肩关节疾病诊断
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肩关节疾病的诊断
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
Anatomy Review Shoulder Girdle
Anatomy Review
Bony Anatomy
– Scapula – Clavicle
Anatomy Review
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
– 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
– Scapular lateral border – Scapular superior angle – Scapular inferior angle
temperature – Weakness or fatigue? – What provides relief?
Shoulder Evaluation (Observation)
– Elevation or depression of shoulder tips
– Position and shape of clavicle
Shoulder Evaluation (Palpation)
Bony Structures
– Sternoclavicular joint – Clavicular shaft – Acromioclavicular joint – Coracoid process – Acromion process – Humeral head – Greater and lesser
Manual Muscle Testing
– Five Point grading system
5 = Complete ROM against gravity, with full resistance
4 = Complete ROM against gravity, with some resistance
– Subacromial bursa
– Sternocleidomastoid
– Biceps and tendΒιβλιοθήκη Baidun
– Coracoacromial ligament
– Glenohumeral joint capsule – Deltoid – Rhomboids – Latissimus dorsi – Serratus Anterior – Levator scapulae – Trapezius – Supraspinatus – Infraspinatus – Teres major and minor
Shoulder Evaluation (Special Tests)
Active Range of Motion (ROM)
– Flexion @ 180o – Extension @ 50o – Abduction @ 180o – Adduction @ 40o – Internal Rotation @ 90o – External Rotation @ 90o
3 = Complete ROM against gravity, with no resistance
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
Bony Anatomy
– Humerus – Ribs
Anatomy Review
Anterior musculature of the shoulder girdle
Anatomy Review
Musculature of posterior shoulder girdle
Anatomy Review
Shoulder Evaluation (Palpation)
Soft Tissue Palpation
– Sternoclavicular, acromioclavicular and coracoclavicular ligaments
– Rotator cuff muscles and tendons
– Acromion process
– Biceps and deltoid symmetry
– Postural assessment (kyphosis, lordosis, shoulders)
– Position of head and arms – Scapular elevation and
Shoulder ligaments
Anatomy Review
Shoulder joint capsule and cartilage
Anatomy Review
Blood Supply and Intervention
Shoulder Evaluation (History)
History
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
Anatomy Review Shoulder Girdle
Anatomy Review
Bony Anatomy
– Scapula – Clavicle
Anatomy Review
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
– 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
– Scapular lateral border – Scapular superior angle – Scapular inferior angle
temperature – Weakness or fatigue? – What provides relief?
Shoulder Evaluation (Observation)
– Elevation or depression of shoulder tips
– Position and shape of clavicle
Shoulder Evaluation (Palpation)
Bony Structures
– Sternoclavicular joint – Clavicular shaft – Acromioclavicular joint – Coracoid process – Acromion process – Humeral head – Greater and lesser
Manual Muscle Testing
– Five Point grading system
5 = Complete ROM against gravity, with full resistance
4 = Complete ROM against gravity, with some resistance
– Subacromial bursa
– Sternocleidomastoid
– Biceps and tendΒιβλιοθήκη Baidun
– Coracoacromial ligament
– Glenohumeral joint capsule – Deltoid – Rhomboids – Latissimus dorsi – Serratus Anterior – Levator scapulae – Trapezius – Supraspinatus – Infraspinatus – Teres major and minor
Shoulder Evaluation (Special Tests)
Active Range of Motion (ROM)
– Flexion @ 180o – Extension @ 50o – Abduction @ 180o – Adduction @ 40o – Internal Rotation @ 90o – External Rotation @ 90o
3 = Complete ROM against gravity, with no resistance
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
Bony Anatomy
– Humerus – Ribs
Anatomy Review
Anterior musculature of the shoulder girdle
Anatomy Review
Musculature of posterior shoulder girdle
Anatomy Review
Shoulder Evaluation (Palpation)
Soft Tissue Palpation
– Sternoclavicular, acromioclavicular and coracoclavicular ligaments
– Rotator cuff muscles and tendons
– Acromion process
– Biceps and deltoid symmetry
– Postural assessment (kyphosis, lordosis, shoulders)
– Position of head and arms – Scapular elevation and
Shoulder ligaments
Anatomy Review
Shoulder joint capsule and cartilage
Anatomy Review
Blood Supply and Intervention
Shoulder Evaluation (History)
History