Ch 14 shoulder conditions
Epiphysis of the proximal humerus
Little league shoulder is found at the
Immobilization with a figure 8 brace & sling and application of cold
An on field eval if an injury sustained by a hs lacrosse player suggests a grade 2 SC sprain, what is the immediate management for this injury?
ROM of glenohumeral internal and external rotation
Apley scratch test is used primarily to determine
Application of ice, prescribed NSAIDS, and use of a cervical collar
A basketball player has sustained a grade 2 strain to the right upper trapezius. The immediate management for this condition should include what?
A fall on an outstretched arm
A common mechanism for an AC sprain is:
Immobilization, immediate physician referral, and application of ice
A hs basketball player sustains a first time anterior glenohuneral dislocation. Immediate management for this condition is what?
Inability to actively abduct the arm between 70-120 degrees
A painful arc involving the shoulder is characterized by an
Supraspinatus
A patient has a subacrominal impingement, what muscle could be weak due to this condition?
Clunk test and compression rotation test
A softball pitcher reports painful clicking and popping in her pitching shoulder. Based on the initial findings in assessing the condition, the AT suspects a tear of the glenoid labrum. Which tests should the AT perform to rule out this suspicion?
In the first 30 degrees of abduction
An AT determines that an individuals rehab program needs to include exercises for strengthening the supraspinatus muscle. This can be accomplished through light resistance exercises performed:
Flattened deltoid
An anterior glenohumeral dislocation outwardly displays:
Posterior displacement of the SC joint
An athlete sustained a blow to the posterolateral aspect of the shoulder with the arm addicted and flexed. He come soft the field reporting difficulty breathing and swallowing. The ATs eval reveals a palpable depression between the sternum end of the clavicle and manubrium, inability to perform shoulder protraction and a diminished radial pulse. What injury should be suspected?
Hills-Sachs lesion
Common finding after an anterior glenohumeral dislocation is:
Recurrent shoulder dislocations
Dead arm syndrome is associated with :
Axillary
During a glenohumeral dislocation, the function of what nerve should be assessed?
Wrist flexion and extension
During a shoulder exam, the AT notes muscle weakness associated with the C6 myotome. Which motions contributed to this finding?
Abduction and flexion
During the initial rehab for a type 3 AC joint sprain, what two motions should be limited to 90 degrees
Gathered position
During the throwing motion of a pitcher, when the arms are raised overhead, it is referred to as the
Stage 3
During which stage of a shoulder impingement syndrome is there noticeable atrophy of the supraspinatus and infraspinatus?
Scapulothoracic joint
Elevation and depression are most prominent at the:
Type 2 SC sprain
Following a pile-up during a rugby game, an athlete slowly comes off the field, holding his L. Arm. forward and close to the body, supporting it across his chest. The ATs exam reveals instability to horizontal adduct the arm without considerable pain. What injury should be suspected?
Clavicular fracture
Following a tackle, a soccer player comes off the field in obvious pain. His head turned to the right side and he is supporting his right arm with his left arm. What injury should be suspected?
Thrombophlebitis
If thoracic outlet syndrome is left untreated, it can lead to what complication?
Slightly abducted and externally rotated
In a first-time anterior glenohumeral dislocation, the injured arm is usually held in which position?
Distal clavicle
In an acromioclavicular separation, the ------- is elevated
Acceleration
Most injuries to the rotator cuff occur during which phase of the throwing motion?
80-90 degrees
Normal ROM for shoulder lay or ext rot is
Bicipital tendinitis
Pain and tenderness over the bicipital groove when the shoulder is internally and externally rotated may be indicative of what?
Apprehension on the part of the patient
Positive test for clunk test?
Flexion and extension
Sagittal plane movements of the humerus at the shoulder include
33%
Scapulohumeral movement contributes to approximately --- of the total rotational movement of the humerus
An undescend scapula
Sprengels deformity presents as
Piano key sign &a the distal clavicle will move and be painful
The AT applies downward pressure on the lateral clavicle. What name is given to this test and what findings constitute a positive test?
Bicipital tendinitis
The AT performs an eval on a 20 yr old shot putter and both the speeds & yergasons tests were positive. What pathology does this result indicate?
Integrity of the supraspinatus muscle
The drop arm test is used to determine what?
25 years of age
The epiphyseal plate of the medial clavicle does not close until approximately what age?
Rotator cuff muscles
The head of the humerus is held against the glenoid fossa by the:
Shoulder abduction
The myotome for C5 is:
Glenohumeral joint
The true shoulder joint is referred to as the:
Aching pain in the back of the neck that extends down the medial arm to the ulnar aspect of the hand, weakness in grasping of the hand, and atrophy of the hand muscles
What are the 3 most common s&is associated with TOS
Biceps brachii, Coracobrachialis, Anterior deltoid, and pectoralis major
What are the four muscles for shoulder flexion?
Provide increased proprioceptive/ kinesthetic feedback, result in less shear forces, &can exercise multiple joints
What are three advantages of performing closed-chain exercises?
Allen, costoclavicular syndrome & adson
What are three eval tests for TOS
Brachial plexus injury and vascular injury
What are two potential early complications of a fracture to the proximal humerus?
Neer test and Hawkins Kennedy test
What are two tests for shoulder impingement?
Overhead throwing motion
What is a common mechanism of injury to the Subacrominal bursa?
Tear or weakness of the subscapularis
What is the lift-off test assessing?
Rhomboid
What muscle plays a major role in positioning the scapula to facilitate the throwing motion
AC ligament and Coracoclavicular ligament
What two ligaments are completely disrupted with a Type 3 AC sprain?
Fibrocartaginous
What type of structure is the glenoid labrum
Triceps brachii
When testing the c7 reflexes, the tendon tapped with the reflex hammer is the
Scapula
Which bony structure articulates with the acrimion?
Pectoralis major (clavicular)
Which muscle is the primary adductor for glehumeral flexion?
Subscapularis, infraspinatus, teres minor, supraspinatus
Which muscles comprise the SITS group?
Long thoracic nerve
Which nerve is associated with Serratus Anterior weakness or winged scapula
C5-T1
Which nerve roots make up the brachial plexus?
Push ups
Which of the following is an example of closed kinetic chain exercise that can be used in shoulder rehab?
The dorsal surface of the middle finger
Which of the following is the C7 dermatome?
SITS muscles
Which soft tissue structures assist in rotating the humerus and form a collagenous cuff around the glenohumeral joint?
Rupture of the proximal long head of the biceps tendon
While performing a bicep curl, a 50 ye old male felt a snapping sensation and intense pain. Ecchymosis and a "popeye" appearance are visible in the distal arm. He has pain and weakness in elbow flexion and supination. What injury should be suspected?
Due to the extreme ROM of the joint
Why is the glenohumeral joint considered to be the least stable joint in the body?