Date post: | 14-Dec-2015 |
Category: |
Documents |
Upload: | treyton-varvel |
View: | 228 times |
Download: | 5 times |
Shoulder Injury Evaluation Overview
Anatomy History Observation Palpation Neurological exam Circulatory exam
Shoulder Anatomy
Clavicle Scapula Humerus Articulations:
◦ Sternoclavicular joint◦ Acromioclavicular
joint◦ Glenohumeral joint
History
Mechanism of injury:1. Describe the mechanism of injury2. Was there a direct blow? 3. What was the angle of impact? 4. What was the position of the arm at impact?5. Did you hear or feel anything at the time of
injury?6. Was the arm forced beyond normal limits? 7. Did the injury occur due to forced muscular
contractions?
History
Pain/Symptoms:8. Demonstrate what movements aggravate pain? 9. What activities increase pain? 10. Describe the onset of symptoms11. Describe symptoms? 12. Sharp or dull? 13. Constant or intermittent? 14. Localized or diffuse? 15. Aggravated by movement?16. Relieved by rest?
History
Pain/Symptoms (cont.):17. Where is the pain? 18. Do you feel pain radiating down the arm? 19. Is there any numbness, burning, tingling or
weakness in the upper extremity? 20. Do you feel tightness, tension, locking, swelling,
or crepitation?
History
Previous injuries:21. Have you had a previous injury? 22. Are the symptoms you are experiencing
currently similar to those associated with the previous injury (‘Your’ pain)?
23. What treatment was used? 24. What rehabilitation was used? 25. Were you fully recovered?
Observation
1. Swelling2. Skin color3. Signs of trauma4. Skin temperature5. Sprengel’s deformity6. Atrophy7. Abnormal position
Observation
1. Swelling2. Skin color3. Signs of trauma4. Skin temperature5. Sprengel’s deformity6. Atrophy7. Abnormal position
Observation
8. Arm hanging limp9. Appear to be in pain 10. Compare 11. Symmetry 12. Deformities 13. Muscle spasm14. Holding or supporting arm 15. Moving or using involved extremity 16. Overall position, posture, and alignment
Palpation: Bone
1. Acromion process 2. Clavicle 3. Acromio-Clavicular (AC) joint 4. Sterno-Clavicular (SC) joint 5. Coraco-Clavicular (CC) joint 6. Coracoid process 7. Axilla
Palpation: Bone
8. Head of humerus 9. Greater tuberosity 10. Lesser tuberosity 11. Bicepital groove 12. Deltoid tuberosity 13. Humerus 14. Scapula
Neurologic Exam: Sensory Sensory dermatomes
C2-C3: Occipital area and angle of jaw C4: Supraclavicular area Axillary Nerve Patch: Lateral aspect of
shoulder C5: Lateral upper arm C6: Lateral forearm, thumb, and index
finger C7: Middle finger and palmar aspect of
hand C8: Small finger, ring finger, and medial
portion of palmar surface T1: Medial side of forearm and elbow T2: Medial aspect of upper arm T3: Medial aspect of upper arm
Neurologic Exam: Motor C1-C2: Neck flexion C1-C2: Neck extension C3: Neck lateral flexion C4: Shoulder elevation C5: Shoulder abduction and external
rotation C6: Elbow flexion and wrist extension C7: Elbow extension and wrist flexion C8: Thumb abduction and ulnar deviation T1: Finger approximation