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Shoulders, Knees, and Ankles – for clinicians who have other priorities. PowerPoint Presentation
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Shoulders, Knees, and Ankles – for clinicians who have other priorities.

Shoulders, Knees, and Ankles – for clinicians who have other priorities.

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Shoulders, Knees, and Ankles – for clinicians who have other priorities.

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  1. Shoulders, Knees, and Ankles –for clinicians who have other priorities. Ron Olson, MD Duke Student Health

  2. Shoulder

  3. Green • Just want to be safe. • Nothing fancy • What needs prompt attention

  4. Shoulder • No diagnosis, no definitive management but recognize what may need urgent care • Based on • Anatomy • What the patient says

  5. Shoulder --Anatomy • head of humerus • scapula • acromion • glenoid • spine • glenohumeral joint • clavicle (collar bone) • acromio-clavicular joint

  6. 1. Head of humerus

  7. 1. Head of humerus Palpate acromion and humeral head

  8. 1. Head of humerus

  9. 2. Scapula -- acromion

  10. 2. Scapula -- spine

  11. 2. Scapula -- glenoid

  12. 2. Scapula -- glenoid • part of the scapula

  13. 3. Glenohumeral Joint

  14. 4. Clavicle

  15. 5. AcromioclavicularJt

  16. 5. AcromioclavicularJt

  17. Shoulder--Assessment • Check neuromuscular status • Check basic movement internal/ext rotation, abduction • Palpate acromioclavicular jt • Palpate acromion and humeral head

  18. Shoulder--assessment 1. Check neuromuscular status • fingers move • light touch fingers

  19. Shoulder--assessment 1. Check neurovascular status • fingers move • light touch fingers • pulse/color

  20. Shoulder--assessment 1. Checkneurovascular status • fingers move • light touch fingers • light touch deltoid

  21. Shoulder--assessment 1. Checkneurovascular status 2. Check basic movement internal/ext rotation, abduction

  22. Shoulder--assessment • Check neuromuscular status • Check basic movement • Palpate acromioclavicularjt

  23. Shoulder--assessment 3. Palpate acromioclavicular jt

  24. Shoulder--assessment • Check neuromuscular status • Check basic movement 3. Palpate acromioclavicularjt 4. Palpate acromion and head of humerus

  25. Anterior Dislocation

  26. acromion clavicular jt acromion humeral head ? Anterior Dislocation

  27. Anterior Dislocation

  28. Shoulder--Management • Check neuromuscular status • Check basic movement internal/ext rotation • Palpate acromioclavicular joint • Palpate acromion and humeral head • If assessment is • fairly normal, If not, • can wait until urgent care • tomorrow needed

  29. Shoulder--management Immobilizer for comfort

  30. Blue • Confident in recognizing urgencies • Recognize a common condition

  31. Rotator Cuff Tendonopathy

  32. Shoulder -- Anatomy • Rotator cuff • Subacromial arch • Impingement

  33. Shoulder -- anatomy • Rotator cuff • Subacromial arch • Impingement

  34. Subacromial Arch

  35. Subacromial Space

  36. Acromion Greater Tuberosity