Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCMI > 1.5. Shoulder Complaint > Flashcards

1.5. Shoulder Complaint Flashcards

1
Q

Why is the shoulder joint so susceptible to injury?

A

Only joint where tendons (rotator cuff) pass between bones (acromion and humerus)

  • 3rd most common MSK complaint
  • Prevelance: 16-34% of general population
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of X-ray view would you get for concern or to best see a shoulder dislocation?

A

AP view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of X-ray view would you get for concern or to best see a shoulder separation?

A

Axillary view or Scapular “Y” view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are all the 8 ROM tests for the shoulder?

A
  • Flex/Ext
  • ABduct/ADduct
  • Internal/External rotation
  • Horizontal ABduct/ADduct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 6 speciality tests for the shoulder?

A
  1. Painful Arc test (most important/most sensitive)
  2. Neer impingement sign
  3. Hawkins impingement sign
  4. Yerhason sign
  5. Empty Can test
  6. Drop Arm test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the specialty test for the Acromioclavicular joint/ligament injury?

A

Cross arm test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the painful arc test, test for?

A

Subacromial impingement and rotator cuff tendon injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the positive and negative likelihood ratios for the positive arc test?

A

Positive: 3.7 (highest + for all rotator cuff maneuvers)
Negative: 0.36 (lowest - for all rotator cuff maneuvers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What degrees of ABduction indicate a positive arc test?

A

Shoulder pain between 60-120 degrees indicates subacromial impingement or rotator cuff disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are traumatic, bone related issues that could present as shoulder pain?

A

Fractures and dislocation

  • Common fx: Clavicle (kids), scapula (BLUNT trauma- coronoid or acromion process), ribs, humerus (most common in elderly)
  • Dislocation: glenohumeral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are traumatic, soft tissue related issues that could present as shoulder pain?

A
  • Myofascial
  • Acromial clavicular
  • Rotator cuff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are traumatic, joint (intra-articular) related issues that could present as shoulder pain?

A
  • Cartilage: labral tear
  • Hemarthrosis
  • Joint capsule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are atraumatic, intrinsic related issues that could present as shoulder pain?

A
  • overuse injures, shoulder instability
  • rotator cuff tendinopathy or impingement syndrome
  • subacromial bursitis, inflammatory synovitis
  • adhesive capsulitis (frozen shoulder)
  • bicipital tendinitis, osteoarthristis
  • myofascial pain, septic arthritis, gout
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How common is a glenohumeral “shoulder” dislocation?

A

50% of all major joint dislocations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 types of glenohumeral dislocations?

A
  1. Anterior: most common (95-97% cases)
  2. Posterior (2-4%)
  3. Inferior (0.5%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does an acromioclavicular joint injury typically occur?

A

-Direct trauma to superior or lateral aspect of shoulder (acromion) with arm ADducted (direct blow or falling on shoulder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the types of acromioclavicular injuries?

A

Many, types 1-6

-Know that is can be an AC or Coracoclavicular L. sprain or ligament rupture

18
Q

What type of PE would you expect to have with an AC joint injury?

A
  • Tenderness over joint
  • Possible deformity
  • Pain with ROM, especially ABduction
19
Q

What type of diagnostic testing would you do for AC joint injury? Specifically

A
  • Single AP x-ray of both AC joints

- US

20
Q

What are risk factors for rotator cuff injuries?

A
  • rotator cuff impingement
  • old age
  • repetitive overhead activity in sport or work
21
Q

What are symptoms of rotator cuff injuries?

A
  • shoulder pain (over lateral deltoid), most prevalent with activity and at night
  • weakness
22
Q

What 4 muscles are involved in the rotator cuff and which one is most commonly injured?

A
  1. Supraspinatus Most common
  2. Infraspinatus
  3. Teres minor
  4. Subscapularis
23
Q

Rotator cuff impingement syndrome

A

symptoms from compression of rotator cuff tendons and subacromial bursa between greater tubercle and lateral edge of acromion process

24
Q

Rotator cuff tendon injury

A
  • Sprain or tear (partial or complete)

- End result from chronic subacromial impingement, progressive tendon degeneration, traumatic injury, or combination

25
Q

Rotator Cuff Tendinopathy

A

Inflammation of tendon due to chronic injury to supraspinatus (ABduct) and/or infraspinatus (external rotation)

26
Q

What are the treatments of a rotator cuff injury?

A

Initial: rest, ice, NSAIDs, PT
Orthopedic: if no improvement or tear

27
Q

What are extrinsic vs intrinsic causes of shoulder pain?

A
  • Extrinsic: not related to shoulder pathology, things that WILL kill you like referred from STEMI
  • Intrinsic: intra- or extra-articular processes
28
Q

Describe the Neer Impingement Sign and what is it testing for?

A

-Pt arm is pronated, you passively flex shoulder to fully flexed position while stabilizing their shoulder with your other hand
+ test = pain, subacromial bursa or rotator cuff impingement

29
Q

Describe the Hawkins Impingement sign and what is it testing for?

A

-Flex shoulder and elbow to 90, and passively rotate humerus into internal rotation. (this opposes rotator cuff against coracoacromial l. and acromion)
+ test = pain, rotator cuff or subacromial bursa impingement

30
Q

Describe the Yergason Sign and what is it testing for?

A

-Elbow flexed to 90 then supinate forearm against resistance

+ test = pain in bicipital groove, testing for bicep pathology like bicipital tendinitis

31
Q

Describe the Empty Can Test and what is it testing for?

A

-Flex patient shoulder to 90 while horizontally abducting to 45, then internally rotate both arms so thumbs are pointing down.
-Press on forearms while patient resists flexion motion
+ test = rotator cuff pathology (specifically supraspinatus) with pain

32
Q

Describe the Drop Arm test and what is it testing for?

A

-Pt ABducts arm to 90 then slowly drops arm.

+ Test = full thickness tear of supraspinatus if arm drops or gentle tap on wrist causes arm to drop

33
Q

what muscles are you testing in arm extension and what is the degree?

A
  • latissimus dorsi and teres major

- 60 degrees

34
Q

what shoulder muscles are you testing in arm ABduction and what is the degree?

A
  • Deltoid and supraspinatus

- 180 degree

35
Q

what shoulder muscles are you testing in arm horizontal ADduction and what is the degree?

A

-pect major and

36
Q

what shoulder muscles are you testing in arm horizontal ADduction and what is the degree?

A
  • pect major and latissimus doors

- 40-50 or 130-140

37
Q

what shoulder muscles are you testing in arm horizontal ABduction and what is the degree?

A
  • Supraspinatus and mid-deltoid

- 40-55 or 130-145

38
Q

What shoulder muscles are you testing in arm external rotation and what is the degree?

A
  • Infraspinatus and tires minor

- 90

39
Q

What shoulder muscles are you testing in arm internal rotation and what is the degree?

A
  • subscapularis and pect minor

- 90

40
Q

What is the Apprehension Test and what does it test for?

A

-Pt supine or seated
-Shoulder externally rotated and block linkage @ shoulder with hand
+ test = glenohumeral instability

PCMI (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions