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29 Cards in this Set
- Front
- Back
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Shoulder
What are normal ROM at the shoulder joint? |
FLX - 180
ABD - 180 ER - 90 IR - 70 EXT - 60 |
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Shoulder
Open and Closed Packed Positions |
OPEN
55 ABD, 30 Hor ADD CLOSED ABD and ER |
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Shoulder
What are the three types of acromion morphology |
Type I
relatively flat undersurface Type II slightly convex Type III hooked, can predispose to rotator cuff pathology |
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Shoulder
Capsular Pattern |
ER > ABD > IR
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Shoulder
Primary Impingement |
Older patients
Degeneration in rotator cuff, acromion, coracoid, anterior tissues |
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Shoulder
Secondary Impingement |
Younger patients
Muscle dynamics upset, and abnormal movement |
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Shoulder
Internal Impingement |
Posterior
Involves undersurface of rotator cuff with posterosuperior glenoid labrum when arm is ABD to 90 and full ER |
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Shoulder Special Test
Neers Impingement |
Block scapula, and passively overpressure pt's arm into flexion/scaption.
Repeat test in ER/neurtral/IR of the shoulder |
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Shoulder Special Test
Hawkins Impingement |
Shoulder up to 90, bring into IR
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Shoulder Special Test
Cross Arm ADD |
Shoulder at 90, passively force into Hor ADD
Tests AC joint, |
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Shoulder Special Test
Yocum Impingement |
hand on opposite shoulder, lift elbow up
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Shoulder Special Test
Supraspinatus test (Dynamic Impingement test) |
Arm out in scaption, full shoulder IR (thumbs down)
Push |
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Shoulder Special Test
Infraspinatus test |
Elbow to 90, arm at side, resist ER
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Shoulder Special Test
Reverse Impingement Test |
Push pt humerus inferiorly as the arm is abducted or ER.
*If pain decreases with this depression, postive test for mechanical impingement under acromion |
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Shoulder Special Test
Posterior Internal Impingement Test |
pt supine, passively ABD shoulder to 90 and max ER
*positive if pain in posterior deltoid |
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When testing for shoulder instability, which type should you do first?
Choices: Inferior/Multidirectional Anterior Posterior |
Inferior/Multidirectional is first
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Shoulder Special Test
Sulcus Sign for Inferior Instability |
Grab arm and pull distally. Unilateral is more significant than bilateral
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Shoulder Special Test
Feagin Test for Inferior Instability |
Shoulder ABD to 90 and resting on PT shoulder, push humeral head inferiorly and forward
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Shoulder Special Test
Apprehension Crank for anterior instability |
Shoulder to 90 ABD, full ER. overpressure into ER
*apprehension is positive sign *pain might indicate impingement |
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Shoulder Special Test
Fulcrum Test |
Fist under shoulder
More Anterior Displacement |
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Shoulder Special Test
Relocation/Release Test for Anterior Instability |
During the Apprehension test (90 ABD, full ER) if you apply posterior force:
1) apprehension lost 2) pain goes away and motion is gained |
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Shoulder Special Test
Anterior Drawer |
Passively translate the humeral head anteriorly
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Shoulder Special Test
Load & Shift |
Compress humerus in and then translate anteriorly
GOLD STANDARD like the drawer test, but with compression |
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Shoulder Special Test
Rockwood test for Anterior Instability |
Arm at side - ER shoulder
^Repeat at 45, 90, 120 *Look for Apprehension |
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Shoulder Special Tests
Posterior Apprehension Test for posterior instability |
Apply an axial load while Hor ADD and IR the shoulder
*look for apprehension |
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Shoulder Special Tests
Posterior Drawer Test for posterior instability |
passively translate humeral head backward
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Shoulder Special Tests
Load & Shift test for posterior instability |
Apply forced compression to humeral head and translate backward
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Shoulder Special Tests
Jerk Test for posterior instability |
pt sits arm IR and FLX 90. axial load through elbow. Hor ADD arm.
*sudden jerk as humeral head slides off |
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ager, agri
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field
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