ch 15 pathologies

Question 1

scapulothoracic articulation pathology (scapular dyskinesis)

Answer 1

insidious, pain not localized, incorrectly positioned scapula, loss of strength & endurance

Question 2

scapulothoracic articulation intervention

Answer 2

remove from aggravating activities, improve scapular function (strength, positioning/mobility, evaluate kinetic chain), pain control

Question 3

sternoclavicular (SC) joint sprain MOI

Answer 3

longitudinal force on clavicle, FOOSH, hit on lateral portion of shoulder, traction forces

Question 4

sternoclavicular joint sprain S&S

Answer 4

localized pain, pain with protraction & retraction & joint play, tilt head toward injured joint for comfort, rapid swelling if dislocated

Question 5

what do you have to rule out for a sternoclavicular joint sprain?

Answer 5

epiphyseal injury

Question 6

what would be considered an emergency with a SC joint sprain? why?

Answer 6

posterior dislocations, threat to subclavian artery & vein

Question 7

SC joint sprain intervention (sprains & dislocation)

Answer 7

sprain- pain control, immobilize in sling, ROM, strengthening, functional training
dislocation- closed reduction or open reduction with joint stabilization with immobilization, rehab, surgery (uses hamstring tendon)

Question 8

acromioclavicular joint pathology MOI

Answer 8

acute- FOOSH, blow to superior acromion process
chronic- repetitive stress, joint degeneration

Question 9

AC sprain S&S

Answer 9

pain localized to AC joint, possible step deformity, pain with shoulder movements

Question 10

what do you have to rule out for an AC sprain?

Answer 10

distal clavicular fracture

Question 11

AC sprain intervention (grade I, II, III)

Answer 11

grade I, II & degenerative conditions- conservative treatment with early ROM & strengthening, immobilize for pain control (if necessary)
grade III or higher- surgery or conservative treatment (depending on activity level), immobilize, ROM, strengthening (include scapula)

Question 12

glenohumeral instability

Answer 12

can be anterior, posterior, or inferior/multidirectional

Question 13

anterior glenohumeral instability structures involved

Answer 13

laxity of anterior stabilizing structures, middle GH ligament, anterior band of inferior GH ligament, superior GH ligament, rotator cuff weakness/tear, glenoid labrum

Question 14

non traumatic anterior instability

Answer 14

MOI- repetitive overhead throwing, use caution when should externally rotates (especially above 90 of abduction)

Question 15

traumatic anterior instability

Answer 15

MOI- forced excessive external rotation & abduction, many tissues can be damaged, common to repeat

Question 16

traumatic & non traumatic anterior instability treatment

Answer 16

nonoperative- immobilization followed by rehab, ROM, strength, neuromuscular control, function, include scapular area too
surgery- possible for structural damage (labrum)

Question 17

posterior instability structures

Answer 17

laxity of posterior stabilizing structures, GH joint capsule and labrum

Question 18

non traumatic posterior instability

Answer 18

MOI- repetitive stress (humerus flexed & internally rotated with longitudinal force placed on humerus), pain with horizontal adduction or loading of posterior GH joint

Question 19

traumatic posterior instability

Answer 19

MOI- posteriorly directed force with humerus flexed and adducted, difficult to diagnose, prominent coracoid process, unable to externally rotate shoulder joint

Question 20

non traumatic & traumatic posterior instability treatment

Answer 20

rehab & activity modification, surgical repair for damaged structures

Question 21

inferior/multidirectional instability