EEO:Lecture 6

Question 1

what shoulder actions make up shoulder elevation?

Answer 1

flexion, abduction, scansion

Question 2

Shoulder questions to ask?

Answer 2

Which hand do you write with?
Activities you are having difficulty with?
Have you ever had a history of neck pain, upper back pain, or headaches?

Other shoulder?

Question 3

Shoulder Questionnaires

Answer 3

Quick DASH
UCLA shoulder scale
UEFS
Patient Specific Functional Scale

Question 4

Shoulder performance measures

Answer 4

Hand Grip Dynamometry
Time Weighted Overhead Test
Upper Quarter Y Balance
UE Endurance
Apely Scratch
UE CKC Stability Test

Question 5

from the front the clavicle is elevated __ degrees

Answer 5

20

Question 6

From the side,
the ________ is in line with the ear
___________ kyphosis
transition at ____
elbow is directly below __________ head

Answer 6

the acromion in line with the ear
thoracic kyphosis
transition at cervical-thoracic
elbow directly below humeral head

Question 7

an elevated clavicle leads to a lengthened ________ &
a short _________

Answer 7

lengthened pec major (clavicular head)
shorted upper trap

Question 8

a depressed clavicle leads to a lengthened ___________ and a short ___________

Answer 8

lengthened upper trap, short pec major (clavicular)

Question 9

T or F: cubital fossa should face primarily anteriorly and slightly lateral with arms at side

Answer 9

F
Correct answer: cubital fossa should face primarily anteriorly and slightly medial with arms at side

Question 10

Increased thoracic kyphosis:
gravity has a _________ moment arm for flexion
correlated with scapular _________ and cervical __________

Answer 10

gravity has stronger moment arm for flexion
correlated with scapular protraction and cervical extension

Question 11

decreased thoracic kyphosis:
gravity _____ through vertebral bodies
possibly __________ work on muscles that attach to scapular

Answer 11

Gravity more through vertebral bodies
Possible increased work on
muscles that attach to scapula

Question 12

T or F: the CT junction should have some kyphosis

Answer 12

T

Question 13

in excessive kyphosis, what is the breakdown point for the CT junction?

Answer 13

hinge in the lower cervical spine

Question 14

excessive kyphosis increased the work for what muscles?

Answer 14

scapular stabilizer muscles

Question 15

excessive kyphosis is possibly associate with scapular __________ & _________

Answer 15

scapular depression and abduction

Question 16

T or F: decreased kyphosis is common

Answer 16

F!
decreases kyphosis is rare

Question 17

Scapulae positioned
between which vertebral levels

Answer 17

T2-T7

Question 18

at which vertebral level is the superior angle of the scapula?

Answer 18

T2

Question 19

at which vertebral level is the inferior angle of the scapula?

Answer 19

T7

Question 20

scapulae is about __ inches from spinous processes

Answer 20

3

Question 21

what to look for with overhead reach test

Answer 21

• symmetry
• single versus multiple reps
• muscles that are dominant
• muscles that are weak

Question 22

what specific movements to look for when screening an overhead reach

Answer 22

does the scapula upwardly rotate?

does the scapula wing?

does the humerus remain internally rotated?

Question 23

causes of AC joint sprain

Answer 23

FOOSH
downward force on acromion
upward force on clavicle

Question 24

AC joint sprain pt presentation

Answer 24

• “pop”
• WEAKNESS at end range arm
• pain at 90 degrees shoulder flex
• pain with horizontal adduction
• pain at joint
• piano key sign

Question 25

Piano key sign

Answer 25

if you press down on the raised end of the clavicle, it depresses, but when you release it springs back up

Question 26

causes of AC joint arthritis

Answer 26

repetitive overhead prior related injury Prior scapular dyskinesia

Question 27

scapular dyskinesia

Answer 27

shoulder blades do not move the way the are supposed to

Question 28

AC joint arthritis pt presentation

Answer 28

pain at end range pain with shoulder flexion, Hor. adduction pain at joint palpable bony growth

Question 29

shoulder impingement causes

Answer 29

bony growth poor mechanics prior injury FOOSH

Question 30

shoulder impingement pt presentation

Answer 30

pain at 60-120 abduction (painful arch) pain irritated with overhead reach click/pop

Question 31

do shoulder impingement patients have pain at rest?

Answer 31

no

Question 32

why is it important to clear the spine with shoulder impingement?

Answer 32

the older you get, the more likely the shoulder pain is coming from the cervical (C5) spine

Question 33

causes of rotator cuff tendinopathy

Answer 33

repeated micro trauma

Question 34

rotator cuff tendinopathy is a progression of what condition

Answer 34

shoulder impingement

Question 35

rotator cuff tendinopathy pt presentation

Answer 35

pain with contraction or stretching, overhead reach, repetitive load, lying on shoulder atrophy in muscle belly NO PAINNFUL ARCH

Question 36

do patients with rotator cuff tendinopathy have pain at rest?

Answer 36

yes

Question 37

cause of rotator cuff tear

Answer 37

FOOSH, repetitive microtrauma

Question 38

pt presentation of rotator cuff tear

Answer 38

**weakness** and **pain** based on degree of tear, muscle **atrophy**, scapular **malpositioning**

Question 39

what motions are limited after rotator cuff surgery?

Answer 39

PROM flexion, abduction, ER, IR no shoulder AROM (4-6 weeks)

Question 40

What will be the difference between the AROM and PROM of a patient with a rotator cuff tear post surgery?

Answer 40

AROM will be significantly lower than PROM due to muscle weakness from being in a sling for 6 weeks

Question 41

what is another name for a labral tear?

Answer 41

bankart lesion

Question 42

causes of labral tears

Answer 42

FOOSH, direct trauma, violent pull of shoulder, loaded lifting

Question 43

pt presentation labral tear

Answer 43

pop, click, clunk arm feels heavy pain with overhead reach weakness

Question 44

type 1 SLAP lesion

Answer 44

frayed not detached or bucket handle

Question 45

type 2 SLAP lesion

Answer 45

detached

Question 46

type 3 SLAP

Answer 46

frayed and bucket handle

Question 47

type 4 SLAP

Answer 47

detached and bucket handle

Question 48

pt presentation of SLAP lesion

Answer 48

pop, click, clunk arm feels heavy, arm feels **about to dislocate** **pain with flexion and/or IR** weakness in shoulder/scapular stabilizers difficulty lying on side

Question 49

frozen shoulder (adhesive capsulitis) causes

Answer 49

insidious, may correlate with middle age, T2 DM, or hypothyroidism

Question 50

"freezing" frozen shoulder stage

Answer 50

losing ROM, painful

Question 51

"frozen" frozen shoulder stage

Answer 51

minimal ROM, less painful

Question 52

"thawing" frozen shoulder stage

Answer 52

regaining ROM, pain varies

Question 53

What is the capsular pattern for adhesive capsulitis? MIDTERM QUESTION

Answer 53

1: Greatest loss of external rotation (most restricted movement). 2: Moderate loss of abduction. 3: Least loss of internal rotation (though still restricted).

Question 54

How will AROM and PROM compare in patients with frozen shoulder?

Answer 54

they will be similar

Question 55

shoulder end feels

Answer 55

FIRM

Question 56

subacromial bursitis end feel

Answer 56

empty

Question 57

frozen shoulder end feel

Answer 57

hard capsular

Question 58

for shoulder MMT, how would you test functionality?

Answer 58

you resist at a longer lever arm location

Question 59

normal shoulder flexion range

Answer 59

180

Question 60

normal shoulder extension range

Answer 60

AAOS- 60 AMA- 50

Question 61

shoulder abduction norm range

Answer 61

180 AMA- 170

Question 62

shoulder IR range

Answer 62

AAOS- 70 AMA- 80

Question 63

shoulder ER range

Answer 63

AAOS- 90 AMA- 60

Question 64

decreased kyphosis leads to possible _________ weight bearing though vertebral bodies and ________ movement through vertebral bodies

Answer 64

possible **increased** weight bearing though vertebral bodies and **increased** movement through vertebral bodies (NOT facets)