Structural Diag

Front 1

Most commonly dislocated Joint

Back 1

GlenoHumoral

Front 2

Glenohumoral joint is dislocated due to lack

Back 2

Bony stability

Front 3

Shoulder is composed of

Back 3

Glenoid, Humurus, scapula, acromium, and soft tissue

Front 4

rotator cuff is composed of four muscles

Back 4

(SITS) Supraspinatus, Infraspinatus, Teres minor, Subscapularis

Front 5

Chronic Shoulder Pain

Back 5

Look for frozen Shoulder, Tears in the rotator cuff

Front 6

History of acute shoulder pain

Back 6

The patient should be asked about shoulder pain, instability, stiffness, locking, catching and swelling.

Front 7

frozen shoulder, dislocation or glenohumeral joint arthritis

Back 7

can present as Stiffness or loss of motion

Front 8

Pain with throwing

Back 8

anterior glenohumeral instability

Front 9

complain of generalized joint laxity

Back 9

multidirectional glenohumeral instability

Front 10

subtle signs of a cervical spine disorder

Back 10

Neck pain and pain that radiates below the elbow

Front 11

Pneumonia, cardiac ischemia and peptic ulcer disease, Gall Bladder, Heart attack

Back 11

present with shoulder pain

Front 12

DX: Serratus anterior or trapezius dysfunction

Back 12

Sign: Scapular winging, trauma, recent viral illness

Front 13

DX: Posterior shoulder dislocation

Back 13

Sign: Seizure and inability to passively or actively rotate affected arm externally

Front 14

Dx: Rotator cuff tear; suprascapular nerve entrapment

Back 14

Sign: Supraspinatus/infraspinatus wasting

Front 15

Dx: Cervical disc disease

Back 15

Sign: Pain radiating below elbow; decreased cervical range of motion

Front 16

Dx: joint pain and impingement Glenohumeral joint instability

Back 16

Sign: Shoulder pain in throwing athletes; anterior glenohumeral joint pain and impingement

Front 17

Dx: Labral disorder

Back 17

Sign: Glenohumeral joint instability
Pain or "clunking" sound with overhead motion

Front 18

Dx: Impingement

Back 18

Sign: Nighttime shoulder pain

Front 19

Dx: Multidirectional instability

Back 19

Sign: Generalized ligamentous laxity

Front 20

evaluation of the painful shoulder, the neck and elbow should also be examined

Back 20

pain can be referred to the shoulder from disease in these areas

Front 21

Inspection

Back 21

Pt. movement, Visual differences, swelling

Front 22

Palpation

Back 22

examination of the acromioclavicular and sternoclavicular joints, the cervical spine and the biceps tendon. The anterior glenohumeral joint, coracoid process, acromion and scapula should also be palpated for any tenderness and deformity.

Front 23

Apley bra test

Back 23

Adduction, internal rotation

Front 24

Appley Scratch

Back 24

Testing abduction and external rotation.

Front 25

Supraspinatus examination ("empty can" test)

Back 25

patient attempts to elevate the arms against resistance while the elbows are extended, the arms are abducted and the thumbs are pointing downward

Front 26

Glenohumeral motion can be isolated

Back 26

holding the patient's scapula with one hand while the patient abducts the arm

Front 27

Infraspinatus/teres minor examination

Back 27

The patient attempts to externally rotate the arms against resistance while the arms are at the sides and the elbows are flexed to 90 degrees

Front 28

Subscapularis function is assessed with the lift-off test

Back 28

The patient rests the dorsum of the hand on the back in the lumbar area. Inability to move the hand off the back by further internal rotation of the arm suggests injury to the subscapularis muscle

Front 29

modified version of the lift-off test

Back 29

hand of the affected arm on the abdomen and resists the examiner's attempts to externally rotate the arm.

Front 30

Neer's test for impingement of the rotator cuff tendons under the coracoacromial arch

Back 30

The arm is fully pronated and placed in forced flexion.

Front 31

Dugas Test

Back 31

Reach across the body anteriorly and touch the opposite shoulder. the elbow should be flat on chest. Negative means Subluxation or dislocation

Front 32

Drop arm test

Back 32

A possible rotator cuff tear. Arm is completely abducted and the slowly lowered to waist.

Front 33

Spring Test

Back 33

AC joint push down on the clavicle watch for excessive movement. Injured by falling with outstretched arms

Front 34

Yergason test

Back 34

biceps tendon instability or tendonitis. The patient's elbow is flexed to 90 degrees, and the examiner resists the patient's active attempts to supinate the arm and flex the elbow.

Front 35

Dawburns sign

Back 35

Subacromium Bursa
Deep Palp. over LI15 and TB14 pain lessened with arm bent and abducted 40 degrees

Front 36

Shoulder tests should be followed by

Back 36

Cervical tests for referred radiculopathy

Front 37

Proximal Clavicular fractures

Back 37

-middle one third of the clavicle
-concomitant posterior dislocation of the sternoclavicular joint
-A standard anteroposterior (AP) view radiograph

Front 38

Displaced distal clavicular fractures

Back 38

result in disruption of the stabilizing ligaments of the acromioclavicular joint. Fractures of this type are more difficult to immobilize properly, and patients with this problem should generally be referred to an orthopedist for further evaluation

Front 39

Humeral fractures

Back 39

-direct blow or a fall onto an outstretched hand
-

Front 40

Scapular fractures

Back 40

-result from a direct blow to the scapular area or from extremely high-force impact elsewhere to the thorax. The patient usually has tenderness at the fracture site, and arm abduction is painful. The neck and scapular body are most commonly involved.
-

Front 41

Glenohumoral Dislocation

Back 41

-Most shoulder dislocations are anterior
-humeral head usually is palpable anteriorly, and the diagnosis is often confirmed by locating a dimple in the skin beneath the acromion
-Shoulder dislocation is treated with relocation of the humerus
-Return to mobilization in 7-10 days

Front 42

A sprain

Back 42

is an injury to a ligament--a stretching or a tearing

Front 43

strains

Back 43

are usually the result of overuse--prolonged, repetitive movement of the muscles and tendons.

Front 44

Acromioclavicular Joint Sprain and Separation

Back 44

-well-localized swelling and tenderness over the AC joint

Front 45

Sternoclavicular Joint Sprain and Separation

Back 45

-SC joint injury will complain of pain, particularly with shoulder adduction. Localized tenderness and deformity
-posterior dislocation can be life-threatening because of compression of the trachea and great vessels of the neck
-Radiographic 40-degree cephalic tilt view

Front 46

Rotator Cuff Tear

Back 46

-common in persons older than 40 years
-

Front 47

Impingement Syndrome

Back 47

m, the tendons of the rotator cuff can be impinged between the bony structures of the arch and the humerus. The impingement syndrome was described by Neer17,18 as a series of pathologic changes in the supraspinatus tendon:
stage I causes hemorrhage and edema;
stage II, tendonitis and fibrosis;
stage III, tendon degeneration of the rotator cuff and biceps, bony changes and tendon rupture.
-Patients who present with impingement syndrome complain of pain over the anterolateral aspect of the shoulder that does not radiate below the elbow.

Front 48

frozen shoulder

Back 48

Adhesive capsulitis results from thickening and contraction of the capsule and causes loss of range of motion and pain.

Front 49

Biceps tendonitis

Back 49

is initially managed with rest, ice, NSAIDs and corticosteroid injections and, when conservative management fails, tendon transfer.

Front 50

Labral Injury

Back 50

Common in throwing athletes

Front 51

nerve impingement

Back 51

referral numbness, tingling, dermatomal distribution

Front 52

vessel compression

Back 52

distal goes numb, reperfusion tingling,

Front 53

trigger point

Back 53

irritable spot in skeletal muscle trigerring a referred pain

Front 54

Space occupying lesion SOL

Back 54

-tumor bone fragment
-Valsava test- bearing down positive recreates pain

Front 55

Cervical compression test

Back 55

-disk herniation
-IVF: intervertebral foramen

Front 56

Adson's test for TOS

Back 56

is done to assess compression of the subclavian artery by the Anterior Scalene.

The test is performed as follows:
1)Monitor the patient's radial pulse at the wrist while you abduct, extend, and externally rotate the upper extremity at the shoulder joint (keeping the elbow straight)
2)Have the patient take a deep breath, rotate, and extend their head TOWARD the side being tested
The test is positive if there is a marked decrease or absence of the radial pulse.

Front 57

TOS

Back 57

Thoracic Outlet syndrome

Front 58

Eden's Test

Back 58

The examiner locates the radial pulse and draws the patient's shoulder down and back into extension with elbow extended, as the patient lifts their chest in an exaggerated "at attention or military" posture. A deep breath can be taken and held for 10 seconds. A positive test is indicated by an absence of a pulse. This test is particularly effective in patients who complain of symptoms while wearing a backpack or a heavy jacket.

Front 59

Wright's Test (for pectoralis minor involvement)

Back 59

-lymph
- Patient hyper-abducts arm above head to 180°, examiner palpates pulse and compares to uninvolved arm.