Conditions Cervical and Shoulder Flashcards
This condition involves overstretching and/or tearing of annular rings, vertebral endplate, and/or ligamentous structures.
Central Bulge/Herniation
What are the common signs and symptoms of a Central bulge/herniation?
Loss of strength, Radicular pain Paresthesia, Inability to perform ADL Possible compression of spinal cord
Does a central bulge/herniation demonstrate UMN or LMN signs?
Upper motor neuron symptoms
This condition often involves intervertebral foremen stenosis, posterolateral disk bulge, nerve root inflammation, or any combination of these.
Cervical Radiculopathy
This condition often presents with a central canal stenosis, central disk bulge, spinal inflammation, ligamentous laxity/damage or any combo of these.
Cervical Myelopathy
How do you diagnose a central bulge or cervical radic, or Cervical Myelopathy?
MRI
Clinical exam can be used to assist
Myelopathy has (bilateral/unilateral) loss of strength and typically demonstrates (UMN/LMN) signs.
Bilateral symptoms, and upper motor signs
Excess shear and tensile forces are exerted on cervical structures during which condition?
Whiplash Associated Disorder
What are some common signs and symptoms associated with Whiplash Associated Disorder?
Headaches, neck pain, vertigo, spinal posture abnormalities, cranial nerve signs, dysethesias, etc…
How do yo diagnose whiplash associated disorder
Plain films, CT, MRI
Clinical exam also used
What are some diagnostic tests for hypermobile spinal segments?
Plain film particularly dynamic/stress views
What movements cause an anterior-inferior shoulder dislocation and are they common?
95% are anterior-inferior
Forceful Abduction and ER
What directions are needed to have a posterior shoulder dislocation?
Forceful horizontal adduction and IR
Name some complications of a shoulder dislocation.
Hill-sacks lesions
Bankart lesions
SLAP lesions
How can you diagnose a dislocation?
Diagnostic tests - Medical imaging
Diagnosis made by examination (apprehension sign)
What does the acronym TUBS stand for and how do you treat it?
Traumatic etiology
Unidirectional instability
Bankart lesion is the pathology
Surgery is required
What does the acronym AMBRI stand for and how do you treat it?
Atraumatic (minor trauma)
Multidirectional instability
Bilateral: (asymptomatic shoulder is also loose)
Rehab is the treatment
Inferior capsular shift (might need surgery if conservative measures fail)
Describe a superior and inferior labral tear.
Superior - above middle of socket - often involves bicep
Inferior - below middle of socket - often involves Bankarts’ lesion
What is the preferred diagnostic test for labral tears?
MRA
Describe the clinical findings for a labral tear (4)
Shoulder pain that can’t be localized
Weakness and instability
Pain with resisted elbow flexion
Positive Biceps Load II Test
In Thoracic Outlet Syndrome, where is the compression of the neruovascular bundle?
Superior thoracic outlet
Scalene triangle
Between 1st rib and clavicle
Between pec minor and chest wall
Are AC/SC disorders usually traumatic or non traumatic?
Traumatic
What are the clinical findings for AC/SC disorders?
Step off at AC
Pain above 120 degrees
Painful to palpation
Describe the Subacromial continuum.
- Subacromial bursitis
- Rotator cuff tendonopathy
- Impingement syndrome
(can start or progress to any stage)
Where is the irritation during posterior internal impingement syndrome?
Irritation between rotator cuff and greater tuberosity
or posterior glenoid/labrum
What type of athlete or working environment has common posterior internal impingement?
Overhead athletes/ workers
True/False: Biciptial Teninopathy mostly involves the short head of biceps and is often present with bankart lesion or subacromial impingement.
FALSE
Long head of biceps is mostly affected and is common with SLAP tear
What is the capsular pattern for the GH joint?
ER -> Abduction & flexion -> IR
Name the 3 stages of adhesive capsulitis
Freezing, Frozen, Thawing
