Shoulder Motion and Dynamics
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Shoulder Motion and Dynamics

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Questions and Answers

What is the correct sequence for assessing range of motion (ROM) during goniometry?

  • Perform assessments on the affected side first.
  • Measure PROM first before AROM.
  • Always start by observing AROM before the contralateral side. (correct)
  • Conduct the assessment without palpating landmarks.

    • Which of the following is a key focus during palpation?

  • To understand the anatomy and know what you’re feeling for. (correct)
  • To perform deep palpation before superficial assessment.
  • To palpate with no specific goal in mind.
  • To document findings using subjective measures only.

    • What is an important factor to consider when assessing shoulder strength?

  • Assessing only the shoulder muscles without consideration of scapular muscles.
  • Isolating and stabilizing the muscles being tested. (correct)
  • Document subjective reports without objective measures.
  • Testing should always be done without considering trunk position.

    • In the context of muscle length testing, which of the following aspects is essential to assess?

    <p>Consider both quality and quantity of movement.</p> Signup and view all the answers

    Which statement about gross strength assessment is true?

    <p>The position of the trunk/spine can influence the results.</p> Signup and view all the answers

    What is the primary reason the shoulder sacrifices stability?

    <p>To increase range of motion</p> Signup and view all the answers

    Which joint is classified as a synovial ball-and-socket joint?

    <p>Glenohumeral Joint</p> Signup and view all the answers

    Which statement about the Glenoid Labrum is correct?

    <p>It enhances stability by increasing glenoid depth.</p> Signup and view all the answers

    What are the additional movements of the shoulder beyond the primary movements?

    <p>Horizontal Abduction and Adduction</p> Signup and view all the answers

    How much does the Glenoid Labrum increase glenoid depth?

    <p>30-50%</p> Signup and view all the answers

    Which joint does not have a true anatomical structure but functions as a joint?

    <p>Scapulothoracic Joint</p> Signup and view all the answers

    What is the primary limitation in the capsular pattern of the Glenohumeral Joint?

    <p>External Rotation</p> Signup and view all the answers

    What type of joint is the Sternoclavicular Joint?

    <p>Saddle Joint</p> Signup and view all the answers

    How many degrees of freedom does the Acromioclavicular Joint have?

    <p>3</p> Signup and view all the answers

    What is the primary function of the joint capsule in the Glenohumeral Joint?

    <p>To provide stability and support</p> Signup and view all the answers

    What is the correct order of steps for assessing range of motion (ROM) using goniometry?

    <p>Palpate landmarks, observe AROM, measure PROM, assess end feel</p> Signup and view all the answers

    Which of the following statements best describes palpation techniques?

    <p>Palpation should start superficially and progress deeper while understanding anatomy.</p> Signup and view all the answers

    When performing muscle length testing, which factor is essential to consider for accuracy?

    <p>Ensure consistency in trunk and spine positioning to avoid altering results.</p> Signup and view all the answers

    What is a critical aspect to document during the assessment of range of motion?

    <p>The subjective report of the patient alongside objective measures</p> Signup and view all the answers

    Which of the following is a recommended practice when assessing shoulder strength?

    <p>Isolate and stabilize muscles of the shoulder and scapula for accurate results.</p> Signup and view all the answers

    What is the role of the glenoid labrum in the shoulder complex?

    <p>Provides stability and increases glenoid depth</p> Signup and view all the answers

    Which joints contribute to the overall range of motion of the shoulder complex?

    <p>Glenohumeral and scapulothoracic joints</p> Signup and view all the answers

    What is true about the acromioclavicular joint's structure?

    <p>It includes a synovial capsule and a fibrocartilaginous disc</p> Signup and view all the answers

    Which muscle function is significantly supported by the structures of the glenohumeral joint?

    <p>Stability through soft tissues</p> Signup and view all the answers

    What movement occurs at the sternoclavicular joint?

    <p>Elevation and depression</p> Signup and view all the answers

    How does the shoulder's design impact its functional capabilities?

    <p>High mobility with limited stability</p> Signup and view all the answers

    Which joint is not classified as a traditional joint but functions as one?

    <p>Scapulothoracic joint</p> Signup and view all the answers

    What is the primary reason for the capsular pattern of limitation in the glenohumeral joint?

    <p>Soft tissue constraints affecting movement</p> Signup and view all the answers

    During which motion does the humerus move relative to the scapula?

    <p>Independent motion along with external rotation</p> Signup and view all the answers

    Which ligament is critical for the stability of the sternoclavicular joint?

    <p>Costoclavicular ligament</p> Signup and view all the answers

    Study Notes

    Shoulder Motion

    • Shoulder has 3 degrees of freedom: flexion-extension, abduction-adduction, internal and external rotation
    • Additional movements include horizontal abduction and horizontal adduction
    • The shoulder sacrifices stability for mobility

    Range of Motion

    • Full ROM of the shoulder complex requires motion at three bones: humerus, scapula and clavicle
    • Joints involved in shoulder motion include: glenohumeral, sternoclavicular, acromioclavicular and scapulothoracic

    Glenohumeral Joint (GHJ)

    • Synovial ball-and-socket joint
    • Humeral head is convex, glenoid fossa is concave
    • Relies heavily on soft tissue structures for stability: glenoid labrum, joint capsule, ligaments and musculature

    Glenoid Labrum

    • Provides stability to the shoulder
    • Increases glenoid depth by 30-50%
    • Injury can contribute to limited function, pain and instability

    ‘Glenohumeral Clock’

    • Helps to understand the components of stability in the shoulder
    • Describes structures injured or repaired during surgery
    • Provides a visual representation of the many components to GHJ stability

    Capsular Pattern of Limitation (GHJ)

    • External Rotation is the most limited movement
    • Abduction is the second most limited movement
    • Internal Rotation is the least limited movement

    Scapulothoracic Joint

    • Not a real joint, but a "functional joint"
    • Motions are caused by the independent or combined motions of the sternoclavicular and acromioclavicular joints

    Sternoclavicular Joint (SCJ)

    • Connects the clavicle to the sternum and cartilage of the 1st rib
    • Synovial joint, saddle shaped
    • Strong joint capsule supported by: anterior and posterior SC ligament, costoclavicular ligament and interclavicular ligament

    SC Joint

    • Motion occurs at the clavicle on a fixed sternum
    • 3 degrees of freedom: elevation-depression, protraction-retraction, anterior-posterior rotation

    Acromioclavicular Joint (ACJ)

    • Connects the scapula to the clavicle
    • Weak joint capsule supported by: superior and inferior AC ligament, coracoclavicular ligament

    AC Joint

    • 3 degrees of freedom: upward-downward rotation, horizontal plane adjustments, sagittal plane adjustments

    Tests and Measures

    • Begin with observation and palpation
    • Assess gross ROM, strength, flexibility, sensation bilaterally
    • Relate findings to the patient's primary complaint, functional limitations and activity limitations
    • Palpate systematically from superficial to deep with purpose
    • Understand the anatomy and what you are feeling for

    ROM/Goniometry

    • Observe posture and starting position
    • Perform on the contralateral side first
    • Observe active ROM
    • Palpate landmarks for goniometry
    • Measure active and passive ROM using an appropriate device
    • Assess end feel
    • Document objective measures, end feel and subjective reports
    • Consider quality in addition to quantity
    • Repeat all steps on the affected side

    Shoulder Strength

    • Assess strength of both scapular and "shoulder" muscles
    • Isolate and stabilize as necessary
    • Trunk/spine position can alter testing

    Shoulder Motion

    • 3 degrees of freedom: Flexion and Extension, Abduction and Adduction, Internal and External Rotation
    • Additional movements: horizontal abduction and horizontal adduction
    • Shoulder sacrifices stability for mobility

    Range of Motion

    • Full range of motion of the shoulder complex requires motion at three bones: Humerus, Scapula and Clavicle
    • Joints involved in shoulder motion: Glenohumeral, Sternoclavicular, Acromioclavicular, Scapulothoracic

    Glenohumeral Joint (GHJ)

    • Synovial ball-and-socket joint
    • Humeral head is convex; Glenoid fossa is concave
    • Relies heavily on soft tissue for stability: Glenoid labrum, joint capsule, ligaments, musculature

    Glenoid Labrum

    • Provides stability to the shoulder
    • Increases glenoid depth by 30-50%
    • Injury can contribute to limited function, pain, and instability

    Glenohumeral "Clock"

    • Helpful way to understand the components of stability in the shoulder
    • Used to describe structures injured and/or repaired during surgical procedures
    • Provides a visual of the many components to stability of the GHJ

    Capsular Pattern of Limitation (GHJ)

    • Describes the order of limitation from most restricted to least restricted
    • External Rotation > Abduction > Internal Rotation

    Scapulothoracic Joint

    • A "functional joint"- not a true joint
    • Motions are caused by independent or combined motions of the sternoclavicular and acromioclavicular joints

    Sternoclavicular Joint (SCJ)

    • Clavicle articulates with the sternum and cartilage of the first rib
    • Synovial joint, saddle shaped
    • Strong joint capsule: Anterior and posterior SC ligament, costoclavicular ligament (inferior clavicle), interclavicular ligament

    SC Joint Motion

    • Clavicle moves on a fixed sternum
    • 3 degrees of freedom: Elevation and Depression, Protraction and Retraction, Anterior and Posterior Rotation

    Acromioclavicular Joint (ACJ)

    • Scapula articulates with the clavicle
    • Fibrocartilagenous disc surrounded by a weak joint capsule
    • Superior and inferior AC ligament, coracoclavicular ligament

    AC Joint Motion

    • 3 degrees of freedom: Upward and Downward Rotation, Horizontal Plane Adjustments (rotation), Sagittal Plane Adjustments (tipping/tilting)

    Tests and Measures

    • Start with observation and palpation
    • Assess gross ROM and strength, as well as flexibility, sensation, and bilateral comparisons
    • Palpate superficially to deeply, understanding the relevant anatomy and its function
    • Document objective measures, end feel, and subjective reports

    ROM/Goniometry

    • Observe posture and starting position
    • Perform on the contralateral side first
    • Observe active range of motion (AROM)
    • Palpate landmarks for goniometry
    • Measure AROM and passive range of motion (PROM) using appropriate devices
    • Assess end feel
    • Document objective measure, end feel, and any subjective reports
    • Assess quality of movement

    Shoulder Strength Assessment

    • Assess both scapular and "shoulder" muscle strength
    • Isolate muscles and stabilize as necessary
    • Trunk/spine position can alter testing results

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    Related Documents

    Examination of the Shoulder PDF

    Description

    Explore the complexities of shoulder motion, including degrees of freedom, range of motion, and the key structures contributing to stability. This quiz covers essential concepts related to the glenohumeral joint and the importance of the glenoid labrum. Test your knowledge on the anatomy and function of the shoulder complex.

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