The shoulder

The G/H joint has 3 degrees of freedom and performs:

For full ROM the G/H joint requires

—G/H joint capsular pattern:

Arthrokinematics of the G/H joint: motion occurs as a _____ and _______ of the head of the humerus on the glenoid fossa.

—The Shoulder Girdle consists of four distinct joints:—

—Normal shoulder ROM-Flexion

Normal shoulder ROM-Extension

Normal shoulder ROM-Abduction

Normal shoulder ROM-Medial (internal) rotation

Normal shoulder ROM-Lateral (external) rotation

Considered a functional rather than anatomical joint

—Osteokinematics: scapular elevation-depression, upward-downward rotation, anterior-posterior tilting, protraction-retraction

S/T —joint surfaces are

—Anatomy: a synovial joint linking scapula and clavicle

Acromioclavicular Joint= 3 degrees of freedom; permits movement of scapula on clavicle in _ planes

Upward-downward rotation, tilting (tipping), protraction-retraction

—A/C joint arthrokinematics: sliding of the concave acromial facet on the convex clavicular facet; acromial sliding on clavicle occurs in ____ direction as movement of scapula

—S/T joint arthrokinematics: _______ of scapula on thorax

—Osteokinematics: 3 degrees of freedom = Elevation-depression, protraction-retraction, anterior-posterior rotation

—Anatomy: SC joint is a synovial joint; links medial end of clavicle with sternum and cartilage of first rib; ________ shaped joint surfaces

S/C joint elevation-depression: convex surface of the clavicle slides on the concave manubrium in direction __________ to the movement of lateral end of clavicle)

S/C joint protraction-retraction: concave surface of clavicle slides on concave manubrium in _____ direction as lateral end of clavicle

S/C joint Rotation: clavicular joint surface _____ on opposing joint surface

—Humeral head slides posteriorly and inferiorly in flexion, anteriorly and superiorly in extension, inferiorly in abduction, and superiorly in adduction

Measuring Shoulder Flexion ROM Test Position:

—Measuring Shoulder Flexion-Goniometer Alignment:

Measuring Shoulder Flexion-stabilization:

—End Feel:

—Test Position: prone, face turned away from shoulder being tested. Shoulder in 0 degrees of ABD, ADD, rotation. Elbow in slight flexion. Forearm in 0 degrees supination and pronation (palm faces body)

STABILIZATION:

When Measuring shoulder ext.-G-H: stabilize scapula at inferior angle or at acromion and coracoid processes to prevent ________ and anterior _______ of scapula

Shoulder ext end feel:

—Goniometer Alignment:

Measuring Shoulder Abduction (Test Position):

Measuring Shoulder Abduction-Stabilization:

When measuring shoulder abduction, G/H joint and shoulder end feel is usually ______.

—Goniometer Alignment when measuring shoulder ABD:

—Test Position when measuring shoulder IR: _______, shoulder in 90 degrees of ___, forearm perpendicular to supporting surface and in 0 degrees of supination and pronation. Place pad (towel) under humerus; elbow should not be supported.

G-H: firm because of tension of posterior joint capsule and infraspinatous and teres minor muscles

—Stabilization:

Measuring Should Internal Rotation:

—Goniometer Alignment same as Internal Rotation

ER Shoulder End Feel:

When MMT Scapular ABD and Upward Rotation which muscle is tested and in what position?

In what position is the patient when MMT Scapular ABD and Upward Rotation for grades 2,1,0 ?

In which grade of MMT scapular ABD and upward rotation does the PT/PTA observe for scapular winging?

When MMT scapular elevation, which muscle is being tested?

What position is the pt. in when MMT scapular elevation grades 5,4?

What position is the pt. in when MMT scapular elevation grades 2,1,0?

What position is the pt. in when MMT scapular elevation grades 3?

GM=

Scapular Adduction MMT test which muscles?

Pt. positioning for scapular adduction MMT grades 5,4,3?

Pt. positioning for scapular adduction MMT grades 2,1,0?

Scapular Depression and Adduction MMT test which muscle?

Patient position: prone with test arm over head to about 145 degrees of ABD, thumb pointing to ceiling

Rhomboid major and minor are tested during which MMT?

Pt positioning for scapular ADD and downward rotation MMT grades 5,4,3?

Pt positioning for scapular ADD and downward rotation MMT grades 2,1,0?

Manual Muscle Testing for Shoulder Test;

Shoulder Flexion:

Shoulder Flexion MMT which muscles?

When MMT grades 5,4,3 for shoulder flexion, pt. position is?

When MMT grades 2,1,0 for shoulder flexion, pt. position is?

Shoulder Extension MMT test:

Shoulder Extension (generic) MMT pt. positioning grades 5,4:

Shoulder Extension MMT pt. positioning grades 3,2:

Shoulder Extension MMT pt. positioning grades 1,0:

Shoulder Scaption MMT which muscles?

—Scaption MMT positioning: Grades 5, 4, 3, 2, 1, 0

Shoulder Abduction MMT test which muscles?

—Pt. positioning for shoulder ABD MMT, Grades 5, 4, 3, 2

Pt. positioning for shoulder ABD MMT, Grades 1,0

Which muscle does MMT for Shoulder Horizontal Abduction test?

Pt. positioning for shoulder horizontal ABD MMT (grades 5,4,3):

Pt. positioning for shoulder horizontal ABD MMT (grades 2,1,0):

Which muscle is tested during Shoulder Horizontal Adduction MMT?

Pt. position for Shoulder Horizontal Adduction MMT (grades 5,4,3): Whole muscle

Pt. position for Shoulder Horizontal Adduction MMT (grades 5,4,3): –Clavicular head

Pt. position for Shoulder Horizontal Adduction MMT (grades 5,4,3): –Sternal head

Pt. position for Shoulder Horizontal Adduction MMT (grades 2,1,0):

Shoulder External Rotation MMT test the __________& ___________ muscles.

Prone with head turned toward test side, shoulder ABD to 90 degrees with arm fully supported on table, forearm off edge of table with elbow flexed. Place towel under arm.

Prone with head turned toward test side, the entire limb hangs loosely form the shoulder in neutral rotation, palm facing table

Pt. pos. for shoulder IR MMT —Grades 5, 4, 3

Shoulder Internal Rotation MMT test the _____________.

Prone with head turned toward test side, the entire limb hangs loosely form the shoulder in neutral rotation, palm facing table

Shoulder Joint Special Tests: