肩关节疾病的诊断(1)复习过程
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tuberosity – Bicipital groove – Spine of scapula – Scapular vertebral border
– Scapular lateral border – Scapular superior angle – Scapular inferior angle
motion (setting phase) – 30 to 90 degrees the scapula abducts and upwardly rotates 1 degree for
every 2 degrees of humeral elevation – Above 90 degrees the scapula and humerus move in 1:1 ratio
肩关节疾病的诊断(1)
Anatomy Review Shoulder Girdle
Anatomy Review
Bony Anatomy
– Scapula – Clavicle
Anatomy Review
Bony Anatomy
– Humerus – Ribs
Anatomy Review
Anterior musculature of the shoulder girdle
Anatomy Review
Musculature of posterior shoulder girdle
Anatomy Review
Shoulder ligaments
Anatomy Review
Shoulder joint capsule and cartilage
symmetry – Scapular protraction or
winging – Muscle symmetry – Scapulohumeral rhythm
Shoulder Evaluation (Observation)
Scapulohumeral Rhythm
– Movement of scapula relative to the humerus – Initial 30 degrees of glenohumeral abduction does not incorporate scapular
Shoulder Evaluation (Special Tests)
Active Range of Motion (ROM)
– Flexion @ 180o – Extension @ 50o – Abduction @ 180o – Adduction @ 40o – Internal Rotation @ 90o – External Rotation @ 90o
Shoulder Evaluation (Palpation)
Soft Tissue Palpation
– Sternoclavicular, acromioclavicular and coracoclavicular ligaments
– Rotator cuff muscles and tendons
3 = Complete ROM against gravity, with no resistance
2 = Complete ROM, with gravity omitted
temperature – Weakness or fatigue? – What provides relief?
Shoulder Evaluation (Observation)
– Elevation or depression of shoulder tips
– Position and shape of clavicle
Manual Muscle Testing
– Five Point gradinwenku.baidu.com system
5 = Complete ROM against gravity, with full resistance
4 = Complete ROM against gravity, with some resistance
– Acromion process
– Biceps and deltoid symmetry
– Postural assessment (kyphosis, lordosis, shoulders)
– Position of head and arms – Scapular elevation and
– Subacromial bursa
– Sternocleidomastoid
– Biceps and tendon
– Coracoacromial ligament
– Glenohumeral joint capsule – Deltoid – Rhomboids – Latissimus dorsi – Serratus Anterior – Levator scapulae – Trapezius – Supraspinatus – Infraspinatus – Teres major and minor
Anatomy Review
Blood Supply and Intervention
Shoulder Evaluation (History)
History
– What is the cause of pain? – Mechanism of injury? – Previous history? – Location, duration and intensity of pain? – Creptitus, numbness, distortion in
Shoulder Evaluation (Palpation)
Bony Structures
– Sternoclavicular joint – Clavicular shaft – Acromioclavicular joint – Coracoid process – Acromion process – Humeral head – Greater and lesser
– Scapular lateral border – Scapular superior angle – Scapular inferior angle
motion (setting phase) – 30 to 90 degrees the scapula abducts and upwardly rotates 1 degree for
every 2 degrees of humeral elevation – Above 90 degrees the scapula and humerus move in 1:1 ratio
肩关节疾病的诊断(1)
Anatomy Review Shoulder Girdle
Anatomy Review
Bony Anatomy
– Scapula – Clavicle
Anatomy Review
Bony Anatomy
– Humerus – Ribs
Anatomy Review
Anterior musculature of the shoulder girdle
Anatomy Review
Musculature of posterior shoulder girdle
Anatomy Review
Shoulder ligaments
Anatomy Review
Shoulder joint capsule and cartilage
symmetry – Scapular protraction or
winging – Muscle symmetry – Scapulohumeral rhythm
Shoulder Evaluation (Observation)
Scapulohumeral Rhythm
– Movement of scapula relative to the humerus – Initial 30 degrees of glenohumeral abduction does not incorporate scapular
Shoulder Evaluation (Special Tests)
Active Range of Motion (ROM)
– Flexion @ 180o – Extension @ 50o – Abduction @ 180o – Adduction @ 40o – Internal Rotation @ 90o – External Rotation @ 90o
Shoulder Evaluation (Palpation)
Soft Tissue Palpation
– Sternoclavicular, acromioclavicular and coracoclavicular ligaments
– Rotator cuff muscles and tendons
3 = Complete ROM against gravity, with no resistance
2 = Complete ROM, with gravity omitted
temperature – Weakness or fatigue? – What provides relief?
Shoulder Evaluation (Observation)
– Elevation or depression of shoulder tips
– Position and shape of clavicle
Manual Muscle Testing
– Five Point gradinwenku.baidu.com system
5 = Complete ROM against gravity, with full resistance
4 = Complete ROM against gravity, with some resistance
– Acromion process
– Biceps and deltoid symmetry
– Postural assessment (kyphosis, lordosis, shoulders)
– Position of head and arms – Scapular elevation and
– Subacromial bursa
– Sternocleidomastoid
– Biceps and tendon
– Coracoacromial ligament
– Glenohumeral joint capsule – Deltoid – Rhomboids – Latissimus dorsi – Serratus Anterior – Levator scapulae – Trapezius – Supraspinatus – Infraspinatus – Teres major and minor
Anatomy Review
Blood Supply and Intervention
Shoulder Evaluation (History)
History
– What is the cause of pain? – Mechanism of injury? – Previous history? – Location, duration and intensity of pain? – Creptitus, numbness, distortion in
Shoulder Evaluation (Palpation)
Bony Structures
– Sternoclavicular joint – Clavicular shaft – Acromioclavicular joint – Coracoid process – Acromion process – Humeral head – Greater and lesser