Posterior - result of forced ADD & IR or falling on a shoulder that is ext & IR Etiology of Acute Shoulder Dislocations
Flattened Deltoid, prominent humeral head in axilla; arm carried in slight ABD &ER; mod pn & disability S & S of Anterior-Inferior Shoulder Dislocation
Permanent anterior defect of shoulder labrum Bankart Lesion
Caused by compression of cancellous bone against anterior glenoid rim creating a divot in the humeral head Hill Sachs Lesion
Defect in superior labrum that begins posteriorly and extends anteriorly impacting attachment of long head of biceps on labrum SLAP Lesion (superior labral anterior posterior)
Clicking or pain; dead arm during cocking phase (when throwing); pain posteriorly, possible impingement; positive apprehension test S & S of Anterior Shoulder Instability
Possible impingement; loss of IR; crepitation; increased laxity; pain anteriorly & posteriorly S & S of Posterior Shoulder Instability
Inferior laxity; positive sulcus sign; pain and clicking w/ arm at side S & S of Multidirectional Shoulder Instability
Treatment for chronic instability involves extensive strengthening of what? (Multi-directional too) Rotator cuff & scap stabilizers; multi - IR, ER, & biceps
Mechanical compression of supraspinatus tendon, subacromial bursa, and biceps long head tendon due to decreased space under CA arch; rep activities; exacerbating factors - laxity & inflam, postural malalignments (kyphosis, rounded shoulders) Etiology of Shoulder Impingement
Diffuse pain, pn on subacromial space; increased GH ER (ERG) and decreased IR (GIRD) in overhead athletes S & S of Shoulder Impingement
Occurs near insertion in greater tuberosity; partial or complete tear; primary mechanism - acute trauma or impingement; involve supraspinatus or rupture of other rotator cuff tendons; Neer Stages I - IV Rotator Cuff Tear
Abnormal movement of of the scapula, due to rep use (often OH athletes), changes are detrimental to normal function & increase risk of injury; SICK scapula Etiology of Scapular Dyskinesis
What does SICK scapula stand for? Scapular malposition, Inferior medial scapular winging, Coracoid tenderness, Kinesis abnormalities if the scapula
Affected shoulder held lower & rolled fwd; prominent inf scap border due to tight pec major/minor, weak serratus anterior/low trap; post tipping contribute to narrowing of subacromial space & pn w/ ABD & ER; winging becomes more pronounced w/ fatigue (imp S & S of Scapular Dyskinesis
Chronic inflammatory condition due to trauma or overuse - subacromial bursa; fibrosis, fluid build-up resulting in constant inflammation Shoulder Bursitis
Contracted & thickened jt capsule w/ little synovial fluid, chronic inflammation w/ contracted inelastic rotator cuff muscles, generalized pain w/ motions (active & passive) resulting in resistance of mvmt Adhesive Capsulitis (Frozen Shoulder)
Compression of brachial plexus, subclavian artery, and vein due to: 1) decreased space b/n clavicle & 1st rib 2) scalene compression 3) compression by pec minor 4) presence of cervical rib Etiology of Thoracic Outlet Compression
Paresthesia and pain, sensation of cold, impaired circulation, muscle weakness, muscle atrophy & radial nerve palsy S & S of Thoracic Outlet Compression
Result of a powerful contraction, occurs near origin of muscle at bicipital groove, hear snap & feel sudden intense pain Biceps Brachii Rupture
Repetitive OH ballistic activity that stretches biceps tendon causing irritation to tendon & sheath Etiology of BicipitalTenosynovitis
Tenderness over bicipital groove, swelling, crepitus due to inflammation, pain with OH activities S & S of Bicipital Tenosynovitis
Blunt trauma or stretch-type injury; constant pain, muscle weakness, and paralysis or atrophy Peripheral Nerve Injuries
Created by: natamccl