Notes for NPTE
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| What is the resting position, close packed position, capsular pattern and non parttern of the glenohumeral joint? | show 🗑
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| show | During 180 of abduction, there is roughly a 2:1 ration of movement of the humerus to the scapula, with 120 of movement occurring at the glenohumeral joint and 60 at the scapulothoracic joint.
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| show | The Scapulohumeral rhythm is commonly altered because of incorrect dynamic functioning of the scapular or humeral stabilizers or both. This may be related to incorrect arthrokinematics at the glenohumeral joint
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| What happen when you have a reverse scapulohumeral rhythm? | show 🗑
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| show | INFERIOR CAUDAL
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| show | Posterior
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| show | Posterior
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| In what way would you mobilize the GH joint to increase Horizontal adduction? | show 🗑
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| show | Anterior
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| show | Anterior
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| In what way would you mobilize the GH joint to increase late flexion (120-180)? | show 🗑
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| show | Arm by side90 abductionPain at extremes of range of motion, especially horizontal adduction and full elevation
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| Which branches innervated the acromiclavicular joint? | show 🗑
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| What is the resting position, close packed position, capsular pattern of the esternoclavicular joint? | show 🗑
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| show | Is not a true joint. The muscles acting on the scapula help to control its movements. It does not have a capsular pattern nor a close packed position.
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| show | Upper trapeziusLevator scapulae
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| show | Serratus, pectoralis major & minor, latisimus, trapezius (lower fibers)
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| Which muscles protract the scapula? (3) | show 🗑
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| show | Trapezius, Rhomboids
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| Which muscles upwardly rotate the scapula? (3) | show 🗑
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| show | Rhomboids, Levator scapulae, Pec major
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| show | Anterior delt, Coracobrachialis, Pec major, Biceps, Supraspinatus
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| show | Lats, Subscap, Post deltoid, Teres major
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| Which muscles abduct the shoulder? (3) | show 🗑
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| Which muscles laterally rotate the shoulder? (3) | show 🗑
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| show | Subscap, Teres major, Pec major, Lats, Anterior deltoid
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| show | They hold the head of the humerus in the glenoid cavity during abduction.
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| show | Patient experiences no difficulty in raising the arm overhead, but a decrease in strength and endurance resulted. Loss of abd as seen in patients with rupture of the supraspinatus tendon is due to pain.
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| What happen when on of the abd muscles is paralyzed? | show 🗑
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| But if both are paralyzed? | show 🗑
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| show | Pull the humerus up.
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| show | Can not perform glenohumeral abd. Instedad, the arm is raised slightly by upward rot. of the scapula nd lateral flex of the trunk
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| show | Patients with isolated deltoid paralysis can By ext rot. The glenohumeral joint (to use the biceps) and a slight motion toward flex at around 90 abd.
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| show | Cause upward rotation of the scapula during arm elevation.Support the shoulder girdle and prevent sagging of the shoulder
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| show | The support is missing and the shoulder sloper down more than it would normally. The weight of the arm tends to draw the tip of the shoulder down, causing the scapula to rotate downward beyond its normal hanging position.
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| How can the shoulder girdle can be elevated even if the trapezius is paralyzed? | show 🗑
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| What is the function of the serratus anterior? | show 🗑
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| What happen when the serratus anterior is paralyzed? | show 🗑
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| show | scapula protracting along chest wall,under load;early contraction of upper trapezius on abduction,under load; Increased work of rotator cuff and biceps, especially with closed chain activity (reverse oringin-insertion);Altered scapulohumeral rhythm
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| show | Weak subscapulares and teres major, tight infraspiatus and teres minor.
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| show | Long/weak serratus anterior
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| Who causes scapular winging fault on eccentric forward flexion? | show 🗑
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| Who causes scapular winging fault on tilting of inferior angle? | show 🗑
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| Winging of the scapula cause: Trapezius or spinal accessory never lesion | show 🗑
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| Winging of the scapula cause: Serratus anterior or long thoracic nerve lesion | show 🗑
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| Winging of the scapula cause: Strain of rhomboids | show 🗑
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| Winging of the scapula cause: Muscle imbalance or contractures | show 🗑
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| Which muscles the spinal accessory nerve innervated? | show 🗑
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| show | Inability to abd arm beyond 900, pain in shoulder on abduction.
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| What sensory alteration occurs when spinal accessory nerve is affected? | show 🗑
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| What is the mechanism of injury of spinal accessory nerve? | show 🗑
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| Which muscles the long thoracic nerve (C5-C7) innervated? | show 🗑
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| show | Pain on flexion fully extended arm, inability to flex fully extended arm, winging starts at 90 forward flexion
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| What is the mechanism of injury of long thoracic nerve? | show 🗑
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| Which muscles the suprascapular nerve (C4-C6) innervated? | show 🗑
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| What happen when the suprascapular nerve (C4-C6) is affected? | show 🗑
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| show | Top of shoulder from clavicle to spine of scapula;Pain in posterior shoulder radiating into arm
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| show | Compression in suprascapular notch;Stretch into scapular protraction plus horizontal adduction;Compression in spinoglenoid notch ; Direct blow; Space occupying lesion
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| Which muscles the axillary (circumflex) nerve (C5-C6) innervated? | show 🗑
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| What happen when the axillary (circumflex) nerve (C5-C6) is affected? | show 🗑
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| show | Deltoid area; Anterior shoulder pain
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| What is the mechanism of injury of axillary nerve? | show 🗑
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| Which muscles the Musculocutaneous nerve (C6-C7) innervated? | show 🗑
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| show | weak elbow flexion with forearm supinated.
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| What sensory alteration occurs when Musculocutaneous nerve (C6-C7) is affected? | show 🗑
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| show | Biceps
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| show | Compression; Muscle hypertrophy; Direct blow; Fracture (clavicle and humerus); Dislocation (anterior);Surgery (Putti-Platt, bankart)
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| What is Yergason’s test used for? Describe it. | show 🗑
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| show | Tendon of biceps long head will “pop out” of groove. May also reproduce pain in long head of biceps tendon.
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| What is Speed’s (straight arm) test used for? Describe it. | show 🗑
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| show | Pain in long head of biceps tendon
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| What is Neer impingement test used for? Describe it. | show 🗑
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| show | Pain within shoulder region
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| show | Tear and/or impingement of supraspinatus tendon or possible suprascapular nerve neuropathy. Patient sitting with shoulder at 90 and no rot. Resist shoulder abd. Then place shoulder in “empty can” position, int rot, 30 forward (horiz add) and resist abd,
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| What is the positive find of Supraspinatus (empty can) test? | show 🗑
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| show | Identifies tear/or full rupture of rotator cuff. Patient sitting with shoulder passively abducted to 120. Patient instructed to slowly bring arm down to side. Guard patient’s arm from falling in case it gives way.
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| What is the positive find of Drop arm test? | show 🗑
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| What is Posterior internal impingement test used for? Describe it. | show 🗑
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| What is the positive find of Posterior internal impingement test test? | show 🗑
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| show | Identifies a glenoid labrum tear. Identifies a glenoid labrum tear.
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| What is the positive find of Clunk test? | show 🗑
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| What is Anterior apprehension sign test used for? Describe it. | show 🗑
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| What is the positive find of Anterior apprehension sign test? | show 🗑
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| show | Past history of posterior shoulder dislocation. Patient supine with shoulder abd 9) (in plane of scapula) with scapula stabilized. Posterior force through shoulder via force on patient’s elbow while moving shoulder into med rot and horizontal adduction.
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| show | Patient does not allow and/or does not like shoulder to move in direction to simulate posterior dislocation.
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| What is Acromiclavicular shear test used for? Describe it. | show 🗑
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| What is the positive find of Acromiclavicular shear test? | show 🗑
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| show | Identifies pathology of structures that pass through thoracic inlet. Patient sitting and find radial pulse of extremity being tested. Rotate head towards extremity being tested then extend and externally rotate the shoulder while extending head.
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| What is the positive find of Adson’s test? | show 🗑
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| What is Costoclavicular syndrome (military brace) test used for? Describe it. | show 🗑
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| What is the positive find of Costoclavicular syndrome (military brace) test? | show 🗑
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| show | Patient sitting and find radial pulse of extremity being tested. Move shoulder into maximal abduction and external rotation. Taking deep breath and rotating head opposite to side being tested may accentuate symptoms
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| show | Neurologic and/or vascular symptoms (disappearance of pulse) will be reproduced in upper extremity.
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| show | Evaluation of peripheral nerve compression. Neurologic symptoms will be reproduced in upper extremity.
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| show |
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| show | Age 30-50 years; pain and weekenss after eccentric load
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| show | Normal bone and soft tissue outlines; protective shoulder hike may be seen
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| show | Weakness of abduction or rotation, or both; crepitus may be present
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| show | Pain if impingement occurs
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| show | Pain and weakenss on abduction and lateral rotation
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| show | Drop-arm test, Empty can test
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| Is the sensory function or reflexes are affected in rotator cuff lesions? | show 🗑
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| show | Tender over rotator cuff
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| What the diagnostic imaging of rotator cuff lesions will show? | show 🗑
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| What is the history of Frozen shoulder? | show 🗑
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| show | Normal bone and soft-tissue outlines
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| show | Restricted ROM, shoulder hiking
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| show | Limited ROM, especially in lateral rotation, abduction, and medial rotation (capsular pattern)
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| What resisted isometric movements are present in Frozen shoulder? | show 🗑
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| What are the special test for Frozen shoulder? | show 🗑
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| Is the sensory function or reflexes are affected in Frozen shoulder ? | show 🗑
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| What the palpation exam in Frozen shoulder will show? | show 🗑
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| show | Radiography negative; Arthrography decreased capsular size
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| What is the history of Atraumatic instability? | show 🗑
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| What can you observe in Atraumatic instability? | show 🗑
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| What happen when you have active movements in Atraumatic instability? | show 🗑
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| show | Normal or excessive ROM
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| What resisted isometric movements are present in Atraumatic instability? | show 🗑
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| show | Augmentation tests positive
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| Is the sensory function or reflexes are affected in Atraumatic instability? | show 🗑
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| What the palpation exam in Atraumatic instability will show? | show 🗑
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| show | Negative
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| show | Age 50+ years; acute or chronic
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| show | Minimal or no cervical spine movement; torticollis may be present
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| show | Limited ROM with pain
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| What are the passive movements of Cervical spondylosis? | show 🗑
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| show | Normal, except if nerve root compressed; myotome may be affected
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| show | Spurling’s test,Distraction test ,ULTT positive, Shoulder abduction test
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| show | Dermatomes affected; reflexes affected
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| What the palpation exam in Cervical spondylosis will show? | show 🗑
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| What the diagnostic imaging of Cervical spondylosis will show? | show 🗑
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| show | Intermittent mild pain with overhead activities. Over age 35
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| What are the symptoms of Exernal primary impingement (stage II? | show 🗑
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| What are the symptoms of Exernal primary impingement (stage III)? | show 🗑
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| What are the symptoms of Rotator cuff tear (full thickness)? | show 🗑
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| show | Inability to perform activities of daily living owing to loss of motion; loss of motion may be perceived as weakness
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| show | Apprehension to mechanical shifting limits activities; slipping, popping, or sliding may present as suitable instability; apprehension usually associated with horiz abd and lat rot; anterior or posterior pain may be present; weak scapular stabilizers
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| show | Slipping or popping of the humerus out the back; this may be associated with forward flexion and medial rotation while the shoulder is under a compressive load.
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| show | Looseness of shoulder in all directions, this may be most pronounced while carrying luggage or turning over while asleep; pain may or may not be present.
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| show |
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| show | Common
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| What is the time for recovery, early presentation of Overuse tendinosis? | show 🗑
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| show | 3-6 months
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| What is the likelihood of full recovery to sport from chronic symptoms of Overuse tendinosis? | show 🗑
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| show | Encouragement of collagen-synthesis maturation and strength
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| What is the role of surgery in Overuse tendinosis? | show 🗑
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| What is the prognostic for surgery in Overuse tendinosis? | show 🗑
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| What is the time for recovery from surgery in Overuse tendinosis? | show 🗑
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| What is the prevalence of Overuse tendinitis? | show 🗑
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| show | Several day to 2 weeks
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| show | 4-6 weeks
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| show | 99%
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| show | Anti-inflammatory modalities and drugs
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| What is the role of surgery in overuse tendinitis? | show 🗑
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| show | 95%
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| show | 3-4 weeks
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| show | yes
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| In wich sex is more like to have anterior painful arc? | show 🗑
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| show | Lateral rotation and abduction
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| Where is located the Tenderness in anterior painful arc? | show 🗑
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| Is there Acromioclavicular joint involvement in anterior painful arc? | show 🗑
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| show | supraspinatus, infraspinatus and/or subscapularis
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| show | no
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| show | good
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| show | yes
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| In which sex is more like to have Posterior painful arc? | show 🗑
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| The pain in the posterior painful arc is aggravated by? | show 🗑
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| show | Posterior aspect of greater tuberosity
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| show | No
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| Is Calcification present in posterior painful arc? | show 🗑
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| Is there a Third-degree strain biceps brachii (long head) present in posterior painful arc? | show 🗑
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| show | Very good
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| Is Night pain present in Superior painful arc? | show 🗑
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| In which sex is more like to have Superior painful arc? | show 🗑
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| The pain in the Superior painful arc is aggravated by? | show 🗑
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| Where is located the Tenderness in Superior painful arc? | show 🗑
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| Is there Acromioclavicular joint involvement in Superior painful arc? | show 🗑
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| show | supraspinatus and/or subscapularis
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| show | Occasional
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| What is the Prognosis in Superior painful arc? | show 🗑
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