Hawkins–Kennedy Test
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Hawkins–Kennedy Test
The Hawkins–Kennedy Test is a test used in the evaluation of orthopedic shoulder injury. It was first described in the 1980s by Canadian Drs. R. Hawkins and J. Kennedy, and a positive test is most likely indicative of damage to the tendon of the supraspinatus muscle. Interpretation A positive Hawkins-Kennedy test is indicative of an impingement of all structures that are located between the greater tubercle of the humerus The humerus (; ) is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a roun ... and the coracohumeral ligament. The impinged structures include the supraspinatus muscle, teres minor muscle, and the infraspinatus muscle. The Hawkins-Kennedy test is considered to be a highly sensitive test (79%) and thus a positive Hawkins-Kennedy test suggests that injury is likely. Procedure The ...
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Shoulder Injury
Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well. Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Other regions within the body (such as gallbladder, liver, or heart disease, or disease of the cervical spine of the neck) also may generate pain that the brain may interpret as arising from the shoulder. Shoulder structures and functions The shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) (see diagram). Two joints facilitate shoulder movement. The acromioclavicular (AC) joint is located between the acromio ...
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Sensitivity And Specificity
In medicine and statistics, sensitivity and specificity mathematically describe the accuracy of a test that reports the presence or absence of a medical condition. If individuals who have the condition are considered "positive" and those who do not are considered "negative", then sensitivity is a measure of how well a test can identify true positives and specificity is a measure of how well a test can identify true negatives: * Sensitivity (true positive rate) is the probability of a positive test result, conditioned on the individual truly being positive. * Specificity (true negative rate) is the probability of a negative test result, conditioned on the individual truly being negative. If the true status of the condition cannot be known, sensitivity and specificity can be defined relative to a " gold standard test" which is assumed correct. For all testing, both diagnoses and screening, there is usually a trade-off between sensitivity and specificity, such that higher sensiti ...
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Internal Rotation
Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relative to the anatomical position of the body parts involved. Anatomists and others use a unified set of terms to describe most of the movements, although other, more specialized terms are necessary for describing unique movements such as those of the hands, feet, and eyes. In general, motion is classified according to the anatomical plane it occurs in. ''Flexion'' and ''extension'' are examples of ''angular'' motions, in which two axes of a joint are brought closer together or moved further apart. ''Rotational'' motion may occur at other joints, for example the shoulder, and are described as ''internal'' or ''external''. Other terms, such as ''elevation'' and ''depression'', describe movement above or below the horizontal plane. Many anatomic ...
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Acromioclavicular Joint
The acromioclavicular joint, or AC joint, is a joint at the top of the shoulder. It is the junction between the acromion (part of the scapula that forms the highest point of the shoulder) and the clavicle. It is a plane synovial joint. Structure Ligaments The joint is stabilized by three ligaments: * The acromioclavicular ligament, which attaches the clavicle to the acromion of the scapula. Superior Acromioclavicular Ligament This ligament is a quadrilateral band, covering the superior part of the articulation, and extending between the upper part of the lateral end of the clavicle and the adjoining part of the upper surface of the acromion. It is composed of parallel fibers, which interlace with the aponeuroses of the Trapezius and Deltoideus; below, it is in contact with the articular disk when this is present. Inferior Acromioclavicular Ligament This ligament is somewhat thinner than the preceding; it covers the under part of the articulation, and is attached to the adjoin ...
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Internal Rotation
Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relative to the anatomical position of the body parts involved. Anatomists and others use a unified set of terms to describe most of the movements, although other, more specialized terms are necessary for describing unique movements such as those of the hands, feet, and eyes. In general, motion is classified according to the anatomical plane it occurs in. ''Flexion'' and ''extension'' are examples of ''angular'' motions, in which two axes of a joint are brought closer together or moved further apart. ''Rotational'' motion may occur at other joints, for example the shoulder, and are described as ''internal'' or ''external''. Other terms, such as ''elevation'' and ''depression'', describe movement above or below the horizontal plane. Many anatomic ...
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Wrist
In human anatomy, the wrist is variously defined as (1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand; "The wrist contains eight bones, roughly aligned in two rows, known as the carpal bones." (2) the wrist joint or radiocarpal joint, the joint between the radius and the carpus and; (3) the anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as ''wrist joints''. "With the large number of bones composing the wrist (ulna, radius, eight carpas, and five metacarpals), it makes sense that there are many, many joints that make up the structure known as the wrist." This region also includes the carpal tunnel, the anatomical snuff box, bracelet lines, the flexor retinaculum, and the extensor retinaculum. As a consequence of these various definitions, fract ...
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Elbow
The elbow is the region between the arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa (also called the chelidon, or the elbow pit), and the lateral and the medial epicondyles of the humerus. The elbow joint is a hinge joint between the arm and the forearm; more specifically between the humerus in the upper arm and the radius and ulna in the forearm which allows the forearm and hand to be moved towards and away from the body. The term ''elbow'' is specifically used for humans and other primates, and in other vertebrates forelimb plus joint is used. The name for the elbow in Latin is ''cubitus'', and so the word cubital is used in some elbow-related terms, as in ''cubital nodes'' for example. Structure Joint The elbow joint has three different portions surrounded by a common joint capsule. These are joints between the three bones of the elbow, the humerus of the upper arm, and the radius ...
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Shoulder
The human shoulder is made up of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder make up the shoulder joints. The shoulder joint, also known as the glenohumeral joint, is the major joint of the shoulder, but can more broadly include the acromioclavicular joint. In human anatomy, the shoulder joint comprises the part of the body where the humerus attaches to the scapula, and the head sits in the glenoid cavity. The shoulder is the group of structures in the region of the joint. The shoulder joint is the main joint of the shoulder. It is a ball and socket joint that allows the arm to rotate in a circular fashion or to hinge out and up away from the body. The joint capsule is a soft tissue envelope that encircles the glenohumeral joint and attaches to the scapula, humerus, and head of the biceps. It is lined by a ...
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Infraspinatus Muscle
In human anatomy, the infraspinatus muscle is a thick triangular muscle, which occupies the chief part of the infraspinatous fossa.''Gray's Anatomy'', see infobox. As one of the four muscles of the rotator cuff, the main function of the infraspinatus is to externally rotate the humerus and stabilize the shoulder joint. Structure It attaches medially to the infraspinous fossa of the scapula and laterally to the middle facet of the greater tubercle of the humerus. The muscle arises by fleshy fibers from the medial two-thirds of the infraspinatous fossa, and by tendinous fibers from the ridges on its surface; it also arises from the infraspinatous fascia which covers it, and separates it from the teres major and teres minor. The fibers converge to a tendon, which glides over the lateral border of the spine of the scapula and passing across the posterior part of the capsule of the shoulder-joint, is inserted into the middle impression on the greater tubercle of the humerus. ...
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Tendon
A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability to withstand significant amounts of tension. Tendons are similar to ligaments; both are made of collagen. Ligaments connect one bone to another, while tendons connect muscle to bone. Structure Histologically, tendons consist of dense regular connective tissue. The main cellular component of tendons are specialized fibroblasts called tendon cells (tenocytes). Tenocytes synthesize the extracellular matrix of tendons, abundant in densely packed collagen fibers. The collagen fibers are parallel to each other and organized into tendon fascicles. Individual fascicles are bound by the endotendineum, which is a delicate loose connective tissue containing thin collagen fibrils and elastic fibres. Groups of fascicles are bounded by the epit ...
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Teres Minor Muscle
The teres minor (Latin ''teres'' meaning 'rounded') is a narrow, elongated muscle of the rotator cuff. The muscle originates from the lateral border and adjacent posterior surface of the corresponding right or left scapula and inserts at both the greater tubercle of the humerus and the posterior surface of the joint capsule. The primary function of the teres minor is to modulate the action of the deltoid, preventing the humeral head from sliding upward as the arm is abducted. It also functions to rotate the humerus laterally. The teres minor is innervated by the axillary nerve. Structure It arises from the dorsal surface of the axillary border of the scapula for the upper two-thirds of its extent, and from two aponeurotic laminae, one of which separates it from the infraspinatus muscle, the other from the teres major muscle. Its fibers run obliquely upwards and laterally; the upper ones end in a tendon which is inserted into the lowest of the three impressions on the greater ...
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Supraspinatus
The supraspinatus (plural ''supraspinati'') is a relatively small muscle of the upper back that runs from the supraspinous fossa superior portion of the scapula (shoulder blade) to the greater tubercle of the humerus. It is one of the four rotator cuff muscles and also abducts the arm at the shoulder. The spine of the scapula separates the supraspinatus muscle from the infraspinatus muscle, which originates below the spine. Structure The supraspinatus muscle arises from the supraspinous fossa, a shallow depression in the body of the scapula above its spine. The supraspinatus muscle tendon passes laterally beneath the cover of the acromion. Research in 1996 showed that the postero-lateral origin was more lateral than classically described. The supraspinatus tendon is inserted into the superior facet of the greater tubercle of the humerus. The distal attachments of the three rotator cuff muscles that insert into the greater tubercle of the humerus can be abbreviated as SIT when ...
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