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OPP 3-2 > 1 - Shoulder (Kusienski) > Flashcards

1 - Shoulder (Kusienski) Flashcards

1
Q

Will most of my questions be clinical?

A

YES, because I’m Dr. K.

and… I Kan!

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2
Q

Glenohumeral joint has a LARGE amount of MOTION with ______ stability

A

LIMITED

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3
Q

The Acromioclavicular joint (AC) has triplanar motion, right?

A

YES

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4
Q

What is the only structural attachment of the scapula to the rest of the body?

A

The Sternoclavicular joint!

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5
Q

Ouch, I hurt my Scapulo-thoracic joint (a pseudojoint). What motions could be limited?

A

Elevation & Depression
Abduction/Adduction
Upward/downward rotation

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6
Q

What are the muscles in the rotator cuff?

A

SITS!

Supraspinatus
Infraspinatus
Teres Minor
Subscapularis

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7
Q

Shoulder movements are complex interactions of how many joints?

A

4 joints

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8
Q

True or False: The shoulder complex depends heavily on muscles for stability

A

True.

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9
Q

A 17 yo cheerleader comes in with pain in their shoulder. She complains that when she raises their hands above her head there is a painful arc from around 60 to around 120 degrees. But when she has her hands straight up, there is no pain. You also note pain with resistance. What problem you think she has?

a) Impingement Syndrome
b) Calcification
c) Juvenile Arthritis
d) Adhesive capsulitis

A

a) Impingement Syndrome

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10
Q

What are the tests for impingement syndrome? What makes the test positive?

A

Neer’s Test
Hawkin’s Kennedy Test

Positive if there is PAIN

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11
Q

A 17 yo cheerleader comes in with pain in their shoulder. She complains that when she raises their hands above her head, from around 60 to around 120 degrees, she feels pain. But when she has her hands straight up, there is no pain. What treatment would you recommend if you think the problem is a primary problem?

A

Primary:
Acromioplasy (A-C joint resection)
Arthroscopic bone spur removal

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12
Q

A 17 yo cheerleader comes in with pain in their shoulder. She complains that when she raises their hands above her head, from around 60 to around 120 degrees, she feels pain. But when she has her hands straight up, there is no pain. What treatment would you recommend if you think the problem is a secondary problem?

A 
Secondary:  
Physical Therapy
Steroid injection (Cortisone)
Inflammatory medications
Surgical repair of instability
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13
Q

A 38 yo female comes in with pain in their shoulder. She complains that when she raises their hands above her head, from around 60 to around 120 degrees, she feels pain. But when she has her hands straight up, there is no pain. She also mentions pain with palpation. What is her problem?

A

rotator cuff tendonitis

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14
Q

A 38 yo female comes in with pain in their shoulder. She complains that when she raises their hands above her head, from around 60 to around 120 degrees, she feels pain. But when she has her hands straight up, there is no pain. She also mentions pain with palpation. What treatment could you recommend?

A 
Rest (stop aggravating activity)
Physical Therapy
Anti-Inflammatory medication
Steroid injections
OMT
Prolotherapy (inject stuff)
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15
Q

What is an absolute contraindication for steroid injection?

a) diabetes
b) anticoagulation/bleeding disorder
c) HIV patient
d) prosthetic joint
e) Severe anxiety

A

d) prosthetic joint

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16
Q

Which is not an absolute contraindicaiton for steroid injection?

a) local sepsis over injection site
b) early trauma
c) prosthetic joint
d) children
e) psychogenic pain

A

e) psychogenic pain

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17
Q

What is a empty can test?

A

???

18
Q

If the Rotator cuff syndrome keeps getting agitated, what could happen?

A

Calcification

19
Q

What is the Incidence of Tears in order?

Supraspinatus
subscapularis
Teres minor
Infraspinatus

A

Supraspinatus >Infraspinatus> subscapularis> Teres minor

20
Q

A patient is able to elevate shoulder, which muscle(s) is/areinvolved?

A

supraspinatous only

21
Q

Patient has loose force couples, limited elevation, and weak ER. What muscle(s) are involved?

A

supraspinatus and infraspinatus

22
Q

Patient has disrupted force couples, with limited elevation and weak internal rotation. What muscles(s) could be partially torn?

A

supraspinatus and subscapularis

23
Q

Patient has their humeral head subluxed posteriorly to create a fulcrum to move. What muscle(s) could be having issues?

A

supraspinatus, infraspinatus and subscpularis

24
Q

A patient comes in complaining of abduction and external rotation weakness of their arm. What is the problem that you suspect?

A

Rotator cuff weakness

25
Q

A patient comes in complaining of abduction and external rotation weakness of their arm. You suspect rotator cuff syndrome What special orthopedic tests would you use? What imaging could you use for definitive diagnosis?

A

DROP ARM and Empty Can tests.

MRI for definitive diagnosis

26
Q

For treatment of Rotator Cuff Tears, what is your train of thought for a partial rotator cuff tear? Conservative? Go straight to surgery?

A

Conservative!

Physical therapy/strengthening
Anti-inflammatory medication
Possibly rotator cuff repair surgery

27
Q

Bicipital tendonitis most commonly occurs where

A

bicipital groove

28
Q

A 18 yo male comes in with history and physical exam concurrent with bicipital tendonitis, what tests could you do?

A

Yergason’s Test (externally rotate and supinate arm)

Speed’s Test (hand in anatomical position and feel for resisted motion as arm comes up)

29
Q

A 58 yo male comes in with gradual onset of pain with motion. A pattern with external rotation > Abduction > internal rotation with compensatory movement. What do you think the problem is?

A

Adhesive capsulitis

30
Q

A 58 yo male comes in with gradual onset of pain with motion. A pattern with external rotation > Abduction> internal rotation with compensatory movement. You realize it is adhesive capsulitis. What test and treatments could you use??

A

Test:

Treatment: Physical therapy, spencer techniques (OMT), medication only as needed, steroid injections, closed manipulation (anesthesia) and capsular release.

31
Q

[Board TQ] What are the 7 Stages of Spencer?

A

Will show in lab.

32
Q

A 67 yo patient comes in complaining of gradual onset of pain with motion. You find restricted ROM and a capsular pattern on physical exam. What special test could you to test your diagnosis?

A

Cross Arm test (for Osteoarthritis)

33
Q

A 67 yo patient comes in complaining of gradual onset of pain with motion. You find restricted ROM and a capsular pattern on physical exam. You think it’s Osteoarthritis. What could be treatments?

A 
Physical therapy
"Graded activity"
NSAIDS
Periodic steroid injections
joint replacement
34
Q

**Which of the following is not an anterior mechanism of injury for a shoulder dislocation

a) trauma
b) forced external rotation
c) Abduction
d) extension
e) forced internal rotation

A

e) forced internal rotation

35
Q

With a Shoulder (G-H) dislocation what should you check fo ron PE?

A

Deformity AND Pulses/Sensation

36
Q

What special orthopedic special tests for a shoulder dislocation?

A

Apprehension sign
relocation sign
drawer tests
sulcus test

37
Q

What are the TRUE joints of the shoulder?

A

Glenohumeral, AC, SC

38
Q

What are two primary causes of impingement syndrome?

A

Abnormal acromial shape, Bone spurs

39
Q

How do you treat primary impingement syndrome?

A

Acromioplasty, Bone spur removal

40
Q

Causes of Secondary impingement syndrome?

A

RC weakness, bicipital weakness, scapular dysfxn, GH Instability

OPP 3-2 (8 decks)

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