Clinical conditions affecting the shoulder
|Shoulder abduction||Shoulder depression||Shoulder flexion|
In performing any clinical examination, always remember that inspection comes first, followed by palpation and hen percussion and finally auscultation.
Observations of surface myology is part of inspection. It is important to recognise muscle wasting, and deformities such as in Dupuytren’s contracture. Muscle disability can arise as a result of loss of nerve supply, blood supply or rupture due to trauma. It is important to remember the different types of nerves and their nerve roots in the identification of muscle paralysis.
In testing the power of individual muscles the Medical Research Council (Britain) recommends that the following gradings should be followed
When muscle weakness is suspected due to nerve damage, in the process of testing, there is the need to perform a thorough neurological examination which involves the study and examination of the dermatomes supplied by the nerve roots that provide motor supply to the muscles under study.
|Shoulder flexion||Shoulder rotation||Shrugging|
Anterior approach to shoulder
Secure the deltoid and divide it 1cm from its insertion to the clavicle. Then turn the deltoid, skin and subcutaneous tissue laterally to expose deeper stratum. Then secure the coracobrachialis and short head of biceps which are divided on their lateral side to expose the subscapularis above and teres major below
Place stay stitches on subscapularis and divide it to expose the capsule of shoulder joint, which is further divided after retraction of subscapularis by stay stitch to expose the interior of shoulder joint.
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Creator: Oluwole Ogunranti