Chapter 13 – The Shoulder and Upper Arm Pages 484 - 488.

Chapter 13 – The Chapter 13 – The Shoulder and Upper Shoulder and Upper ArmArmPages 484 - 488Pages 484 - 488

Question #1Question #1

What are the most important pathologies What are the most important pathologies to rule out?to rule out? Why?Why?

On-Field Evaluation of On-Field Evaluation of Shoulder InjuriesShoulder Injuries

Most important to rule out Most important to rule out FracturesFractures DislocationsDislocations

Distal PulseDistal Pulse

Evaluation of cervical and/or thoracic Evaluation of cervical and/or thoracic spinespine


Describe equipment considerations when Describe equipment considerations when evaluating a shoulder on the field.evaluating a shoulder on the field.

Equipment Equipment ConsiderationsConsiderations

Familiarize yourself!Familiarize yourself!

Palpation Under the Shoulder PadsPalpation Under the Shoulder Pads Figure 13-36 , page 485Figure 13-36 , page 485

Removal of the Shoulder PadsRemoval of the Shoulder Pads Figure 13-37,page 486Figure 13-37,page 486

On-Field HistoryOn-Field History

Location of PainLocation of Pain Shoulder vs. brachial plexus pathologyShoulder vs. brachial plexus pathology

Mechanism of InjuryMechanism of Injury


Describe an on-field inspection of the Describe an on-field inspection of the shoulder.shoulder.

On-Field InspectionOn-Field Inspection

Arm PostureArm Posture Arm splinted against the torsoArm splinted against the torso

Clavicular fracture, AC joint pathologyClavicular fracture, AC joint pathology

Arm hanging limplyArm hanging limply Brachial plexus pathologyBrachial plexus pathology

Arm “locked”Arm “locked” GH dislocationGH dislocation

Gross DeformityGross Deformity


Describe on-field palpation of the Describe on-field palpation of the shoulder. shoulder.

On-Field PalpationOn-Field Palpation

Position of humeral headPosition of humeral head AC joint alignmentAC joint alignment

Piano key signPiano key sign

ClavicleClavicle SC jointSC joint HumerusHumerus


Describe on-field functional tests for the Describe on-field functional tests for the shoulder.shoulder.

On-Field Functional TestsOn-Field Functional Tests

Rule out dislocation or fractureRule out dislocation or fracture

Apley’s Scratch testApley’s Scratch test

Initial Management of Initial Management of On-Field Shoulder On-Field Shoulder InjuriesInjuries

Figure 13-38, page 487Figure 13-38, page 487


Describe scapular fractures.Describe scapular fractures.

Scapular FracturesScapular Fractures

Body of scapula, glenoid fossa, glenoid Body of scapula, glenoid fossa, glenoid neck, coracoid processneck, coracoid process Secondary to GH dislocationSecondary to GH dislocation

S/S similar to rotator cuff pathologyS/S similar to rotator cuff pathology Immobilization/transportationImmobilization/transportation

Clavicular InjuriesClavicular Injuries

Clavicular FracturesClavicular Fractures Immobilization, referral to physicianImmobilization, referral to physician

SC Joint InjuriesSC Joint Injuries Potential compromise to underlying Potential compromise to underlying

structures from posterior dislocationstructures from posterior dislocation Immobilization, transportation (supine)Immobilization, transportation (supine)

Clavicular InjuriesClavicular Injuries

AC Joint InjuriesAC Joint Injuries Figure 13-39, page 488Figure 13-39, page 488 Nonsurgical treatmentNonsurgical treatment Protection during activityProtection during activity


Describe GH dislocations.Describe GH dislocations.

GH DislocationsGH Dislocations

Monitor distal pulses, circulation, Monitor distal pulses, circulation, sensationsensation

ImmobilizationImmobilization Keep wrist and hand exposedKeep wrist and hand exposed Immediate transportationImmediate transportation

Reductions performed by physicianReductions performed by physician


Describe humeral fractures.Describe humeral fractures.

Humeral FracturesHumeral Fractures

Extreme pain, dysfunction, obvious Extreme pain, dysfunction, obvious deformitydeformity

May be secondary to GH dislocationMay be secondary to GH dislocation ImmobilizationImmobilization

Keep wrist and hand exposedKeep wrist and hand exposed Immediate referral to physicianImmediate referral to physician

Chapter 13 – The Shoulder and Upper Arm Pages 484 - 488.

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Transcript of Chapter 13 – The Shoulder and Upper Arm Pages 484 - 488.