Name: Pt(s) Value. Pt(s) Earned

Transcription

1 Name: Evaluation of the Shoulder I. History What is the mechanism of pain? 1 2 Were you able to continue the activity? 1 3 Prior injury or surgery? 2 a. Resolution 1 4 Location of pain 1 5 On a scale of 1-10 what is your level of pain? 1 6 Type of pain? Sharp, dull, diffuse, or radiating 5 7 Onset of pain 1 8 Signs and symptoms? 2 9 Did you hear or feel a pop? 2 10 Actions that increase or decrease the pain 2 11 Family history 1 12 General Medical Health 1 II Observation Swelling 1 2 Obvious Deformity 1 3 Discoloration 1 4 Crepitus/Sound 2 5 Muscle Symmetry/Atrophy/Tone 3 6 Shoulder Tilt - Lateral view 2 7 Contour of Clavicle - Anterior View 2 8 Shoulder Alignment - Ant./Post. View 3 9 Scars, Open Wounds 2 10 Carrying Angle, Standing and Walking 3 III Palpation Boney Landmarks 1 a Suprasternal Notch 1 b Sternoclavicular (SC) Joint 1 c Corocoid Process 1 d Acromion Process 1 e Acromioclavicular (AC) Joint 1 f Glenohumeral (GH) Joint 1 g Bicepital Groove/Lesser and Greater Tuberosity 1 h Scapular Spine 1 i Infraspinatus Fossa 1 j Supraspinatus Fossa 1 k Medial Border 1 l Inferior Angle 1 m Superior Angle 1 2 Pitting Edema 1 3 Temperature 1 4 Point Tenderness 1 5 Shoulder Tilt - Lateral view 2 6 Shoulder Alignment 1 IV Special Test - Student must perform test 15 1 Range of Motion 1 a. Active 1 * Flexion/Extension (Fl/Ex) 2 Pt(s) Value Pt(s) Earned

2 * Internal/External Rotation (IR/ER) 2 * Abduction/Adduction (Abd/Add) 2 * Transverse Abd/Add 3 * Circumduction 1 b. Passive 1 * Flexion/Extension (Fl/Ex) * Internal/External Rotation (IR/ER) * Abduction/Adduction (Abd/Add) * Transverse Abd/Add * Circumduction (Circ) c. Restrictive 1 * Flexion/Extension * Internal/External Rotation * Abduction/Adduction * Transverse Abd/Add * Circumduction 2 Manual Muscle Testing 1 17 a. Deltoids 1 I Anterior - (Sh. Flexion) 2 ii Medial - (Sh. Abduction) 2 iii Posterior - (Sh. Extension) 2 b. Trapezius 1 I Upper - (Superior Rotation and Elevation of Scapula) 3 ii Middle - (Retraction of Scapula) 2 iii Lower - (Retraction and Depression of Scapula) 3 c. Triceps - (1 o Extension of Elbow, 2 o Extension of GH Joint) 3 d. Biceps - (1 o Flexion of Elbow, 2 o Flexion of GH Joint) 3 e. Pectoralis Major - (IR, Adduction and Flexion the GH joint) 5 f Latissimus Dorsi - (IR, Add, and Ext. the GH Joint) 5 g Rhomboids - (Adduct and elevates the scapula) 4 h Levator Scapulae (Elevates the scapula and assists in rotation so the glenoid cavity faces caudally) 6 I Supraspinatus - (Abducts the GH joint and stabilized the humeral head in the glenoid cavity) 6 j Subscapularis - ( IR the GH joint, stabilizes the humeral head in the glenoid cavity) 6 k Teres Minor - (ER the GH joint, stabilizes the humeral head into the glenoid cavity) 6 l Infraspinatus - (ER the GH joint, stabilizes the humeral head into the glenoid cavity) 6 m Serratus Anterior - (Abd the scapula, keeps medial border firmly against the thorax) AC Joint compression 1 a. Acromioclavicular (joint) and/or coracoclavicular ligament sprain SC Joint Stress 1 a. Sternoclavicular (joint) ligament sprain (SC joint stress test Empty Can 1 a. Involvement of the supraspinatus muscle and/or tendon Yergason's 1 a. Bicipital tendinitis or tear/laxity of the transverse humeral ligament Speed's 1 a. Bicipital tendinitis Drop Arm 1 a. Rotator cuff pathology 2

3 1 9 Hawkin's Kennedy Impingment 1 a. Possible shoulder impingement of the supraspinatus or long head of the biceps brachii tendon Anterior Apprehension 1 a. Inferior glenohumeral ligament compromised Posterior Apprehension Test 1 a Posterior capsule instability Jobe Relocation Test 1 a Anterior pain due to increased laxity in the anterior ligamentous and capsular structures 4 b. Posterior pain may be from the impingement of the posterior capsule or labrum Grind Test 1 a Glenoid labrum tear to the specific location which is being compressed Active Compression Test (O'Brien's Test) 1 a SLAP (Superior Labrum Anterior to Posterior) tear Adson's Maneuver Test 1 a Thoracic outlet syndrome or compression of the subclavian artery by the scalene muscles Circulation 1 a. Distal Pulse - Radial pulse 1 17 Nerves 1 a. Dermatomes - Checks Sensory Nerves: L 1 -S C5 Anterior shoulder medially distal to anterior wrist 4 C6 Lateral shoulder distal to thumb 4 C7 Posterior superior shoulder distal to posterior 2nd and 3rd phalanges 5 C8 Posterior inferior shoulder distal to posterior 3rd and 4th phalanges 5 T1 Posterior medial scapula lateral to axilla 4 b. Myotomes - Checks Motor Nerves: C 5 -T C5 Shoulder abduction 3 C5-6 Elbow flexion 4 C6-7 Elbow and wrist extension 5 C7-8 Wrist and finger flexion 5 C8 Finger extension 3 T1 Finger abduction 3 TOTAL 253 NOTES

4 NOTES

5