examinarea umarului
TRANSCRIPT
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SHOULDER
EXAMINATION
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the scapula is offset 30 degrees from the
frontal plane -- this is called the scapular
plane
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Glenohumeral joint
Capsu lar l igaments:joins theglenohumeral joint capsule
anteriorly, inferiorly, andposteriorly
Coracohumeral l igament:provides stability superiorly,preventing superior translation
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Rotator Cuff
Supraspinatus:abducts thehumeral head and acts as a humeralhead depressor
Infrasp inatus:externally rotates
and horizontally extends thehumerus
Subs capular is:internally rotatesthe humerus
Teres m inor: externally rotates andextends the humerus
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Subscapularis
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Conditions
Tumors/swellings
Nonunions
Instability
Subacromial impingement
Rotator cuff rupture SLAP Lesions
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History
Pain/instabilty/both
Decreased ROM
Dominant hand
Occupation
Trauma Childhood history
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General examination
Prominent veins
Neck viens/swellings
Chest movements
Fingerstrophic changes
General condition
CHEST EXAMINATION
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Shoulder examination
LOOK
TOUCH
MOVE
MEASURE
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Inspection
Attitude
Front
Side
Back
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Inspection
Front
Chest wall
Pect majorClavicle/recess
AC joint alignment
Deltoid contour
Any other swellings
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Side
Deltoid
AC jointWasting of cuff muscles
Swellings head of humerus
Scapula
Ant chest wall
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Back
Swellings
Muscles = wasting
Scapula alignment
AC joint
Deltoid Interscapualar region
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Palpation
Temperature
Tenderness
Swellings
Bony points Clavicle
Acromion
Humeral head
Coracoid AC joint
Scapula
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Movements
Flexion
Extension
Internal rotation
External rotation
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abduction
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Measurements
Arm length
Arm span:height
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Special tests
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Apley
scratch testPatient touches superior and inferior
aspects of opposite scapula
Loss of range of motion:
rotator cuff problem
Neer's sign Arm in full flexion Subacromial impingement
Hawkins'
testForward flexion of the shoulder to 90
degrees and internal rotation
Supraspinatus tendon
impingement
Drop-armtest
Arm lowered slowly to waist Rotator cuff tear
Cross-arm
testForward elevation to 90 degrees and active
adduction
Acromioclavicular joint
arthritis
Spurling'stest
Spine extended with head rotated toaffected shoulder while axially loaded
Cervical nerve rootdisorder
Apprehensi
on testAnterior pressure on the humerus with
external rotation
Anterior glenohumeral
instability
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Relocation
test
Posterior force on humerus while externally
rotating the arm
Anterior glenohumeral
instability
Sulcus sign Pulling downward on elbow or wrist Inferior glenohumeral
instability
Yergason test Elbow flexed to 90 degrees with forearm
pronated
Biceps tendon instability or
tendonitis
Speed's
maneuver
Elbow flexed 20 to 30 degrees and forearm
supinated
Biceps tendon instability or
tendonitis
"Clunk" sign Rotation of loaded shoulder from extension
to forward flexion
Labral disorder
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Special Tests - Instability
Sulcus sign
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Special TestsInstabilityGerber-Ganz Anterior Drawer Test &
Jerk test
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Special Tests - Instability
Anterior apprehension sign
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Special Tests - Impingement
Neers sign
Hawkins sign
Jobes sign
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Neers sign
Special Tests - Impingement
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Special Tests - Impingement
Hawkins test
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Special Tests - Impingement
Jobes test
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Special Tests - Rotator Cuff
External rotation lag sign (ERLS)
Hornblowers sign
Infraspinatus / teres minor
Internal rotation lag sign (IRLS)
Liftoff test
Subscapularis
Zaslavs internal impingement test
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Special Tests - Rotator Cuff
External rotation lag sign (ERLS)
Infraspinatus / teres minor
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Special Tests - Rotator Cuff
Internal rotation lag sign (IRLS)
Liftoff test Subscapularis
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Special Tests - Rotator Cuff
Belly Press test
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Special Tests - Rotator Cuff
Zaslavs internal impingement test
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Special Tests - Biceps
Speeds test
Yergasons test
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Special Tests - Biceps
Speeds test
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Special Tests - Biceps
Yergasons tests
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Special TestsSLAP Lesions
OBriens Test
Compression / rotation test
Pain Provocation test
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Special TestsSLAP Lesions
OBriens Test
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Special TestsSLAP Lesions
Compression / rotation test
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Special TestsSLAP Lesions
Crank test
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Special TestsSLAP Lesions
Kiblers anterior slide test
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Ac jointcross arm test
Point tenderness over AC joint
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Scarf test
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Finally
Neurological examination
Hand functions
Pulses
Other shoulder
Same elbow
SPINE