Examen
SHOULDER COMPLEX EXAMINATION (INCLUDES PATHOLOGIES)
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SHOULDER COMPLEX EXAMINATION (INCLUDES PATHOLOGIES)
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SHOULDER COMPLEX EXAMINATION (INCLUDESPATHOLOGIES)
Pain generating tissues - Answers- •Bone
•Muscle
•Tendon
•Capsule
•Labrum
•Ligaments
•Nerves
•Bursa
Stressors - Answers- compression
tension
shear
chemical/ ischemic
During exam figuring out which structures aren't handling certain ----- well - Answers-
stressors
. At lot of times when I hear that a person has bursitis, I think of how that pathology
often does not occur ---- - Answers- alone
These structures have mechanoreceptors and pain sensors, if overstressed can be pain
generating tissues - Answers- ligaments
what is adhesive capulitis "frozen shoulder" - Answers- •Synovial inflammation of joint
capsule
•Progresses to capsular fibrosis
what kind of onset does frozen shoulder have? - Answers- idiopathic
What is frozen shoulder correlated with/ things to look for in the hx? - Answers- -women
-age over 40
-diabetes/thyroid disease
-autoimmune disease
-immobilization
-stroke
Adhesive capsulitis= mainly issue with --- and ----; --- should be good up until you rly get
into this pathology do to atrophy of not using the musculature - Answers- AROM and
PROM
RROM
what is the pain generator in adhesive capsulitis? - Answers- capsule
,Patient subjective of frozen shoulder - Answers- -severe pain
-Pain for several months
-Achy pain at lateral arm
-No known MOI
-Loss of ability to raise arm overhead
History should include questions for known
-DM
-Thyroid disease
-Autoimmune disease
What are the four stages of adhesive capsulitis? - Answers- I= progressive pain, pre
freezing
II= freezing
III= frozen
IV= thawing
is the early stage where there is a lot of pain and the patient loses ROM pretty quickly. -
Answers- stage I of frozen shoulder
In this stage the pain is present and they don't have motion despite stretching or almost
anything else they try - Answers- stage II
At this point the pain is better but ROM continues to be limited - Answers- stage III
This is where the ROM begins to return slowly. - Answers- stage IV
Stage I adhesive capsulitis - Answers- •months 0-3)
•Progressive pain
•Global loss of AROM & PROM due to pain at this time
•Stage II (months 3-9)
Stage II adhesive capsulitis - Answers- •months 3-9)
•Freezing phase
•Persistent pain & loss of motion
•Capsular fibrosis is present
•No inflammatory markers in capsule at this point
Stage III adhesive capsulitis - Answers- •months 9-14)
•Frozen stage
•Pain is reduced
•Global loss of AROM & PROM due to capsular fibrosis
•DECREASED CAPSULAR VOLUME
Stage IV adhesive capsulitis - Answers- •14 month - 3 years)
•Thawing phase
, •Slow steady recovery of AROM & PROM
•CAPSULE REMODELS
Objective of adhesive capsulitis
-Global loss of --- = ----
-must do ----
----- often misdiagnosed as frozen shoulder
what would you see with RROM= ----
--- or ---- free
see poor ----- kinematics
-would see excessive ---- --- and ---- trunk ----
would see shoulder ---- due to --- ---
are there special tests? - Answers- AROM= PROM
both
RTC
strong
painful or pain free
scapulohumeral
scapular elevation excessive contralateral trunk lean
atrophy
non use
no
What's this structure?
•Fibrocartilaginous rim
•
•Assists in providing stability to glenohumeral joint
•
•Long head of the biceps has direct attachment superiorly
•
•Damage often results in structural ---- of joint - Answers- glenoid labrum
instability
If you know your pt has labral tear what tendon might you want to check the integrity of?
- Answers- biceps
is the glenoid labrum a pain generating tissue? - Answers- yes
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