CATA: Shoulder

Question 1

. Point of greatest tension for ....
Anterior GH ligament
Posterior GH ligament
Middle GH ligament
Inferior GH ligament

Answer 1

Anterior GH - abd/ext/er
Posterior GH - ext/er
Middle GH -flex/er
Inferior GH - abd/ext//er

Question 2

Setting phase

Answer 2

No scapula movement as humerus extends to 30 degrees

Question 3

Step deformity Indication of?

Answer 3

prominent lateral end of clavicle

AC joint inury

Question 4

2 signs of a GH dislocation

Answer 4

prominent lateral acromion process + loss of deltoid contour

Question 5

Thoracic Kyphosis signs

Which muscles are weak/tight?

Answer 5

slumped shoulders (erector muscle weakness and pec tightness)

Question 6

Sprengel’s deformity

Answer 6

Congenitally higher scapula on 1 side

Question 7

A sign that pecs are tight

Answer 7

Protracted scapula

Question 8

Sign that serratus anterior is tight

Answer 8

1 or both winged scapula

Question 9

Only 1 winging scapula is a sign of?

Answer 9

Long thoracic nerve injury or Scoliosis

Question 10

What mainly determines GH position?

Answer 10

Scapula

Question 11

0.Nerve roots and muscles?
Axillary
Musculocutaneous 
22
Sub scapula
Dorsal scapula
Pectoral
Long thoracic
Spinal accessory

Answer 11

Axillary- C5-6 (deltoid + teres minor)
Musculocutaneous- C5-7- (Bachialis, coracoid brachialis, biceps brachii)
Sub scapula- C5/6 (subscap, teres major, lat dorsi)
Dorsal scapula- C5-(Rhomboids, levator scap)
Pectoral- C5-T1 (pec major+minor)
Long thoracic- C5-7 (Serratus anterior)
Spinal accessory - CN 11 (Traps)

Question 12

GH instability tests

Answer 12

Load and shift
Post/ant draw
Apprehension
Sulcus sign

Question 13

Clunk Sign positive? Indicates?

Answer 13

Clunking

GH labrum tear

Question 14

O’brians sign positive? Indicates?

Answer 14

Pain is present w/ IR but decreases w/ER and their is clicking
(+) Slap lesion

Question 15

Shoulder impingement tests

Answer 15

Neers + Hawkins

Question 16

Supraspinatus weakness tests

Answer 16

Drop arm + empty can

Question 17

Biceps tendon tests

Answer 17

yergesons + speeds + Ludington’s

Question 18

Thoracic outlet syndrome tests

Answer 18

Anterior scalene syndrome
Hyperabduction syndrome
Military brace position tests
Costoclavicular syndrome (Roo’s) test

Question 19

With a clavicular fracture, patient normally supports which arm? and tilts head
to what side?

Answer 19

Injured arm

Towards injured side

Question 20

What nerve is at risk w/a humeral fracture?

Answer 20

Radial (wrist drop)

Question 21

AC joint sprain 6 grades

Answer 21

Grade 1 sprain -Point tenderness and discomfort during movement at
acromion end Grade 2 sprain - Tearing of AC ligs and stretching of
coracoclavicular ligs -partial displacement and prominence of lateral
clavicle
Grade 3 Sprain- Full rupture of AC ligs
Grade 4 Sprain- Full rupture and posterior separation of clavicle
Grade 5 Sprain -Complete rupture of BOTH AC + coracoclavicular ligs+
tearing of traps, and deltoid at clavicle attachment- distal clavicle
prominence +severe pain and loss of movement
Grade 6 Sprain- clavicle displaced inferior to coracoid behind
coracobrachialis

Question 22

Bankart Lesion

Answer 22

Permanent anterior labrum deformity

Question 23

Hill Sachs lesion

Answer 23

divot on posterior lateral humeral head caused by compression of
cancellous bone against anterior glenoid rim during anterior dislocation

Question 24

SLAP lesion

Answer 24

• Superior labrum anterior to posterior
  Injury to superior lesion that starts Posteriorly and moves anteriorly and
  effects long of the biceps attachment to sup labrum

Question 25

Result of transverse lig rupture?

Answer 25

causes biceps tendon dislocation/subluxation

Question 26

S/S of anterior GH dislocation? How does patient how arm?

Answer 26

flattened deltoid + humeral head prominence + Patient carries affected arm in slight abd/ER + unable to touch opposite shoulder w/affected arm

Question 27

S/S posterior GH dislocation? How does patient hold arm?

Answer 27

Arm held in add/IR flattened anterior deltoid + acromial and coracoid process prominence + humeral head posterior prominence

Question 28

Sling immobilization position of posterior and anterior GH dislocations

Answer 28

Immobilization of posterior dislocation- ER/slight abd | Immobilization of anterior dislocation- IR/add (relaxed position)

Question 29

Sports/movements causing anterior GH instabilities? How does this effect throwing mechanics?

Answer 29

tennis serving + freestyle swimming | Dead arm syndrome in cooking phase of overhead throw

Question 30

Posterior GH instability sports/movements S/S

Answer 30

backstroke swimming + tennis backstroke anterior and posterior pain, impingement, decrease in IR, pain in Hawkins position

Question 31

Anterior instability strengthening should work on what groups of muscles vs posterior instability

Answer 31

Anterior- internal rotators | Posterior-External rotators

Question 32

Components of shoulder impingement

Answer 32

compression of supraspinatus tendon, subacromial bursae and long head biceps tendon from repetitive compression/inflammation under subacromial arch

Question 33

GH internal vs external rotation gain

Answer 33

GH External rotation gain (ERG): Increased GH ER GH | Internal rotation gain (IRG): decreased GH IR

Question 34

Scapula dyskinesis

Answer 34

abnormal scapular movement

Question 35

SICK scapula: How does patient hold scapula? How is throwing mechanics affected?

Answer 35

(S-scapular malposition I-inf/med winging C-cocaroid tenderness K-kinesis abnormalities) - holding affected shoulder lower and slouched + Posterior tipping of scapula (narrows subacromial space during overhead motion leading to abduction and external rotation) - medial winging at rest medial boarder prominence in cocking phase (due to anterior pec tightness and weakness of lower traps and serratus anterior)

Question 36

Thoracic Outlet syndrome

Answer 36

compression of brachial plexus, subclavian artery, and vein (neurovascular bundle)- compression b/w first rib/clavicle, anterior/middle scalene, pec minor/coracoid or presence of cervical rib

Question 37

Mechanism of biceps rupture | Normal rupture location

Answer 37

powerful concentric or eccentric contraction | *normally ruptures at origin

Question 38

5 throwing phases and what happens during each

Answer 38

1.Wind-up Phase- First movement until ball leaves the glove 2.Cocking Phase - From when hands separate and ends w/ maximal ER of humerus -lead foot comes forward in contact w/ the ground during this phase 3.Acceleration phase-max ER until ball release- scap elevates/abducts/upwardly rotates 4. Deceleration Phase - From ball release until max IR -External rotators contract eccentrically to decelerate humerus -Rhomboids contract eccentrically to decelerate scapula 5.Follow through phase - Lasts from max IR until end of motion when athlete is balanced

Question 39

During throwing the? muscle groups are first to assist and it progresses to? muscle groups

Answer 39

most powerful | Least powerful

Question 40

During throwing the body's center of gravity is transported in direction of ? as the which leg? is first elevated and then moved forward and planted on the ground, thus stopping ? movement

Answer 40

Direction of the throw Leg opposite to throwing arm Stopping forward movement

Question 41

Throwing arm forcibly moved from position of? through flexion to forcible and complete extension in the terminal phase of delivery using the? muscles

Answer 41

extreme ER/abd/ext | powerful IR/adductor

Question 42

PNF pattern closely resembles overhead activity

Answer 42

D2