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MSK Fall P2 > 6] SHoulder > Flashcards

6] SHoulder Flashcards

1
Q

AP axis SC joint

A

Elevation/depression

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2
Q

SI axis SC joint

A

Protraction and retraction

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3
Q

Longitudinal axis SC joint

A

Posterior and anterior rotation

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4
Q

Saddle joint

A

sternoclavicular joint

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5
Q

Articulates with sternum, clavicle and 1st rib

A

SC joint

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6
Q

Plane joint

A

AC joint

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7
Q

Articulates with acromion and distal clavicle

A

AC joint

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8
Q

Improves GH stability
Shock absorption
Increases total shoulder ROM

A

Scapulothoracic ROM

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9
Q

Scapulohumeral rhythm

A

1/3 ST motion and 2/3 GH motion but new research says elevation requires both GH and ST motion

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10
Q

Scapula is oriented ?

A

30 deg anterior to frontal plane

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11
Q

Humerus orientation- angle of inclination

A

130 - 150

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12
Q

Humerus orientation - angle of Torsion

A

30 deg retroversion

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13
Q

Ball and socket joint

A

GH joint

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14
Q 
Articular bony anatomy
Glenoid labrum
Capsule and ligaments
- intra-articular pressure
Adhesion-cohesion
A

Static factors that provide mechanical stability

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15
Q

Limits inferior translation

A

SGHL and CHL

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16
Q

Primary restraint to anterior translation in 45-75 deg ABDuction. Also limits ER in mid ABDuction.

A

Middle GH lig

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17
Q

Anterior band
Posterior band
Axillary pouch

A

3 parts of inferior GH lig

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18
Q

Controls inferior translation of humeral head in glenoid

A

inferior GH lig

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19
Q
  • pressure within the joint is negative creating a vacuum in the joint
  • venting of capsule increases translation
A

Negative intra-articular pressure

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20
Q

Characteristics of adhesion-cohesion

A

High tensile strength (difficult to pull apart)

Low shear strength (slide easily)

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21
Q

Shoulder depressors

A

Pec major

Lats

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22
Q

Move and stabilize scapula

A

Serratus anterior

Traps

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23
Q

Rotator cuff muscles and tendons function as

A

Dynamic ligaments

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24
Q

Resultant force is towards joint compression

A

Supraspinatus

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25
Q

Humeral head depressors ad apply compressive force. Reduce anterior strain on ligaments.

A

Posterior rotator cuff and subscapularis

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26
Q

Coupled force for stability

A

Rotator cuff and deltoid

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27
Q

Loss of space

A

Primary impingement

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28
Q

Excess movement

A

Secondary impingement

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29
Q 
Acromial morphology
Degenerative spurs - AC joint
Posterior GH capsule tightness
Subacromial swelling 
RTC weak
A

Primary impingement

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30
Q

Tissues in subacromial space

A

Bursa
Supraspinatus
Long head of biceps tendon

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31
Q

GH instability
Scapular weakness/dyskinesia
biceps/SLAP lesion
GIRD

A

Secondary impingement

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32
Q

Inflammation of subacromial bursa and RC tendons

A

Stage 1 Neer

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33
Q

Fibrosis and tendinitis

A

Neer stage 2

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34
Q

Tendo ruptures, possibly bony changes

A

Neer stage 3

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35
Q

Less than 25 years old

Reversible

A

Neer stage 1

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36
Q

25 - 40 years old

Still reversible- requires rest, anti-inflammatory modalities and meds, TE

A

Neer stage 2

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37
Q

More than 40 years old

Complicated, may require surgery

A

Neer stage 3

38
Q

Rotator cuff tears

A

Older patients

39
Q

Rotator cuff tendinopathy

A

Overuse

40
Q

Rotator cuff weakness

A

Athletes

41
Q

Most common rotator cuff tear

A

Supraspinatus

42
Q

Critical zone of RCT

A

1 cm proximal to insertion

43
Q

Partial vs full thickness for RCT

A

Partial is more common.

Full is articular- bursal surface.

44
Q

Sizes to classify RCT

A

Small is less than 1 cm
Medium is less than 3 cm
Large is less than 5 cm
Massive is more than 5 cm

45
Q 
History- insidious, possible incident
Pain- C5 myotome
Frequency - depends on irritability
Night pain
Difficulty lifting arm
A

RCT symptoms

46
Q

RCT treatment stretch

A

Tight posterior capsule - sleeper stretch

47
Q

Strengthening for RCT

A

RTC
Shoulder girdle
Ab and thoracic muscles

48
Q

Which exercises activate RC muscles?

A 
IR
ER
Full can
Horizontal ABD with ER
Concentric and eccentric exercises
49
Q

Hyperactivity and early activitation of scapular muscle dysfunction

A

Upper trap

50
Q

Insufficient activity and late activation of scapular dysfunction

A

Lower trap

51
Q

Strength deficit of scapular dysfunction

A

Serratus anterior

52
Q

3 tests for GH laxity

A

Load and shift
Sulcus sign
Posterior sublux test (jerk test?)

53
Q

What are the 3 acronyms for shoulder dislocations?

A

TUBS
AIOS
AMBRI

54
Q

What does TUBS stand for?

A

Traumatic
Unidirectional
Bankart
Surgery

55
Q

What does AIOS stand for?

A

Acquired
Instability
Overstress
Surgery

56
Q

What does AMBRI stand for?

A 
Atraumatic
Multidirectional
Bilateral
Rehabilitation
Inferior
57
Q

Dislocation happens at ?

A

GH joint

58
Q

Separation happens at ?

A

AC joint

59
Q

What is a bankart lesion ?

A

Separation of anterior labrum from glenoid

60
Q

What is a hill Sachs lesion?

A

Compression Fx of posterolateral humeral head

61
Q

Most common nerve injured

A

Axillary nerve

62
Q

Muscles for full can

A

Supra
Subscapularis
Serratus
Upper and lower trap

63
Q

Muscles for prone horizontal ABD (100-135 deg ABD)

A

Supra

All traps

64
Q

Push up plus muscles

A

Subscapularis

Serratus

65
Q

Dynamic hug muscle

A

Serratus

66
Q

Sidelying ER 0 deg abd muscles

A

Infra

Teres minor

67
Q

Standing ER 45 deg in scapular plane

A

Infra

Teres minor

68
Q

What does SLAP stand for

A

Superior labrum lesion from anterior to posterior

69
Q

Causes of ?

  • acute trauma
  • excessive load on biceps tendon during deceleration and follow through phase of throwing
A

SLAP lesion

70
Q

SLAP lesion MOI?

A

Changes in direction biceps tendon

71
Q

SLAP lesion etiology

A

FOOSH
Forceful eccentric biceps contraction
Degeneration

72
Q

Symptoms of ?

  • clicking, catching, locking
  • pain
  • instability
  • frequently associated with other shoulder pathology
A

SLAP lesion

73
Q

Superior lateral fraying

A

Type I SLAP

74
Q

Unstable attachment

A

Type 2 SLAP

75
Q

Bucket handle tear

A

Type 3 SLAP

76
Q

SLAP type 4

A

3 plus extension into biceps tendon

77
Q

What does GIRD stand for?

A

GH internal rotation deficit

78
Q
  • Jobe
    + Neer post
  • Hawkins
A

Internal (posterior) impingement

79
Q

+ : jobe, Neer ant, Hawkins

A

External subacromial impingement

80
Q

Relocation +

Release + pain

A

Secondary impingement

81
Q

Relocation -

A

Primary impingement

82
Q

+ full can

A

RC pathology

83
Q

+ SAT and SRT

A

Scapular dyskinesia

84
Q

+ laxity tests
+ apprehension
Relocation + apprehension

A

Instability

85
Q

Speeds +
O’Brien’s +
Biceps load II +

A

Biceps/SLAP

86
Q

Decreased IR ROM

A

GIRD

87
Q

GIRD is associated with?

A

Scapular dyskinesia and decreased subacromial space

88
Q

Proximal humerus fractures classifications 1 - 4

A

1 part = the articular segment
2 part = greater tuberosity
3 part = lesser tuberosity
4 part = humeral shaft

89
Q

PT management for one part Fx

A

Conservative with sling for 1-3 weeks

90
Q

PT management for 3/4 part Fx

A

ORIF; initiate AROM in pain free range 7-10 days post op

91
Q

“Stinger”

A

Brachial plexus injury

MSK Fall P2 (10 decks)

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