肩关节疾病的诊断PPT课件
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symmetry – Scapular protraction or
winging – Muscle symmetry – Scapulohumeral rhythm
12
.
Shoulder Evaluation (Observation)
Scapulohumeral Rhythm
– Movement of scapula relative to the humerus – Initial 30 degrees of glenohumeral abduction does not incorporate scapular
– Coracoacromial
15
ligament
.
Shoulder Evaluation (Special Tests)
Active Range of Motion (ROM)
– Flexion @ 180o – Extension @ 50o – Abduction @ 180o – Adduction @ 40o – Internal Rotation @ 90o – External Rotation @ 90o
Manual Muscle Testing
– Five Point grading system
5 = Complete ROM against gravity, with full resistance
4 = Complete ROM against gravity, with some resistance
History
– What is the cause of pain? – Mechanism of injury? – Previous history? – Location, duration and intensity of pain? – Creptitus, numbness, distortion in
tuberosity – Bicipital groove – Spine of scapula – Scapular vertebral border
14
– 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
– Rotator cuff muscles and tendons
– Subacromial bursa
– Sternocleidomastoid
– Biceps and tendon
– Rhomboids – Latissimus dorsi – Serratus Anterior – Levator scapulae – Trapezius – Supraspinatus – Infraspinatus – Teres major and minor
.
Shoulder Evaluation (Palpation)
Soft Tissue Palpation
– Glenohumeral joint capsule – Deltoid
– Sternoclavicular, acromioclavicuHale Waihona Puke Baiduar and coracoclavicular ligaments
肩关节疾病的诊断
山东省中医院运动损伤 骨科 王少山
1
.
肩关节的疾病你知道多少
普通人 医务工作者 骨科医生 运动医学医师
肩关节疾病的特征 疼痛
关节僵硬
2
.
Anatomy Review Shoulder Girdle
3
.
Anatomy Review
Bony Anatomy
– Scapula – Clavicle
– Acromion process
– Biceps and deltoid symmetry
– Postural assessment (kyphosis, lordosis, shoulders)
– Position of head and arms – Scapular elevation and
temperature – Weakness or fatigue? – What provides relief?
11
.
Shoulder Evaluation (Observation)
– Elevation or depression of shoulder tips
– Position and shape of clavicle
13
.
Shoulder Evaluation (Palpation)
Bony Structures
– Sternoclavicular joint – Clavicular shaft – Acromioclavicular joint – Coracoid process – Acromion process – Humeral head – Greater and lesser
4
.
Anatomy Review
Bony Anatomy
– Humerus – Ribs
5
.
Anatomy Review
Anterior musculature of the shoulder girdle
6
.
Anatomy Review
Musculature of posterior shoulder girdle
7
.
Anatomy Review
Shoulder ligaments
8
.
Anatomy Review
Shoulder joint capsule and cartilage
9
.
Anatomy Review
Blood Supply and Intervention
10
.
Shoulder Evaluation (History)
winging – Muscle symmetry – Scapulohumeral rhythm
12
.
Shoulder Evaluation (Observation)
Scapulohumeral Rhythm
– Movement of scapula relative to the humerus – Initial 30 degrees of glenohumeral abduction does not incorporate scapular
– Coracoacromial
15
ligament
.
Shoulder Evaluation (Special Tests)
Active Range of Motion (ROM)
– Flexion @ 180o – Extension @ 50o – Abduction @ 180o – Adduction @ 40o – Internal Rotation @ 90o – External Rotation @ 90o
Manual Muscle Testing
– Five Point grading system
5 = Complete ROM against gravity, with full resistance
4 = Complete ROM against gravity, with some resistance
History
– What is the cause of pain? – Mechanism of injury? – Previous history? – Location, duration and intensity of pain? – Creptitus, numbness, distortion in
tuberosity – Bicipital groove – Spine of scapula – Scapular vertebral border
14
– 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
– Rotator cuff muscles and tendons
– Subacromial bursa
– Sternocleidomastoid
– Biceps and tendon
– Rhomboids – Latissimus dorsi – Serratus Anterior – Levator scapulae – Trapezius – Supraspinatus – Infraspinatus – Teres major and minor
.
Shoulder Evaluation (Palpation)
Soft Tissue Palpation
– Glenohumeral joint capsule – Deltoid
– Sternoclavicular, acromioclavicuHale Waihona Puke Baiduar and coracoclavicular ligaments
肩关节疾病的诊断
山东省中医院运动损伤 骨科 王少山
1
.
肩关节的疾病你知道多少
普通人 医务工作者 骨科医生 运动医学医师
肩关节疾病的特征 疼痛
关节僵硬
2
.
Anatomy Review Shoulder Girdle
3
.
Anatomy Review
Bony Anatomy
– Scapula – Clavicle
– Acromion process
– Biceps and deltoid symmetry
– Postural assessment (kyphosis, lordosis, shoulders)
– Position of head and arms – Scapular elevation and
temperature – Weakness or fatigue? – What provides relief?
11
.
Shoulder Evaluation (Observation)
– Elevation or depression of shoulder tips
– Position and shape of clavicle
13
.
Shoulder Evaluation (Palpation)
Bony Structures
– Sternoclavicular joint – Clavicular shaft – Acromioclavicular joint – Coracoid process – Acromion process – Humeral head – Greater and lesser
4
.
Anatomy Review
Bony Anatomy
– Humerus – Ribs
5
.
Anatomy Review
Anterior musculature of the shoulder girdle
6
.
Anatomy Review
Musculature of posterior shoulder girdle
7
.
Anatomy Review
Shoulder ligaments
8
.
Anatomy Review
Shoulder joint capsule and cartilage
9
.
Anatomy Review
Blood Supply and Intervention
10
.
Shoulder Evaluation (History)