<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/1bdad0cf-6026-4efc-995a-0501d79cd84b/bg1.png"><div class="c x1 y1 w2 h0"><div class="t m0 x2 h2 y2 ff1 fs0 fc0 sc0 ls0 ws5">P<span class="blank _0"> </span>E<span class="blank _0"> </span>R<span class="blank _0"> </span>G<span class="blank _0"> </span>U<span class="blank _0"> </span>N<span class="blank _0"> </span>T<span class="blank _0"> </span>A<span class="blank _0"> </span> <span class="blank _0"> </span>1<span class="blank _0"> </span> </div><div class="t m0 x3 h3 y3 ff2 fs1 fc1 sc0 ls1 ws0">1.<span class="ls0 ws5"> <span class="blank _1"> </span>Na avaliação do p<span class="blank _2"> </span>aciente S.A., pós fratur<span class="blank _2"> </span>a de rádio, <span class="blank _2"> </span>nota<span class="blank _2"> </span>-se hipotrofia <span class="blank _2"> </span>muscular </span></div><div class="t m0 x4 h3 y4 ff2 fs1 fc1 sc0 ls0 ws5">generalizada no antebraç<span class="blank _2"> </span>o acometido, d<span class="blank _2"> </span>iminuição da ADM <span class="blank _2"> </span>de pronação e su<span class="blank _2"> </span>pinação do </div><div class="t m0 x4 h3 y5 ff2 fs1 fc1 sc0 ls0 ws5">antebraço. Quais seria<span class="blank _2"> </span>m os objetivos <span class="blank _2"> </span>de tratamento co<span class="blank _2"> </span>m est<span class="blank _2"> </span>e paciente<span class="blank _2"> </span>? </div></div><div class="c x4 y6 w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y6 w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls2 ws1">a.<span class="ls0 ws5"> </span></div></div><div class="c x7 y6 w5 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Fortalecimento do su<span class="blank _2"> </span>pinador e rotadores ex<span class="blank _2"> </span>ternos do <span class="blank _2"> </span>ombro.<span class="blank _2"> </span> </div></div><div class="c x4 y9 w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y9 w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls3 ws2">b.<span class="ls0 ws5"> </span></div></div><div class="c x7 y9 w5 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Alongamento e fort<span class="blank _2"> </span>alecimento dos <span class="blank _2"> </span>pronadores <span class="blank _2"> </span>quadrado e redo<span class="blank _2"> </span>ndo. </div></div><div class="c x4 ya w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 ya w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls4 ws3">c.<span class="ls0 ws5"> </span></div></div><div class="c x7 ya w5 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Alongamento dos m<span class="blank _2"> </span>úsculos do ombro e<span class="blank _2"> </span> fortaleciment<span class="blank _2"> </span>o do manguito rotad<span class="blank _2"> </span>or.<span class="blank _3"> </span> </div></div><div class="c x4 yb w3 h6"><div class="t m0 x5 h5 yc ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 yb w4 h6"><div class="t m0 x1 h5 yd ff3 fs2 fc1 sc0 ls5 ws4">d.<span class="ls0 ws5"> </span></div></div><div class="c x7 yb w5 h6"><div class="t m0 x1 h3 ye ff2 fs1 fc1 sc0 ls0 ws5">Alongamento e fort<span class="blank _2"> </span>alecimento dos músc<span class="blank _2"> </span>ulos pronadores<span class="blank _2"> </span>, quadrado e redon<span class="blank _2"> </span>do e </div><div class="t m0 x1 h3 yf ff2 fs1 fc1 sc0 ls0 ws5">supinador do antebraç<span class="blank _2"> </span>o. </div></div><div class="c x4 y10 w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y10 w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls2 ws1">e.<span class="ls0 ws5"> </span></div></div><div class="c x7 y10 w5 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Alongamento dos m<span class="blank _2"> </span>úsculos pronador r<span class="blank _2"> </span>edondo e quadrado.<span class="blank _3"> </span> </div></div><div class="c x1 y1 w2 h0"><div class="t m0 x8 h5 y11 ff4 fs2 fc1 sc0 ls0 ws5">0,25 pontos <span class="ls6"> <span class="blank _4"> </span></span> </div><div class="t m0 x2 h2 y12 ff1 fs0 fc0 sc0 ls0 ws5">P<span class="blank _0"> </span>E<span class="blank _0"> </span>R<span class="blank _0"> </span>G<span class="blank _0"> </span>U<span class="blank _0"> </span>N<span class="blank _0"> </span>T<span class="blank _0"> </span>A<span class="blank _0"> </span> <span class="blank _0"> </span>2<span class="blank _0"> </span> </div><div class="t m0 x3 h3 y13 ff2 fs1 fc1 sc0 ls1 ws0">1.<span class="ls0 ws5"> <span class="blank _1"> </span>Durante a avaliação do <span class="blank _2"> </span>paciente S.D.G<span class="blank _2"> </span>., o fisioterape<span class="blank _2"> </span>uta nota dimin<span class="blank _2"> </span>uição da ADM<span class="blank _2"> </span> de </span></div><div class="t m0 x4 h3 y14 ff2 fs1 fc1 sc0 ls0 ws5">abdução da gleno u<span class="blank _2"> </span>meral, com uma a<span class="blank _2"> </span>derência escap<span class="blank _2"> </span>ular associada. Depois <span class="blank _2"> </span>disso, </div><div class="t m0 x4 h3 y15 ff2 fs1 fc1 sc0 ls0 ws5">alerta ao paciente qu<span class="blank _2"> </span>e será necess<span class="blank _2"> </span>ário restabelecer os<span class="blank _2"> </span> músculos que atu<span class="blank _2"> </span>am na </div><div class="t m0 x4 h3 y16 ff2 fs1 fc1 sc0 ls0 ws5">escápula para que a <span class="blank _2"> </span>haja retorno da <span class="blank _2"> </span>harmonia do m<span class="blank _2"> </span>ovimento Gleno u<span class="blank _2"> </span>meral. A esta </div><div class="t m0 x4 h3 y17 ff2 fs1 fc1 sc0 ls0 ws5">relação de movimento e<span class="blank _2"> </span>ntre a articul<span class="blank _2"> </span>ação gleno<span class="blank _2"> </span>-umer<span class="blank _2"> </span>al e a escápulo<span class="blank _2"> </span>-torácica, da<span class="blank _2"> </span>mos o </div><div class="t m0 x4 h3 y18 ff2 fs1 fc1 sc0 ls0 ws5">nome de ritmo escap<span class="blank _2"> </span>ulo-u<span class="blank _2"> </span>meral, podendo ser <span class="blank _2"> </span>definida como:<span class="blank _2"> </span> </div></div><div class="c x4 y19 w3 h7"><div class="t m0 x5 h5 yc ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y19 w4 h7"><div class="t m0 x1 h5 yd ff3 fs2 fc1 sc0 ls2 ws1">a.<span class="ls0 ws5"> </span></div></div><div class="c x7 y19 w5 h7"><div class="t m0 x1 h3 ye ff2 fs1 fc1 sc0 ls0 ws5">Relação de movim<span class="blank _2"> </span>ento entre acrôm<span class="blank _2"> </span>io-clavicu<span class="blank _2"> </span>lar e esterno<span class="blank _2"> </span>-clavicular, amb<span class="blank _2"> </span>as </div><div class="t m0 x1 h3 yf ff2 fs1 fc1 sc0 ls0 ws5">com movimentos a<span class="blank _2"> </span>mplos.<span class="blank _2"> </span> </div></div><div class="c x4 y1a w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y1a w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls3 ws2">b.<span class="ls0 ws5"> </span></div></div><div class="c x7 y1a w5 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Relação de movim<span class="blank _2"> </span>ento entre ombro e co<span class="blank _2"> </span>tovelo, na proporç<span class="blank _2"> </span>ão de 2:1, sempre.<span class="blank _3"> </span> </div></div><div class="c x4 y1b w3 h8"><div class="t m0 x5 h5 y1c ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y1b w4 h8"><div class="t m0 x1 h5 y1d ff3 fs2 fc1 sc0 ls4 ws3">c.<span class="ls0 ws5"> </span></div></div><div class="c x7 y1b w5 h8"><div class="t m0 x1 h3 y1e ff2 fs1 fc1 sc0 ls0 ws5">Relação de movim<span class="blank _2"> </span>ento entre a articul<span class="blank _2"> </span>ação gleno<span class="blank _2"> </span>-umer<span class="blank _2"> </span>al e escápulo-torác<span class="blank _2"> </span>ica, </div><div class="t m0 x1 h3 ye ff2 fs1 fc1 sc0 ls0 ws5">sendo de 2:1, ou seja, <span class="blank _2"> </span>a cada 2 graus d<span class="blank _2"> </span>e abdução da <span class="blank _2"> </span>gleno umeral, a esc<span class="blank _2"> </span>ápula </div><div class="t m0 x1 h3 yf ff2 fs1 fc1 sc0 ls0 ws5">roda para cima 1 grau,<span class="blank _2"> </span> após 30 graus <span class="blank _2"> </span>de <span class="blank _2"> </span>abdução. </div></div><div class="c x4 y1f w3 h7"><div class="t m0 x5 h5 yc ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y1f w4 h7"><div class="t m0 x1 h5 yd ff3 fs2 fc1 sc0 ls5 ws4">d.<span class="ls0 ws5"> </span></div></div><div class="c x7 y1f w5 h7"><div class="t m0 x1 h3 ye ff2 fs1 fc1 sc0 ls0 ws5">Relação de movim<span class="blank _2"> </span>entos dos músc<span class="blank _2"> </span>ulos do manguito rot<span class="blank _2"> </span>ador, estabilizand<span class="blank _2"> </span>o o </div><div class="t m0 x1 h3 yf ff2 fs1 fc1 sc0 ls0 ws5">ombro. </div></div><div class="c x4 y20 w3 h9"><div class="t m0 x5 h5 y21 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y20 w4 h9"><div class="t m0 x1 h5 y22 ff3 fs2 fc1 sc0 ls2 ws1">e.<span class="ls0 ws5"> </span></div></div><div class="c x7 y20 w5 h9"><div class="t m0 x1 h3 y23 ff2 fs1 fc1 sc0 ls0 ws5">Relação de movim<span class="blank _2"> </span>ento entre todas as articu<span class="blank _2"> </span>lações do mem<span class="blank _2"> </span>bro superior, que </div><div class="t m0 x1 h3 y24 ff2 fs1 fc1 sc0 ls0 ws5">deve ser de 2:1.<span class="blank _2"> </span> </div></div><div class="c x1 y1 w2 h0"><div class="t m0 x8 h5 y25 ff4 fs2 fc1 sc0 ls0 ws5">0,25 pontos <span class="ls6"> <span class="blank _4"> </span></span> </div><div class="t m0 x2 h2 y26 ff1 fs0 fc0 sc0 ls0 ws5">P<span class="blank _0"> </span>E<span class="blank _0"> </span>R<span class="blank _0"> </span>G<span class="blank _0"> </span>U<span class="blank _0"> </span>N<span class="blank _0"> </span>T<span class="blank _0"> </span>A<span class="blank _0"> </span> <span class="blank _0"> </span>3<span class="blank _0"> </span> </div><div class="t m0 x3 h3 y27 ff2 fs1 fc1 sc0 ls1 ws0">1.<span class="ls0 ws5"> <span class="blank _1"> </span>R.A.C. chega ao consu<span class="blank _2"> </span>ltório queixando<span class="blank _2"> </span>-se do d<span class="blank _2"> </span>or ao levantar o<span class="blank _2"> </span> braço acima da<span class="blank _2"> </span> cabeça. </span></div><div class="t m0 x4 h3 y28 ff2 fs1 fc1 sc0 ls0 ws5">Diz que não consegue<span class="blank _2"> </span> lavar o cabelo ou est<span class="blank _2"> </span>ender a roupa <span class="blank _2"> </span>no varal, pois seu om<span class="blank _2"> </span>bro dói. </div><div class="t m0 x4 h3 y29 ff2 fs1 fc1 sc0 ls0 ws5">Na avaliação, nota-<span class="blank _2"> </span>se força<span class="blank _2"> </span> muscular grau 2 p<span class="blank _2"> </span>ara abdutores e rot<span class="blank _2"> </span>adores externos <span class="blank _2"> </span>da </div><div class="t m0 x4 h3 y2a ff2 fs1 fc1 sc0 ls1 ws0">gl<span class="ls0 ws5">eno umeral, associ<span class="blank _2"> </span>ado ao aumento da <span class="blank _2"> </span>dor, os demais<span class="blank _2"> </span> grupos musculares </span></div><div class="t m0 x4 h3 y2b ff2 fs1 fc1 sc0 ls0 ws5">apresentaram grau <span class="blank _2"> </span>3 de força. Perg<span class="blank _2"> </span>unta-s<span class="blank _2"> </span>e: de acordo com o <span class="blank _2"> </span>quadro clínico, quai<span class="blank _2"> </span>s </div><div class="t m0 x4 h3 y2c ff2 fs1 fc1 sc0 ls0 ws5">músculos podem est<span class="blank _2"> </span>ar envolvidos na <span class="blank _2"> </span>disfunção?<span class="blank _2"> </span> </div></div><div class="c x4 y2d w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y2d w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls2 ws1">a.<span class="ls0 ws5"> </span></div></div><div class="c x7 y2d w6 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Redondo menor e ro<span class="blank _2"> </span>mboides.<span class="blank _2"> </span> </div></div><div class="c x4 y2e w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y2e w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls3 ws2">b.<span class="ls0 ws5"> </span></div></div><div class="c x7 y2e w6 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Supra espinhal e trap<span class="blank _2"> </span>ézio fibras médias.<span class="blank _3"> </span> </div></div><div class="c x4 y2f w3 ha"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y2f w4 ha"><div class="t m0 x1 h5 y30 ff3 fs2 fc1 sc0 ls4 ws3">c.<span class="ls0 ws5"> </span></div></div><div class="c x7 y2f w6 ha"><div class="t m0 x1 h3 y31 ff2 fs1 fc1 sc0 ls0 ws5">Subscapular e coracobr<span class="blank _2"> </span>aquela.<span class="blank _2"> </span> </div></div><div class="c x4 y32 w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y32 w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls5 ws4">d.<span class="ls0 ws5"> </span></div></div><div class="c x7 y32 w6 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Supra espinhal e infraes<span class="blank _2"> </span>pinhal.<span class="blank _2"> </span> </div></div><div class="c x4 y33 w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y33 w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls2 ws1">e.<span class="ls0 ws5"> </span></div></div><div class="c x7 y33 w6 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Trapézio fibras inferiores <span class="blank _2"> </span>e subescapu<span class="blank _2"> </span>lar.<span class="blank _2"> </span> </div></div><div class="c x1 y1 w2 h0"><div class="t m0 x8 h5 y34 ff4 fs2 fc1 sc0 ls0 ws5">0,25 pontos <span class="ls6"> <span class="blank _4"> </span></span> </div><div class="t m0 x2 h2 y35 ff1 fs0 fc0 sc0 ls0 ws5">P<span class="blank _0"> </span>E<span class="blank _0"> </span>R<span class="blank _0"> </span>G<span class="blank _0"> </span>U<span class="blank _0"> </span>N<span class="blank _0"> </span>T<span class="blank _0"> </span>A<span class="blank _0"> </span> <span class="blank _0"> </span>4<span class="blank _0"> </span> </div><div class="t m0 x3 h3 y36 ff2 fs1 fc1 sc0 ls1 ws0">1.<span class="ls0 ws5"> <span class="blank _1"> </span>Na avaliação postural<span class="blank _2"> </span> de um pacient<span class="blank _2"> </span>e com queixa de <span class="blank _2"> </span>dor na região torác<span class="blank _2"> </span>ica, nota<span class="blank _3"> </span>-se </span></div><div class="t m0 x4 h3 y37 ff2 fs1 fc1 sc0 ls0 ws5">protusão de ombr<span class="blank _2"> </span>o. Pergunta<span class="blank _2"> </span>-se: quais os <span class="blank _2"> </span>músculos ev<span class="blank _2"> </span>olvidos nesta disfunção <span class="blank _2"> </span>postural </div><div class="t m0 x4 h3 y38 ff2 fs1 fc1 sc0 ls0 ws5">e sua situação?<span class="blank _2"> </span> </div></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi x4 y39 w7 hb" alt="" src="https://files.passeidireto.com/1bdad0cf-6026-4efc-995a-0501d79cd84b/bg2.png"><div class="c x4 y3a w3 ha"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y3a w4 ha"><div class="t m0 x1 h5 y3b ff3 fs2 fc1 sc0 ls2 ws1">a.<span class="ls0 ws5"> </span></div></div><div class="c x7 y3a w8 ha"><div class="t m0 x1 h3 y3c ff2 fs1 fc1 sc0 ls0 ws5">Músculo peitoral mai<span class="blank _2"> </span>or encurtado e rom<span class="blank _2"> </span>bóides frac<span class="blank _2"> </span>os. </div></div><div class="c x4 y3d w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y3d w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls3 ws2">b.<span class="ls0 ws5"> </span></div></div><div class="c x7 y3d w8 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Músculo trapézio fibras <span class="blank _2"> </span>inferiores forte.<span class="blank _2"> </span> </div></div><div class="c x4 y3e w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y3e w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls4 ws3">c.<span class="ls0 ws5"> </span></div></div><div class="c x7 y3e w8 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Músculo peitoral mai<span class="blank _2"> </span>or fraco e rombóides f<span class="blank _2"> </span>ortes.<span class="blank _2"> </span> </div></div><div class="c x4 y3f w3 h4"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y3f w4 h4"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls5 ws4">d.<span class="ls0 ws5"> </span></div></div><div class="c x7 y3f w8 h4"><div class="t m0 x1 h3 y8 ff2 fs1 fc1 sc0 ls0 ws5">Músculo peitoral mai<span class="blank _2"> </span>or forte e peitoral <span class="blank _2"> </span>menor fraco.<span class="blank _2"> </span> </div></div><div class="c x4 y40 w3 hc"><div class="t m0 x5 h5 y1 ff3 fs2 fc1 sc0 ls0 ws5"> </div></div><div class="c x6 y40 w4 hc"><div class="t m0 x1 h5 y7 ff3 fs2 fc1 sc0 ls2 ws1">e.<span class="ls0 ws5"> </span></div></div><div class="c x7 y40 w8 hc"><div class="t m0 x1 h3 y41 ff2 fs1 fc1 sc0 ls0 ws5">Músculo rombóide m<span class="blank _2"> </span>aior fraco e ro<span class="blank _2"> </span>mbóide menor f<span class="blank _2"> </span>orte. </div></div><div class="c x1 y1 w2 h0"><div class="t m0 x2 hd y42 ff5 fs3 fc1 sc0 ls0 ws5"> </div></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div>
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