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2) Patho 2 > 7) Shoulder > Flashcards

7) Shoulder Flashcards

1
Q

Fxn of superior GH & coracohumeral ligaments

A

Limits ER of the adducted shoulder

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2
Q

Fxn of middle glenohumeral ligament

A

Limits anterior translation of the abducted shoulder

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3
Q

Fxn of inferior glenohumeral complex

A

Gives multidirectional stability

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4
Q

Fxn of glenoid labrum

A
  • Increases depth of the glenoid

* Attachment site for GH ligaments

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5
Q

Fxn of subacromial Burma

A

Water balloon for the shoulder

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6
Q

Things that are important when taking a hx for shoulder:

A
  • Age
  • MOI (Trauma, overuse, etc)
  • Stage of healing
  • OLDCARTS
  • Night pain
  • Meds
  • Hx of spinal patho
  • Pain vs weakness vs ROM
  • Parasthesia
  • Difficulty w/motor tasks
  • Hand Dominance
  • ADL limitations
  • Catching
  • Constitutional Sx’s
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7
Q

Things to consider when doing a shoulder exam

A
  • Inspect skin for bruising
  • Look for anatomical deformity
  • Muscle atrophy
  • Scapular Winging
  • Contours & creases
  • Asymmetry
  • Palpation
  • ROM
  • MMT
  • Sensation
  • Ligament Laxity
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8
Q

Purpose of differential subAC injection

A

Helps to differentiate a tear from inhibition causing 2 weakness

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9
Q

What causes anterior traumatic GH instability & why?

A

Hyperabduction & ER–>Causes capsulolabral avulsion between 3-6 o’clock on the glenoid

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10
Q

True or False: Anterior traumatic instability often requires surgery.

A

True

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11
Q

Classic Bankart Lesion

A

Labrum & capsule get avulsed from the glenoid

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12
Q

Anterior Labroligamentous Periosteal Sleeve Avulsion (ALPSA)

A

Labrum is torn but periosteum remained intact

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13
Q

Does ALPSA have healing potential?

A

Yes

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14
Q

Bony Bankart Lesion

A

Associated w/dislocation

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15
Q

Hill-Sachs Lesion

A

Dent/chip in the humeral head

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16
Q

HAGL

A

Capsular avulsion on the inferior aspect of the glenoid

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17
Q

Multi-Directional Instability

A

Symptomatic subluxation/dislocation in 2 or more directions

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18
Q

Type 1 Multidirectional Instability

A

Multidirectional laxity & global instability

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19
Q

Type 2 Multidirectional Instability

A

Multidirectional laxity & anteroinferior instability

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20
Q

Type 3 Multidirectional Instability

A

Multidirectional laxity & posteroinferior instability

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21
Q

Type 4 Multidirectional Instability

A

Multidirectional laxity & anteroposterior instability

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22
Q

Typical profile of pt w/shoulder pathologies

A

Young adults who are often athletic & reporting generalized pain

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23
Q

Common shoulder pathologies:

A
  • Loose/torn capsule
  • Weak/overwhelmed dynamic stabilizers
  • Generalized laxity
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24
Q

Non-operative management of shoulder pathologies is effective in up to what percent of cases?

A

90%

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25
Q

What things should non-operative management of shoulder pathologies focus on?

A
  • Adductor ER, & IR strengthening
  • Progressive ROM
  • Periscapular Re-ed
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26
Q

When is surgical management of shoulder pathologies indicated?

A

When 6-12 months of rehab has failed

27
Q

Contraindications to surgical management of shoulder pathologies

A
  • Voluntary dislocators w/emotional problems

* Behaviorally immature teens

28
Q

Post-op protocols

A
  • Protect the subscap & labrum repair
    • Limit passive ER & active IR
    • Wait 6wks to progress ROM
    • Wait 10-12wks to progress strengthening
  • Ok to start periscapular program
29
Q

ACLR

A

Tx of shoulder pain in throwing athletes focused on excessive anterior laxity

30
Q

What is the benefit to an ACLR?

A

Don’t have to protect the subscap so you can start early strengthening & periscapular program

31
Q

After an ACLR, when can you begin to progress ROM?

A

After 6wks

32
Q

180 Rule in Throwers

A

IR loss < ER gain

33
Q

What is the peel-back mechanism responsible for?

A

Causing type 2 SLAP tears in throwers

34
Q

Grade 0 GH Instability

A

No translation

35
Q

Grade 1 GH Instability

A

Humeral head moves slightly up the face of the glenoid (0-1cm translation)

36
Q

Grade 2 GH Instability

A

Humeral head rides up the face to, but not over the rim of the glenoid (1-2cm translation)

37
Q

Grade 3 GH Instability

A

Humeral head rides up & over the glenoid rim (>2cm translation)

*Usually reduces when stress is removed, but not always

38
Q

Principles of tx for

A
  • Avoid repetitive stress
  • Restore strength & flexibility
  • Activity modification
  • General conditioning
39
Q

Rehab implications for

A
  • Must decr pain before attaining motion
  • Need motion for strength
  • Can take wks to months
40
Q

Rehab implications for

A
  • Must decr pain before attaining motion
  • Need motion for strength
  • Can take wks to months
41
Q

Benefits of scope vs open repair

A
  • Avoids deltoid morbidity
  • Surgeon can better asses tear geometry
  • More precise
  • Faster rehab & earlier return to ADL’s
42
Q

Principles of tx for impingement

A
  • Avoid repetitive stress
  • Restore strength & flexibility
  • Activity modification
  • General conditioning
43
Q

Tx for adhesive capsulitis

A
  • Tx should be conservative for 6 months
  • NSAID’s & articular injections
  • Aggressive ROM
  • Strengthening when motion returns
44
Q

Surgical tx for adhesive capsulitis

A

Surgical release w/manipulation

45
Q

What condition is surgical release w/manipulation done for?

A

Adhesive capsulitis

46
Q

Why are pain pumps not used anymore & what is used instead?

A

Pain pumps kill cartilage so scalene blocks are now used

47
Q

Tx after surgical manipulation

A
  • Aggressive ROM
  • Nerve Block
  • CPM
  • Motion, motion, motion!
48
Q

Tx after surgical manipulation

A
  • Aggressive ROM
  • Nerve Block
  • CPM
  • Motion, motion, motion!
49
Q

What is a SLAP tear associated w/?

A

Biceps tendon rupture

50
Q

Neer Test

A

Tests for subacromial impingement

51
Q

Hawkins-Kennedy Impingement Test

A

Tests for subacromial impingement

52
Q

O’Brien’s Compression Test

A

Tests for SLAP tear

53
Q

What does the acronym TUBS stand for?

A

Traumatic
Unidirectional
Bankart
Surgery

54
Q

What does the acronym AMBRII stand for?

A 
Atraumatic
Multidirectional
Bilateral 
Rehabilitation
Inferior capsular shift
Interval
55
Q

What pathologies are under the umbrella of RTC disease?

A
  • RTC tendinitis/osis/opathy
  • Calcific tendinitis
  • RTC tear
  • Subacromial bursitis
  • Impingement Syndrome
56
Q

What pathologies are under the umbrella of RTC disease?

A
  • RTC tendinitis/osis/opathy
  • Calcific tendinitis
  • RTC tear
  • Subacromial bursitis
  • Impingement Syndrome
57
Q

Grade 1 AC jt dislocation

A

Partial tear of AC ligament caused by a mild blow

58
Q

Grade 2 AC jt dislocation

A

Subluxation bc of a full AC ligament tear

59
Q

Grade 3 AC jt dislocation

A

AC ligament, coracoclavicular ligament, & capsule are torn

60
Q

Grade 4 AC jt dislocation

A

Clavicle is posteriorly displaced & pushed through the fascia of the traps

61
Q

Grade 5 AC jt dislocation

A

Severe displacement of the GH jt w/the clavicle 300% to the acromion

62
Q

True or false: In a grade 2 AC jt separation, the coracoclavicular ligament is intact.

A

True

63
Q

Grade 6 AC jt dislocation

A

Acromial end of the clavicle is locked inferior to the coracoid

2) Patho 2 (20 decks)

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