Competency PDF

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Competency - MT...

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Competency #2 (Shoulder) 1. How to rule out appropriate joints when doing a shoulder assessment AROM: Ruling out associated joints Joint Above (neck) - Ask patient to perform flexion and extension - Feedback - Overpressure Joint Below (elbow) - Ask patient to perform flexion and extension - Feedback - Overpressure 2. One Complete ROM (AROM, PROM, RROM) AROM - Demonstrate/describe movements to patient - Ask patient to perform movements - Visually compares available ranges bilaterally - Feedback - Assess all ranges AROM of Shoulder Flexion Extension Horizontal adduction Abduction Internal Rotation Lateral Rotation Normal Ranges for Shoulder Flexion- 160 Extension- 60 Horizontal adduction- 135 Abduction- 130

Unaffected

Affected

Internal Rotation- 60 to 100 External Rotation- 90

Consent – rule out the joints above and below – observe range of motion of the affected joint bilaterally – measure available ranges at the affected joint – document

AROM assessment of Shoulder Ruling out (affected side) - Chin to your chest (flex the neck) - Rotate the neck - Flex elbow - Extend elbow Range of motion - Arms all the way up/back - Arms across chest/other side - Arms all the way up (abduction) - Arms in neutral/rotate back and in (bicycle) Measuring Flexion and Extension - Arms up - Arms back Abduction and Horizontal Adduction - Arms back - Arms to the side (across chest) *Measure from back Medial and Lateral Rotation Lay on back - Arm at 90 degrees - Rotate inward - Rotate outward *Measure from tip of olecranon process Measure unaffected and then affected PROM Passive range of motion is when the therapist moves the patient’s joint for them. We use passive range of motion to determine the range of motion available and to determine end feels. 1. Have client in relaxed seated position. Legs uncrossed. 2. Rule out the joints above and below the shoulder joint. 3. Apply passive range of motion to the unaffected side first to determine end feels and normal range available. 4. Position hand on the joint for stabilization and use the other hand to guide the patient’s arm into each movement (flexion, extension, abduction, adduction, medial rotation, and lateral rotation). 5. Apply assessment to the affected side. 6. Communication is essential. When patient feels pain, do not continue any further and document findings.

RROM Flexion Extension Adduction Abduction Medial Rotation Lateral Rotation I’m going to add resistance try to resist me Mastery Quiz Review Where and in which direction is pressure placed in examining resisted shoulder horizontal adduction? Where and in which direction does the examiner apply pressure to examine resisted shoulder flexion? Where and in which direction does the examiner apply pressure to examine resisted shoulder abduction? -

Medial side of the elbow, in direction of horizontal abduction

Which special orthopedic test is used to test for subacromial impingement at the shoulder joint? -

hawkins-kennedy test

The stationary arm of the goniometer is placed parallel to the sternum/spine when measuring shoulder abduction How many different measurable ranges of motion are there for the shoulder complex? -

6

Resisted isometric movements are performed to assess contractile tissue Overpressure is applied at the end of the available movement in order to assess the end-feel during passive range of motion Speed’s test is a passive test where the therapist flexes the shoulder to 90 degrees and watches for complaints of pain in the shoulder -

False

Passive ROM for external rotation of the shoulder is best evaluated with the patient in the supine position, with the shoulder abducted to 90 degrees Inert tissue can be defined as all tissue that is not considered neurological or contractile

The MMT for supraspinous requires that the patient be seated, with the arm abducted to 90 degrees and slightly forward flexed in a few degrees of external rotation. The head is held in extension with lateral flexion toward the test side, face turned toward the tested side. -

False

The axis of the goniometer is placed on top of the acromion when measuring horizontal adduction of the shoulder. Which test is most appropriate to use if you suspect a tear in the supraspinous tendon? -

Empty can test

Which one of the following is an example of a normal end feel of a joint? -

Tissue stretch

When performing the MMT for pectoralis major, having the patients elbow extended, shoulder in flexion, and slight medial rotation with the arm in adduction obliquely toward the opposite iliac crest gives us information about the sternocostal fibres of this muscle. -

True

The MMT for middle trapezius requires that the patient be in prone with the arm abducted in 90 degrees with the shoulder internally rotated. -

False

When performing the MMT for Latissimus Dorsi, positioning for the patient is prone with the arm adducted, in extension and medial rotation. -

True

The MMT for rhomboids requires that the patient be in the prone position with the arm abducted to 90deg, with the shoulder in internal rotation. -

True

Which axis does shoulder abduction and adduction occur around? -

Sagittal horizontal axis...