Anatomy
Name the 4 joints associated with the shoulder
1. Acromioclavicular
2. Sternoclavicular
3. Scapularthoracic
4. Glenohumeral
Name 3 special tests for indications of glenohumeral instability
1. Shoulder Glide (drawer)
2. Sulcus sign
3. Load and Shift
(Also Accepted: Apprehension (anterior and posterior-laxity or subluxations)
What is the MOI for an AC joint sprain (BE SPECIFIC) and 1 test to confirm?
-FOOSH, blow to superior acromion process
-AC Distraction Test, AC Compression Test
How much flexion (in degrees) should the GH joint have?
0-120 degrees
Describe Apley's Scratch test
-ABD+ER
(dominant arm will have more ER, but less IR)
-ADD+IR
Name 3 muscles acting to stabilize the scapula
1. Rhomboids Major/Minor
2. Levator Scapulae
3. Serratus Anterior
4. Trapezius
5. Latissimus Dorsi
6. Pectoralis Major
Briefly describe how the O'Brien's test is performed and its indication
-Seated with 90 of shoulder flexion and 30-45 of horizontal ADD and max IR
-Grasp 1 hand medially on wrist
-Subject horizontal ADD and Flex shoulder vs resistance
IND: SLAP lesion
What is the difference between TUBS and AMBRI?
TUBS=Traumatic Unidirectional Bankart Surgery
AMBRI=Atraumatic Multidirectional Rehabilitation Inferior Capsule Shift
-Tubs is "torn loose" while AMBRI is "born loose"
Name AROM movements during examination to run through
Flexion, Extension, ABD, ADD, Scaption, ER, IR, Horizontal ABD
Name the GH Ligaments
Superior GH Ligament
Middle GH Ligament
Inferior GH LIgament
Name 3 muscles acting on the humerus to assist in movements
1. Rotator Cuff Muscles (subscapularis, supraspinatus, infraspinatus, teres minor)
2. Deltoid (Anterior, Middle, Posterior fibers)
3. Pectoralis MAjor
4. Latissimus group
5. Long head of Triceps Brachii
6. Coracobrachilais
7. Biceps Brachiii
Briefly describe how to perform the Jerk Test and its indication
-Sitting with examiner holding scapula with one hand ABD shoulder with other
-While applying axial load, move patient into horizontal ADD
IND: posterior labral lesion
True/False: A traumatic anterior dislocation has a higher chance of recurrence as you age.
FALSE: Recurrence is inversely proportional to age.
What 3 landmarks would you start your palpation exam with?
2. Clavicle
3. Coracoid Process
What are the scapula's motions?
-elevation
-depression
-protraction
-retraction
Where does the Biceps short head and long head each attach?
Long head: top of humerus (through the interturbercular sulcus)
Short head: coracoid process
Briefly describe how to perform the Yergason's test and its indication
-Seated with elbow flexed to 90 and stabilized against thorax with forearm in pronation
-Examiner stabilizes forearm and upper humerus
-Resist attempt as subject supinates and ER
IND: bicipital tendonitis
Name the difference between Bankart lesion vs Hill Sachs lesion
Bankart: tear of labrum (specifically in the front), mainly soft tissue
Hill Sachs: compression fracture on humeral head caused by bone hitting the edge of the socket (during a dislocation), mainly bony
Describe what Scapular Dyskonisis is and use 3 symptoms?
scapula moves abnormally during movement
1. Pain/tenderness
2. Snapping or popping
3. Asymmetrical posture
What does SLAP stand for?
Superior
Labrum
Anterior
to
Posterior
Name 3 articulating bones in the shoulder complex
1. Clavicle
2. Humerus
3. Sternum
4. Scapula
5. Ribs
Name 3 Thoracic Outlet Syndrome tests
1. Allen's test
2. Adson Test
3. Roo's Test (EAST)
4. Halstead Maneuver
5. Eden Test (Military Brace Position)
What is "Paget-Schroetter" Syndrome?
HINT: Thrombosis related
What is a "windlass effect" physiologically?
-is caused by: tight/short posterior capsule reduces IR
-pulls the glenoid forward and inferiorly with arm motion (which appears as protraction or rotation of scapula)
What are the 3 types of scapular dyskonisis?
Type 1: prominent inferior medical scapular boarder
Type 2: Prominent medial boarder of scapula
Type 3: Superior translation of the scapula with prominence of medial boarder