上肢体检【英文】
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• Rotator Cuff
– Supraspinatus ABD
– Infraspinatus ER
– Teres minor ER – Supscapularis IR
Depress humeral head against glenoid to allow full abduction
Clinical Anatomy
Bony Anatomy
Anterior
Bony Anatomy
Posterior
SHOULDER JOINTS
1. 2. 3. 4. Glenohumeral Scapula thoracic Acromio-clavicular Sterno-clavicular
Bony Anatomy
Shoulder Inspection
• • • • Anterior side Posterior side Lateral side Medial side
Physical Exam
Inspection
• Front & back • Height of shoulder and scapulae • Muscle atrophy, asymmetry
Physical Exam
Range of Motion
• Forward flexion:
– 0o – 180o
Physical Exam
Range of Motion
• Extension
– 0o – 40 to 60o
Physical Exam
Range of Motion • Internal rotation – 80-90o
Joints and Articulations
•
STATIC STABILIZERS
Clinical Anatomy
– Deltoid – Rotator cuff – Teres major – Latissimus dorsi – Biceps – Pectoralis muscles
Clinical Anatomy
Shoulder Abduction muscle test
ห้องสมุดไป่ตู้
Shoulder flexion and extension muscle test
Shoulder external and internal rotation muscle test
Shoulder abduction and adduction muscle test
SHOULDER PALPATION and PRESSION
• • • • • • Bones Joints Muscles Bursae Nerves Lymph nodes
SHOULDER Range Of Motion
• • • • • • Flexion-180 degree Extension -45 degree Abduction -180 degree Adduction -30 degree Internal rotation -90 degree External rotation -90 degree
Physical Examination of the Upper Extremities
Prof.Dr.Hidayet Sarı Physical Medicine and Rehabilitation Department
Shoulder Examination
ANATOMY • Bones • Joints • Muscles • Bursae • Nerves • Blood supply
Neurological Examination of the Shoulder
sensory tests : • C4 • C5 • C6 • C7 • C8 • T1 • T2
Special Tests for the Shoulder Problems
• Yergason test –biceps tendinitis • Neer impingement test-acromioclavicular impingement • Drop arm test –rotator cuff tear • Resisted flexion (Speed)test –biceps tendinitis • Resisted abduction(Supraspinatus) testsupraspinatus lesion • Aprehension test –glenohumeral joint instability
Muscle testing scoring
• • • • • 0 No contraction 1 Flicker or trace contraction 2 Active movement, with gravity eliminated 3 Active movement against gravity 4 Active movement against gravity and resistance • 5 Normal power
• External rotation
– 80-90o
Speed shoulder tests
External rotation
Internal rotation
Neurological Examination of the Shoulder
Muscle tests : • Flexion • Extension • Abduction • Adduction • Internal rotation • External rotation
• Bursae – subacromial – subdeltoid – subscapular
Physical Examination
• • • • • • Inspection Palpation –pression Range of motion examination Neurological examination Special tests for the shoulder problems Examination of the related areas
– Supraspinatus ABD
– Infraspinatus ER
– Teres minor ER – Supscapularis IR
Depress humeral head against glenoid to allow full abduction
Clinical Anatomy
Bony Anatomy
Anterior
Bony Anatomy
Posterior
SHOULDER JOINTS
1. 2. 3. 4. Glenohumeral Scapula thoracic Acromio-clavicular Sterno-clavicular
Bony Anatomy
Shoulder Inspection
• • • • Anterior side Posterior side Lateral side Medial side
Physical Exam
Inspection
• Front & back • Height of shoulder and scapulae • Muscle atrophy, asymmetry
Physical Exam
Range of Motion
• Forward flexion:
– 0o – 180o
Physical Exam
Range of Motion
• Extension
– 0o – 40 to 60o
Physical Exam
Range of Motion • Internal rotation – 80-90o
Joints and Articulations
•
STATIC STABILIZERS
Clinical Anatomy
– Deltoid – Rotator cuff – Teres major – Latissimus dorsi – Biceps – Pectoralis muscles
Clinical Anatomy
Shoulder Abduction muscle test
ห้องสมุดไป่ตู้
Shoulder flexion and extension muscle test
Shoulder external and internal rotation muscle test
Shoulder abduction and adduction muscle test
SHOULDER PALPATION and PRESSION
• • • • • • Bones Joints Muscles Bursae Nerves Lymph nodes
SHOULDER Range Of Motion
• • • • • • Flexion-180 degree Extension -45 degree Abduction -180 degree Adduction -30 degree Internal rotation -90 degree External rotation -90 degree
Physical Examination of the Upper Extremities
Prof.Dr.Hidayet Sarı Physical Medicine and Rehabilitation Department
Shoulder Examination
ANATOMY • Bones • Joints • Muscles • Bursae • Nerves • Blood supply
Neurological Examination of the Shoulder
sensory tests : • C4 • C5 • C6 • C7 • C8 • T1 • T2
Special Tests for the Shoulder Problems
• Yergason test –biceps tendinitis • Neer impingement test-acromioclavicular impingement • Drop arm test –rotator cuff tear • Resisted flexion (Speed)test –biceps tendinitis • Resisted abduction(Supraspinatus) testsupraspinatus lesion • Aprehension test –glenohumeral joint instability
Muscle testing scoring
• • • • • 0 No contraction 1 Flicker or trace contraction 2 Active movement, with gravity eliminated 3 Active movement against gravity 4 Active movement against gravity and resistance • 5 Normal power
• External rotation
– 80-90o
Speed shoulder tests
External rotation
Internal rotation
Neurological Examination of the Shoulder
Muscle tests : • Flexion • Extension • Abduction • Adduction • Internal rotation • External rotation
• Bursae – subacromial – subdeltoid – subscapular
Physical Examination
• • • • • • Inspection Palpation –pression Range of motion examination Neurological examination Special tests for the shoulder problems Examination of the related areas