WEBVTT 00:00:00.000 --> 00:00:02.500 00:00:03.100 --> 00:00:07.350 Para asegurar una evaluacion exhaustiva es mejor llevar a cabo el examen muscuoesqueletico del 00:00:07.350 --> 00:00:09.160 hombro en una manera sistematica 00:00:09.160 --> 00:00:12.930 La siguiente es un orden sugerido que incorpora las tecnicas comunes para 00:00:12.930 --> 00:00:17.100 el diagnostico de las lesiones de hombro. 00:00:17.100 --> 00:00:19.630 El examen de hombro comienza la inspeccion. 00:00:19.630 --> 00:00:25.380 En una vista anterior evaluar los hombres para asimetria, deformidad clavicula, atrofia muscular. 00:00:25.380 --> 00:00:26.870 o los cambios de piel. 00:00:26.870 --> 00:00:30.860 En una vista posterior evaluar para el mismo. 00:00:30.860 --> 00:00:33.199 Siguiente evaluar para el rango activo de movimiento. 00:00:33.199 --> 00:00:36.790 Si dolor o limitacion existe, repetir el movimiento pasivamente. 00:00:36.790 --> 00:00:41.800 Para descartar causas de dolor en el hombro, evaluar rangos de movimiento del cuello: flexion, 00:00:41.800 --> 00:00:45.989 extension, flexion lateral, y rotacion. 00:00:45.989 --> 00:00:57.239 Siguiente evaluar el rango activo de movimiento de los hombres: flexion, extension, secuestro, 00:00:57.239 --> 00:01:03.460 adducion, rotacion externa, y rotacion interna. 00:01:03.460 --> 00:01:08.909 En la vista posterior se puede evaluar mas la aduccion y rotacion externa combinada 00:01:08.909 --> 00:01:12.020 con Apley prueba de marcar de rotacion externa. 00:01:12.020 --> 00:01:15.130 Haga que el paciente alcance de arriba y abajo de la columna vertebral. 00:01:15.130 --> 00:01:22.130 La mayoria de los pacientes pueden llegar mas alla de C7. 00:01:25.270 --> 00:01:29.659 Combina la adducion y rotacion interna con la Apley prueba de marcar de rotacion interna. 00:01:29.659 --> 00:01:32.429 Haga que el paciente alcance detras de la espalda y hasta la columna vertebral. 00:01:32.429 --> 00:01:36.259 La mayoria de pacientes pueden alcancar a T7 o el borde inferior de la escapula. 00:01:36.259 --> 00:01:39.130 Siguiente evaluar la fuerza de los musculos del manguito de los rotadores. 00:01:39.130 --> 00:01:42.889 La prueba de caida del brazo evalua para un desgarro musculo supraespinoso. 00:01:42.889 --> 00:01:47.899 Pasivament aducir el hombro a novento grados, flexione a 30 grados, apuntar los pulgares hacia abajo. 00:01:47.899 --> 00:01:53.300 La prueba es positiva si la paciente no puede mantener las brazos elevados despues el investigador solta. 00:01:53.300 --> 00:01:57.189 00:01:57.189 --> 00:02:01.099 00:02:01.099 --> 00:02:04.489 00:02:04.489 --> 00:02:08.699 00:02:08.699 --> 00:02:11.910 00:02:11.910 --> 00:02:18.330 00:02:18.330 --> 00:02:22.330 00:02:22.330 --> 00:02:26.170 00:02:26.170 --> 00:02:30.030 00:02:30.030 --> 00:02:33.330 00:02:33.330 --> 00:02:36.340 00:02:36.340 --> 00:02:46.500 00:02:46.500 --> 00:02:57.040 00:02:57.040 --> 00:03:01.180 00:03:01.180 --> 00:03:08.000 00:03:08.000 --> 00:03:15.790 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