Shoulder Evaluation Module
Page address: http://ahn.mnsu.edu/athletictraining/spata/shouldermodule/Bony Anatomy
Subjective/ History
Determine 6: activity, MOI, location of pain, type of pain, severity of pain, onset of pain, unusual sounds/ sensations, actions that increase & decrease pain, S/S, change in S/S over time, prior injury/ surgery, family history & general medical health
Objective
Inspection 1,6:
General: swelling, discoloration, deformity, muscle symmetry/atrophy, symmetry of head and arm while standing & walking
Skin: discoloration, open wounds, scars & skin infections
Anterior View: level of shoulders, contour of clavicles, deltoid muscle group, anterior humerus & biceps brachii
Lateral View: deltoid muscle group, acromion process, position of humerus & spinal vertebrae alignment
Posterior View: alignment of spinal vertebrae, position of scapula, muscle tone & position of humerus
Shoulder Palpation Rollover: using internet explorer rollover the images to trace some anatomy of the shoulder
Bony Palpation 1: Suprasternal Notch, SC Joint, Clavicle, Coracoid Process, AC Joint, Acromion, Lesser Tuberosity of the Humerus/Bicipital Groove/Greater Tuberosity of Humerus, Spine of Scapula, Vertebral/Medial Border of Scapula, Inferior Angle of the Scapula, Superior Angle of the Scapula
Soft Tissue Palpation 1:
Zone 1 (Rotator Cuff ): supraspinatus, infraspinatus & teres minor
Zone 2 (Subacromial/ Subdeltoid Bursa): subacrominal/ subdeltoid bursa
Zone 3 (Axilla): pectoralis major (anterior wall), latissimus dorsi (posterior wall), ribs 2–6 and serratus anterior muscle (medial wall), bicipital groove of humerus (laterall wall), axillary lymph nodes, brachial plexus, axillary artery
Zone 4 (Prominent Muscles of the Shoulder Girdle): sternocleidomastoid, pectoralis major, biceps, deltoid, trapezius, rhomboid (minor/major), latissimus dorsi, serratus anterior
Range of Motion 1,5:
AROM: abduction, adduction, extension, flexion, internal rotation & external rotation
PROM: abduction (0–180°), adduction (0°), extension (0–60°), flexion (0–180°), internal rotation (0–70°) & external rotation (0–90°)
RROM: abduction, adduction, extension, flexion, internal rotation & external rotation
Biceps Brachii, Brachialis, Coracobrachialis, Triceps Brachii, Anconeus, Supraspinatus, Middle Deltiod, Anterior Deltiod, Posterior Deltoid, Teres Major, Pectoralis Major (Upper/Clavicular), Pectoralis Major (Lower/Sternal), Pectoralis Minor, Latissimus Dorsi, Subscapularis, Infraspinatus, Teres Minor, Rhomboids, Rhomboides (Alternate), Levator Scapulae, Trapezius (Upper), Trapezius (Middle), Trapezius (Lower), Serratus Anterior
Acromioclavicular Joint Compression (Shear), Sternoclavicular (SC)/Acromioclavicular (AC) Joint Stress, Empty Can, Yergason, Speed's, Ludington's, Drop Arm, Hawkins–Kennedy Impingement, Piano Key Sign, Anterior Apprehension, Posterior Apprehension, Sulcus Sign/Long Arm Traction/Inferior Apprehension, Anterior Drawer, Posterior Drawer, Jobe Relocation, Grind, Clunk, Active Compression, Adson's Maneuver, Allen's, Provactive Elevation, Military Brace Position, Pectoralis Major Contracture, Cross–Over Impingement, Railroad Whistle, Swim Stroke, Jerk, Neer Impingement
Assessment
Identifies examiner's impression of injury & potientally complicating factors based on subjective & objective information
Plan
Explains examiner's goals as well as how the examiner intends on meeting these goals through initial management, treatment, rehabilitation