what is most effective passive stabilize of shoulder joint?
-vacuum phenomena of bone in socket
-labrum also very important
why avoid NSAIDs in treating fracture?
NSAIDs interere with bony healing via PGs. PGs contribute to bone healing.
-what nerves are vulnerable? what to look for?
-Axillary and musculocutaenous nerves are vulnerable.
-check deltoid function with arm abduction--first 30 degrees is supraspinatus, then deltoid
-check sensory on deltoid and forearm (musculocutaneous)
grade 1. fx, no ligament disruption so no displacement
2. fx, with tear of CC ligament. so upward dispacement of medial clavicular fragment
3. fx through AC joint, no displacement
capsulitis of shoulder
-inflammation of capsule
-etiology unknown (sometimes follows trauma)
3 clinical stages:
1. freezing (pain, losing ROM)
2. frozen (no pain, no ROM)
3. thawing (no pain, increase ROM)
Tx: reassurance because usually self-limiting. (thawing may take 1/2 to 2 years). can use NSAIDs
AC injury grades
grade 1--AC ligament injury
2--AC ligament tear, CC stretch
3--complete AC and CC ligament tears
Biceps brachii proximal long head rupture:
-leave as is. Still have function with other muscles.
-only tx is if person is professional bodybuilder for aesthetics
carpal tunnel syndrome
-sensation: first 3 1/2 fingers.
-motor: thenar muscles. can result in thenar wasting
-strain of wrist flexors
Bones with vulnerable blood supply (3)
1. scaphoid--radial artery
3. femoral head (adults)--medial circumflex femoral
-strain of wrist extensors (most likely extensor carpi radialis)
For OA arthrtitic joint, what 2 things can you inject?
2. hyaluronic acid (viscosupplementation injection)--give building blocks of articular surface
what is joint subluxation?
partial displacement, not full dislocaiton
-what exam tests/findings?
1. cross-arm flexion test
-have person raise arm to 90 degrees, then adduct over chest to elicit AC pain.
2. painful arc of abduction over 150 degrees
shoulder impingement tests:
1. hawkin's ('like a hawk handler') --internally rotate shoulder
2. neer's ('near the ear')
3. jobe's (empty can)