Opp2: Test 1: 3. Comeaux: Shoulder Somatic Dysfunction

Front 1

if a pt has a shoulder tear, is OMT indicated? what about a contusion?

Back 1

NO for both

Front 2

please label

Back 2

1. Sternoclavicular joint
2. Coracoid process
3. Acromioclavicular join
Subacromial bursa
4. Greater tuberosity
5. Bicipital groove
6. Lesser tuberosity
Subscapularis
/ Glenohumeral joint
7. Deltoid bursa
X. First Rib

Front 3

when do you start to use imaging for diagnosis?

Back 3

after 3 visits with no improvement

Front 4

list the 5 articulations of the shoulder

Back 4

glenohumeral
acromioclavicular
sternoclavicular
First rib (costochondral, chondrosternal, costovertebral)
Scapulothoracic

Front 5

what are some of the key muscles you must think of when a pt presents with shoulder pain?

Back 5

rotator cuff

supraspinatus (impingement)

trapezius

rhomboid

levator scapulae

Front 6

how do you screen peripheral neuropathy?

Back 6

Spurling's (extend neck rotate head, push down)

positive if pain radiates down same side

or

Adson's sign (seen when you turn your head to one side, take a deep breath, and the pulse goes away in the arm)

Front 7

in addition to muscular, fracture, or cartilage damage, what is another important consideration when evaluating for shoulder pain

Back 7

neural compression

Front 8

following history, observation, and palpation, you must make sure to do this in a shoulder pain evaluation

Back 8

Range of Motion testing (major and accessory)

Front 9

Neer test

Back 9

raise arm over head, look for impingement

Front 10

Yergason test

Back 10

external rotation of the shoulder against force

Front 11

when doing ROM testing always make sure to compare

Back 11

active and passive ROM

Front 12

if pt has reduced shoulder ROM think...

Back 12

adhesive capsulitis

on both active and passive motion

Front 13

when you have shoulder abduction, what is the ratio of scapula rotation to glenohumeral joint abduction?

Back 13

for ever 15 degrees abduction...

5 is scapula; 10 is GH

so 1:2 ratio

Front 14

most common SC somatic dysfunction?

Back 14

Anterior and superior glide

Front 15

Most common AC somatic dysfunction

Back 15

Superior glide

Front 16

3 counterstrain tenderpoints

Objective

Back 16

Supraspinatus

Subscap

Levator scap

Front 17

tenderness in bicipital groove alone is clinical of...

Back 17

Biceps Tendonitis

Front 18

tenderness, position change, edema below AC joint is clinical of..

Back 18

Subacromial bursitis

Front 19

tenderness at origins and insertions of muscles; MRI evidence can help you find

Back 19

Rotator cuff Strain/Sprain/Tear

Front 20

pain on abduction, external rotation of humerus and scapula are the clinical findings of?

Back 20

impingement syndrome

Front 21

limitation of motion in the shoulder on active/passive movement and history can lead you to what diagnosis

Back 21

adhesive capsulitis

Front 22

what 2 organs can lead to referred shoulder pain?

Back 22

heart and gallbladder

Front 23

steps for Spencer Technique (in order)

Back 23

Every fat cat tries abduction in pumps

Extension
Flexion
Compression
Traction
Abduction
Internal rotation
Pump

Front 24

for the glenohumeral joint, which way does it glide with aBduction and extension respectively

Back 24

aBduction: inferior

Extension: anterior

this can lead to dislocation

Front 25

PAIN IS NEVER A DIAGNOSIS

Back 25

find the cause bro, find the cause

Front 26

34 year old male presents with right shoulder pain. He has recently resumed an exercise regimen including pushups, rowing machine and free weight curls. Patient has normal reflexes and muscle strength. Glenohumeral joint motion and scapular rotation are normal and elicit no pain. He has positive tenderness at the upper greater tuberosity of the humerus, none at the bicipetal groove or lesser tuberosity. Empty can test is mildly positive. If counterstrain is to be effective for this acute strain, which of the following would represent the usual beginning counterstrain position?

Hold the wrist, flex and adduct the shoulder, and apply slight traction down the arm;

Extend arm and rotate the scapula medially with cephalad push

abduct the arm about 45°; fine tune with slight arm external rotation

Extend, internally rotate and slightly abduct the humerus

Back 26

abduct the arm about 45°; fine tune with slight arm external rotation

Front 27

supraspinatus inserts where

Back 27

greater tubercle of the humerous

Front 28

A 45 year old female this morning fell off a horse, using an extended arm to break her fall. Radiographs confirm your suspicion from observation of shoulder contour that she has an anterior dislocation, that there is no fracture , and that brachial plexus entrapment is unlikely. Neurological exam is normal. The most appropriate immediate next step would be:

A. Counterstrain OMT
B. MRI
C. Orthopedic referral
D. Rest and ice
E. Reduction in the office

Back 28

E. Reduction in the office

Front 29

In palpation of the shoulder:

A. The levator scapula runs from the medial angle of the scapula to C 2
B. The first rib is not a functional part of the shoulder
C. The supraspinatus attaches distally to the lesser tuberosity
D. The deltoid bursa is best appreciated just below the corocoid process
E. The pectoralis minor muscle attaches to the glenoid labrum

Back 29

A. The levator scapula runs from the medial angle of the scapula to C 2

Front 30

List the degrees of ROM for the shoulder

o Extension-
o Flexion-
o Abduction-
o Adduction-
o Internal rotation-
o External rotation-

Back 30

o Extension- 50
o Flexion- 180
o Abduction- 180
o Adduction- 50
o Internal rotation- 90
o External rotation- 90