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ECOS I > Approach to Shoulder Final Exam > Flashcards

Approach to Shoulder Final Exam Flashcards

1
Q

PMH must asks for shoulder complaint?

A

Htn, DM, CAD complaint specific: prior injury, systemic illness that causes joint pain

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2
Q

PSH for shoulder complaint.

A

General surgeries such as appendix gallbladder Complaint specific such as prior ortho surgery or procedure

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3
Q

Medication asks for shoulder complaint

A

General: blood thinner, Diabetic meds, Cardiac meds, Htn meds Complaint: NBarcotics, NSAIDS, Tylenol, Steroids

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4
Q

Social history needed with shoulder complaint?

A

General: smoking etoh, drugs Complaint: what how how often how recent

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5
Q

Joint objective exam necessities?

A

Inspection, Palpation, ROM, Specialty tests, Neurovascular exam

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6
Q

What is the painful arc test?

A

Tests for subacromial impingement and rotator cuff tendon injury **test has the highest + LR and -LR of all rotator cuff maneuvers Patient will abduct their arm and a positive test will show shoulder pain from 60 to 120

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7
Q

What roots are tested with tricep reflex?

A

C6-7

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8
Q

What roots are tested with Biceps and rachioradialis reflexes?

A

C5-6

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9
Q

What dermatome is thumb, pinky, nipples and umbalicas?

A

C6 thumb C8 Pinky T4 Nipples T10 belly button

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10
Q

Clavicle fractures?

A

Most common in kids and young adults

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11
Q

Proximal humerus fractures?

A

Most common in elderly

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12
Q

Scapular fracture?

A

Associated with blunt trauma

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13
Q

Glenohumeral anterior dislocation

A

Most common type of shoulder dislocation. 95-97% of cases

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14
Q

Acromioclavicular Joint Injury

A
  • Usually from direct trauma or lateral aspect of acromion with arm adducted
  • Can be AC sprain or rupture
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15
Q

Rotator Cuff Components?

A
  • Subscapularis
  • Supraspinatus
  • Infraspinatus
  • Teres Minor
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16
Q

Rotator cuff risk factors and symmptoms.

A
  • Rotator cuff impingement or older age
  • Symptoms are pain over lateral deltoid and more prominent with overhead activity and at night, also weakness
17
Q

What speciality test do you perform for a suspected Rotator Cuff injury?

A
  • Painful Arc*** best one
  • Neer impingement
  • Hawkins impingement
  • empty can
  • Drop arm

Diagnostics:

  • X ray is NOT helpful
  • Ultrasound and MRI are standard

Treatment:

  • Rest, Ice, NSAIDS, PT
18
Q

Atraumatic cases of shoulder pain?

A
  • Extrinsic: Can be referred pain with no pathology of shoulder, shoulder exam looks normal, examples are MI, free blood retroperitoneum
  • Intrinsic: intra and extra articular
19
Q

What are the most common causes of shoulder pain?

A

Acute:

  • Rotator cuff injuries most common
  • Fracture dislocation
  • AC joint injuries
  • Myofascial injury

Chronic: >6months

  • rotator cuff disorders
  • adhesive capsulitis
  • shoulder instability
  • arthritis
  • Life Threatening:
    • Septic Arthris
20
Q

When the scapula depresses what happens to the clavicle?

A

scapula depresses and the distal clavicle at the AC joint will inferiorly glide and proiximal clavicle at the SC joint will superiorly glide.

Scapula elevates the distall clavicle will supereiorly gilde at AC joint and Prosimal clavicle will inferiorly glide at SC joint

21
Q

With abduction what happens to Scapular motion and clavicular motion at AC and SC joint?

A

Depress scapula, inferior glide of AC and superior glide at SC

22
Q

Abduction what happens with scapula and clavicle?

A
  • Scapula will elevate
  • Clavicle at the AC joint will superiorly glide
  • Clavicle at the SC joint will inferirly glide
23
Q

What happens to the scapula and clavicle with flexion of the shoulder?

A
  • Protract scap
  • Anterior glide of clavicle at the AC joint
  • Posterior glide of clavicle at the SC joint
24
Q

What happens to the scapula and clavicle with shoyulder extension?

A
  • Retraction scap
  • Posterior glide of clavicle at AC
  • Anterior glide of clavicle at SC joint
25
Q

What happens with internal and external rotation of the shoulder at the scapula and clavicle?

A
  • N/A for scapula and clavicle at SC joint
  • Clavicle at AC joint will internally rotate with internal rotation and externally rotate with external rotation
26
Q

Patient with an inferior glide SC joint dysfunction, how do you treat?

A

ADduct the shoulder

27
Q

Patient with a superior glide SC joint SD, how do you treat

A

Resist shoulder ABduction

28
Q

Patient with an Anterior glide SC joint SD, how do you treat?

A

Resist shoulder flexion

29
Q

Patient with a posterior glide SC joint SD, how to treat?

A

Resist shoulder extension

30
Q

AC joint SD of superior, how do you treat?

A

Resist inferior pressure to distal clavicle

31
Q

Patient with an internal rotation AC joint SD, how do you treat?

A

Resist shoulder external rotation

32
Q

Patient with an external rotation AC joint somatic dysfunction, how do you treatt?

A

Resist internal rotation

ECOS I (15 decks)

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