MS II 4
Card Set Information
MS II 4
spring Rosen & Pivko
post glide at GH helps w what 3 motions?
to distract GH joint, start w pt where?
90 degrees flex
do lat distraction by wrapping hands right into axilla
GH jt inf glide details
pt supine, shoulder at edge of table
heel of PT's mobilizing hand on greater tub of pt's shoulder
other hand holding elbow, can add a bit of traction
force goes caudally
GH jt post glide details
arm in resting pos
heel of PT's hand on ant inf hum w other hand on elbow to guide hum to make it move as a parallel unit
force goes post
GH jt lateral glide details
flat surface of palm of PT's hand in axilla, facing lat, other hand on elbow
GH jt ant glide in prone, details
twoel roll or wedge under coracoid
arm in resting pos
heel of PT's hand on post humerus, other hand under elbow
GH jt ant glide in supine
PT supports arm in resting pos by holding it btwn body and arm
both f pt's hands wrapped around prox hum, pull up
3 joints of shoulder that'll dislocate
ANT sublux or dislocate:
5 results of trauma to shoulder, and the 2 most common
RC impingement (cumulative trauma)
biomechanical error - humerus is ramming up on things nort of it bc it's not moving correctly
RC tear (cumulative trauma or degen)
biceps tendon ruputer - 2/2 huge trauma at GH jt or the tendon is super-loaded in one exercise and it ruptures
adhesive capuslitis - capsular irritation or inflam dud to poor osteokinematics of GH jt
glenoid labrum injury - usually sup & slightly ant
3 types of itis-es you can get in shoulder from overuse/cumulative trauma/overload of tissue capacity (repetition, 1-sidedness, aging)
7 basic elements of exam/eval
active movment testing
passive movement testing
special tests, other tests (neuro)
if no pain in AROM, should you do PROM?
nah, it's moot
6 elements of active movement testign for the shoulder in an exam/eval
clear jts above & below
quick tests (tests the shoulder complex)
quick tests w overpressure
GH jt motions
elbow flexion and extension
3 basic things to do in passive movement testing in a shoulder exam
clear jts above &below
PROM for physiologic motions (osteokinematics) in shoulder complex, ST, and GH jts
joint mobility testing (aka accessory movement = arthrokinematics) ST, SC, AC, GH jts
what to look for in subjective exam of shoulder?
systems review - search for referred pain
job/sport - simulate offending mvmnts
what to look for in "observation & palpation?"
attitude of arm
willingness to move
atrophy or hypertrophy - which muscles?
what to palpate for?
tenderness (capsule, tendon, bursa, etc)
analyze alignment & position
how to "clear the head and neck"
have head lean to sides, rotate, turn,
look for pain and assymetry
how to clear arms
check scapulothoracic rhythm & symmetry
hands behind back
run thumbs up back and look for symmetry in reach distances
hands behind head
run hands down back
elbows at waist and flap hands back and forth for ER and IR
if no pain, apply overpressure
pain where in abd ROM indicates supra/infraspinatus problems?
45-60 degrees abd, with unpainful areas on either side
pain where in abd suggests acromioclavicular troubles?
supraspinatus & radial nerve
a circle a bit sup to deltoid groove in hum
3 areas that'll refer pain to the L shoulder
4 areas that'll refer pain to the R shoulder
Pancoast tumor is where? pain from it will radiate where?
it's in the upper lobe of lung
pain in surface of shoulder crest, radiating into neck
where is T3 dermatome?
armpit - and it's big, bleeding into chest, down inf arm, down under armpit
where is T2 dermatome?
armpit and upper chest, and also inner arm
where is C4 dermatome?
shoulder, and some sup chest and neck
where is C5 dermatome?
lateral arm, if arm is abd to 90 it's the upper surface
where is C6 dermatome?
lat arm, but a wider surface, going more ant than C5 does
where is C7 dermatome?
if arm is abd to 90, it's the part that faces forward w/o getting to the top or bottom ridge
where are the T4,5,6 dermatomes?
chest, by ribs osame name?
supraclavicular N dermotome is where?
shoulder, where suprascap is
axillaryN dermotome is where?
over the body of deltoid
post brachial cutaneous N dermotome is where?
post humerus, distal to the axillary/deltoid region
lower lat brachial cutaneous N dermotome is where?
lower lateral humerus
medial cutaneous N dermotome is where?
medial distal humerus
anterior apprehension test for shoulder
not judged by pain, just by look of nervousness on pt's face
pt supine, arm in 90 abd & ER w some horiz abd
see if pt fears the head of hum will stretch out over inf capsule
(shoulder & elbow at 90 degrees)
similarto ant apprehension test, but w fist under shoulder and applying pressure down w other hand
then press on hum head to push it back in
if this feels like a relief to the pt, there's laxity
ant drawer test at shoulder
tests how much hum head goes ant
pt is prone, y're doing ant distraction
should get just scap mvmnt
done in neutral, while normal ant glideis in resting