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The Shoulder
(CN) The Shoulder
| Front | Back |
|---|---|
| Which muscles elevate the scapula? (2) | Upper traps, Levator scapulae |
| Which muscles depress the scapula? (4) | Serratus, pectoralis major & minor, latisimus, trapezius (lower fibers) |
| Which muscles protract the scapula? (3) | Serratus anterior, Pec major and minor |
| Which muscles retract the scapula? (2) | Traps, Rhomboids |
| Which muscles upwardly rotate the scapula? (3) | Upper and Lower traps, Serratus anterior |
| Which muscles downwardly rotate the scapula? (3) | Rhomboids, Levator scapulae, Pec major |
| Which muscles flex the shoulder? (5) | Anterior delt, Coracobrachialis, Pec major, Biceps, Supraspinatus |
| Which muscles extend the shoulder? (4) | Lats, Subscap, Post deltoid, Teres major |
| Which muscles abduct the shoulder? (3) | Middle delt, Supraspinatus, Infraspinatus |
| Which muscles adduct the shoulder? (3) | Pec major, Lats, Teres major |
| Which muscles laterally rotate the shoulder? (3) | Teres minor, Infraspinatus, Posterior delt |
| Which muscles medially rotate the shoulder? (5) | Subscap, Teres major, Pec major, Lats, Anterior deltoid |
| What is Ludington’s used to test for? Describe how it is performed. | Tests for rupture of the long head of the biceps tendon. Place pt in sitting, have him clasp hands behind head and interlock fingers. Alternately contract and relax biceps. Positive test is absence of movement in biceps tendon. |
| What is Speed’s test used for? Describe how it is performed. | Tests for bicipital tendonitis. Place pt in sitting or standing w/ elbow extended and forearm supinated. Place hand on bicipital groove and resist active shoulder flexion. Positive test indicated by pain or tenderness in bicipital groove region. |
| What is Yergason’s test used for? Describe how it is performed. | Used for bicipital tendonitis. Place pt in sitting w/ 90 deg elbow flexion w/ forearm pronated.Resist supination and lateral rotation. Positive test is pain or tenderness in bicipital groove. |
| What is the Drop Arm Test used for? Describe it. | Used to indicate rotator cuff tear. Abduct arm to 90, and have pt slowly lower their arm to their side. Positive test: pt fails to lower the arm, or presence of severe pain. |
| What is the Hawkins-Kennedy test used for? Describe it. | Indicates shoulder impingement involving the supraspinatus tendon. Flex pt's shoulder to 90 and medially rotate the arm. Positive test is indicated by pain with this passive maneuver. |
| What is the Neer test used for? Describe it. | Indicates shoulder impingement involving supraspinatus tendon. Stabilize pt's scapula posteriorly, and passively flex their arm. Positive test is facial grimace or pain. |
| What is the Supraspinatus test used for? Describe it. | Indicates tear of the supraspinatus tendon, impingement, or suprascapular nerve damage. Position pt with arm in 90 abduction, 30 horizontal adduction, with thumb pointed downward. Resist the pt's attempt to abduct the arm. Positive test : weakness or pain |
| What is the Adson maneuver used for? Describe it. | Tests for TOS. Monitor radial pulse. Pt rotates head toward test shoulder, and extends their head while therapist laterally rotates and extends the shoulder. Positive test: Diminished radial pulse. |
| What is teh Allen test used for? Describe it. | Indicates TOS. Abduct the arm to 90. Pt rotates head away from test shoulder while PT monitors radial pulse. Positive test: Absent or diminished pulse w/ head turned away. |
| What is costoclavicular syndrome? Describe the test for it. | TOS via compression of the subclavian artery between 1st rib and clavicle. Monitor radial pulse, and assist pt to assume military posture (shoulders back). Positive test: Diminished or absent radial pulse. |
| What is the roos test used for? Describe it. | Indicates TOS. Position both arms in 90 abduction, lateral rotation, and elbow flexion. Pt opens and closes hands for three mins. Positive test:Inability to maintain test position, weakness of the arms, sensory loss, or ischemic pain. |
| What is the Wright test AKA? What is it used for? Describe it. | AKA: Hyperabdduction Test. Use to indicate compression in costoclavicular space. PT moves pt's arm overhea in the frontal plane while monitoring radial pulse. Positive test: Diminished or absent radial pulse. |
| Describe the glenoid labrum tear test (Clunk test). | Place pt in supine. PT puts one hand over posterior aspect of humeral head. Passively abduction and laterally rotate the arm over pt's head and apply anteriorly directed force to humerus. Positive test: Clunk or grinding sound. |
| Locations and causes of TOS? | Scalenus anterior syndrome, cerviacal rib syndrome, costocalvicular space syndrome, hyperabduction syndrome |
| Causes od dynamic scapula winging? | Long thoracic N. Palsy and Spinal Accessory N. Palsy, Raeticulopathy of trapezius, rhomboid, serratus anterior |
| wwhat happens with scapula in Long Thoracic N. Palsy | Scapula is elevated and the inferior angle is medialy rotated |
| what happens with scapula inSpinal Accessory N. Palsy? | The scapula is depressed, moved laterally, and the inferior angle is lateraly rotated |
| What is the Sprengel's deformity? | congenitaly high or undescended scapula. Scapular muscles are poortly developed or replaced by fibrouse band. Shoulder abduction is lomited. Scapula is small and mid. rotated |
| painfull abduction of shoulder between 60 - 120 degree? | subacromial bursa, calcium deposit, rotator cuff tendonitis |
| painfull abduction of shoulder between 170-180 degree? | acromioclavicular lesion, impingement |
| what are the primary ligaments in GH joint? | the superior,middle, and inferior glenohumeral ligaments |
| what is the primary role of superior glenohumeral ligament? | It limits inferior translation in adduction |
| what is the primary role of middle glenohumeral ligament? | it limits lateral rotation to 45 degree and 90 abduction |
| what is the primary role of inferior GH ligament? | supports the humeral head above 90 degree abduction limiting inferior translation |
| What is a step deformity? | caused by acromioclavicular dislocation, with the distal end of clavicle lying superior to the acromion process. Both coracoclavicular and acromioclavicular ligaments are torn. |
| What i sthe sulcus deformity? | apparence of sulcus or groove below the acromion process caused by multidirectional instability or loss of muscle control due to the nerve injury |
| What is the normal ROM in GL fforward lexion? | 160 - 180 degree |
| What is the normal ROM in GH Extension? | 50- 60 degree |
| What i sthe normal ROM in Lateral Rotation? | 80 -90 degree |
| What is the ROM in GH Medial rotation? | 60 - 100 degree |
| What is the normal ROM in GH Abduction? | 170-180 degree |
| What is the normal ROM in Adduction? | 50-75 degree |
| What is the ROM nessesery for eating? | 70 -100 horizontal adduction/ 45-60 abduction |
| What is the ROM nessesery for combing hair? | 30-70 horizontal adduction/105-120 abduction/90 lateral rotation |
| What is the ROM nessesery for reaching perineum? | 75-90 horizontal abduction/30-44 abduction/90+ medial rotation |
| What is the ROM nessesery for tacking in shirt? | 50-60 horiz. add/55-65 abd/90 med.rot. |
| What is the ROM nessesery to put hand behind head? | 10-15 hor.add/110-125 forward flex/90 lat.rot. |
| What is the ROM nessesery to put something on the shelf? | 70-80 hor. add/70-80 forward flex/45 lat.rot. |
| What is the ROM nessesery to wash opposite shoulder? | 60-90 forward flex/60-120 hor.add |
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PT Board Exam
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