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30 Cards in this Set

  • Front
  • Back
if a pt has a shoulder tear, is OMT indicated? what about a contusion?
NO for both
please label
1. Sternoclavicular joint
2. Coracoid process
3. Acromioclavicular join
Subacromial bursa
4. Greater tuberosity
5. Bicipital groove
6. Lesser tuberosity
/ Glenohumeral joint
7. Deltoid bursa
X. First Rib
when do you start to use imaging for diagnosis?
after 3 visits with no improvement
list the 5 articulations of the shoulder
First rib (costochondral, chondrosternal, costovertebral)
what are some of the key muscles you must think of when a pt presents with shoulder pain?
rotator cuff

supraspinatus (impingement)



levator scapulae
how do you screen peripheral neuropathy?
Spurling's (extend neck rotate head, push down)

positive if pain radiates down same side


Adson's sign (seen when you turn your head to one side, take a deep breath, and the pulse goes away in the arm)
in addition to muscular, fracture, or cartilage damage, what is another important consideration when evaluating for shoulder pain
neural compression
following history, observation, and palpation, you must make sure to do this in a shoulder pain evaluation
Range of Motion testing (major and accessory)
Neer test
raise arm over head, look for impingement
Yergason test
external rotation of the shoulder against force
when doing ROM testing always make sure to compare
active and passive ROM
if pt has reduced shoulder ROM think...
adhesive capsulitis

on both active and passive motion
when you have shoulder abduction, what is the ratio of scapula rotation to glenohumeral joint abduction?
for ever 15 degrees abduction...

5 is scapula; 10 is GH

so 1:2 ratio
most common SC somatic dysfunction?
Anterior and superior glide
Most common AC somatic dysfunction
Superior glide
3 counterstrain tenderpoints



Levator scap
tenderness in bicipital groove alone is clinical of...
Biceps Tendonitis
tenderness, position change, edema below AC joint is clinical of..
Subacromial bursitis
tenderness at origins and insertions of muscles; MRI evidence can help you find
Rotator cuff Strain/Sprain/Tear
pain on abduction, external rotation of humerus and scapula are the clinical findings of?
impingement syndrome
limitation of motion in the shoulder on active/passive movement and history can lead you to what diagnosis
adhesive capsulitis
what 2 organs can lead to referred shoulder pain?
heart and gallbladder
steps for Spencer Technique (in order)
Every fat cat tries abduction in pumps

Internal rotation
for the glenohumeral joint, which way does it glide with aBduction and extension respectively
aBduction: inferior

Extension: anterior

this can lead to dislocation
find the cause bro, find the cause
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
abduct the arm about 45°; fine tune with slight arm external rotation
supraspinatus inserts where
greater tubercle of the humerous
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
C. Orthopedic referral
D. Rest and ice
E. Reduction in the office
E. Reduction in the office
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
A. The levator scapula runs from the medial angle of the scapula to C 2
List the degrees of ROM for the shoulder

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