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PTA 201 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are the components of the shoulder joint complex? (Different joints within the shoulder)

A

-Glenohumeral Joint
-Acromioclavicular Joint
-Sternoclavicular Joint
-Scapulothoracic Joint (Not an actual bone on bone joint)

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2
Q

Which movements occur at the Sternoclavicular Joint?

A

-Elevation
-Depression
-Retraction
-Protraction
-Upward Rotation
-Downward Rotation

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3
Q

At which point of shoulder elevation does Sternoclavicular elevation occur

A

30-90 degrees of shoulder elevation

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4
Q

Where is most of the movement of the clavicle seen?

A

The Acromioclavicular Joint

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5
Q

Which 3 ligaments stabilizes the Acromioclavicular joint?

A

-Acromio-clavicular
-Coraco-acromio
-Coraco-clavicular

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6
Q

Where is the scapula positioned?

A

2 inches (5 cm) lateral of the spinous processes and between T2 and T7

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7
Q

Where is the Scaption Position?

A

30-45 degrees anterior to the frontal plane

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8
Q

What is the term used for the combination of scapular motions in conjunction with upper extremity movements, and is the key to stability of the GH joint?

A

Scapulohumeral Rhythm

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9
Q

What shape is the Glenoid?

A

Pear shaped

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10
Q

How many degrees of articular surface does the Glenoid have?

A

180 degrees

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11
Q

What is the fibrocartilaginous rim around the glenoid which enhances the concavity of the glenoid fossa?

A

The Glenoid Labrum

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12
Q

What is considered the “roof” over the humeral head?

A

The Coracoacromial Ligament

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13
Q

What is the term used for anything that stabilizes the shoulder joint that is not a muscle?

A

Static Stabilizers

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14
Q

What is the term used for the type of shoulder stabilizers which are muscle?

A

Dynamic Stabilizers

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15
Q

How much smaller is the glenoid than the humeral head?

A

3-4 times smaller

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16
Q

Which way does the Glenoid face?

A

-Superiorly
-Anteriorly
-Laterally

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17
Q

How much of the Humeral head is in contact with the glenoid?

A

25-30%

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18
Q

At what point does the Glenohumeral Joint have the most Articular Contact?

A

Between 60-120 degrees of elevation

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19
Q

What is the Glenoid Labrum made out of and what is it’s purpose?

A

-Fibrocartilage
-Doubles the depth of the glenoid fossa
-Serves as a buttress or chock-block controlling glenohumeral translation
-Increases surface area and load bearing for head of humerus

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20
Q

What is attached to the Glenoid Labrum, and what goes through it?

A

-The glenohumeral ligament is attached to it
-The biceps tendon goes through it

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21
Q

What does not return after surgery to a torn or punctured capsule and therefore results in shoulder instability?

A

Intraarticular pressure and joint cohesion

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22
Q

Which ligament gives anterior stability to the shoulder?

A

The Glenohumeral Ligament

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23
Q

What is the function of the Superior Glenohumeral Ligament?

A

Limits inferior motion of the humerus when carrying a load

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24
Q

What is the function of the Middle Glenohumeral Ligament?

A

Limits ER and Abd. at 45 degrees

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25
Q

What is the function of the Inferior Glenohumeral Ligament?

A

-This is the most important of the stabilizing ligaments in the shoulder
-The Anterior portion limits ER and Abd
-The Posterior portion limits IR and Abd

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26
Q

Which 3 things contribute to the depth of the glenoid fossa?

A

-Slight concavity of the glenoid
-Articular cartilage thicker in the periphery
-Glenoid labrum’s deepening effect

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27
Q

Definition: Muscles that produce movement about the glenohumeral joint also generate the primary forces responsible for stabilizing the joint

A

Dynamic Stabilizers

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28
Q

What are the Primary active stabilizers of the shoulder?

A

-Rotator Cuff Muscles
-Deltoid
-Long head of biceps brachii

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29
Q

What are the Secondary active stabilizers of the shoulder?

A

-Teres Major
-Latissimus Dorsi
-Pectoralis Major

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30
Q

Definition: 2 parallel forces of equal magnitude but opposite direction are applied to a structure at equal distances from the center mass; 2 groups of muscles contracting synchronously to enable a specific motion to occur

A

Force Couple

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31
Q

Which muscles work as a Force Couple to hold the head of the humerus inferiorly?

A

The IR and ER (Subscapularis and Infraspinatus/Teres Minor)

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32
Q

Which muscles work as a Force Couple to hold the head of the humerus superiorly?

A

The Deltoid and Inferior Rotator Cuff Muscles

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33
Q

What happens when the rotator cuff muscles become fatigued?

A

Superior migration of the humeral head

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34
Q

What do the Ruffinian/Pacinian Corpuscles and Golgi Mechanoreceptors present in the shoulder capsule do?

A

Give us feedback for proprioception

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35
Q

What are the Prime Movers (muscles) that span from the scapula to the humerus?

A

-Deltoid
-Latissimus Dorsi
-Pectoralis Major

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36
Q

Which muscles must work together to keep the head of the humerus in alignment?

A

The deltoid and rotator cuff muscles

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37
Q

What is it called when traction on the Coracoacromial ligament causes abnormal bone growth?

A

Traction Spur

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38
Q

When the anterior shoulder capsule is tight, ER against the tight capsule can produce a force in which direction?

A

Posteriorly

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39
Q

Tightness of the posterior shoulder capsule can create a force in which direction with humerus elevation?

A

Anterior-superior

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40
Q

Which scapular muscles do you need to strengthen in scapular dumping?

A

Upward Rotators

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41
Q

How is Shoulder Internal Rotation Tested?

A

The highest segment of posterior anatomy reached with the thumb

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42
Q

What does the Drop Arm test for?

A

Full thickness RC tear

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43
Q

What does the Empty Can/Full Can test for?

A

Supraspinatus weakness or lesion (RC disfunction)

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44
Q

What does the Apprehension Test test for?

A

Shoulder instability and proneness to subluxation

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45
Q

What does the Speeds Test test for?

A

Biceps Tendon/SLAP/Labrum

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46
Q

What does the Neer’s Sign Test for?

A

Shoulder Impingement

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47
Q

What does the Hawkin’s Kennedy test for?

A

Shoulder Impingement

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48
Q

What is the most common reason for instability of the shoulder?

A

Impairment to the Static or Dynamic Stabilizers

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49
Q

What are the RC muscles and what do they do?

A

-Supraspinatus: Shoulder Abduction to 90 degrees
-Infraspinatus: Shoulder ER
-Teres Minor: Shoulder ER
-Subscapularis: Shoulder IR
They all depress and stabilize the head of the humerus in the glenoid

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50
Q

Which RC muscle(s) insert into the Greater Tubercle?

A

-Supraspinatus
-Infraspinatus
-Teres Minor

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51
Q

Which RC muscle(s) insert into the Lesser Tubercle?

A

-Subscapularis

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52
Q

Which nerve innervates the Supraspinatus and Infraspinatus?

A

Suprascapular nerve

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53
Q

Which nerve innervates the Teres Minor?

A

Axillary nerve

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54
Q

Which nerve innervates the Subscapularis?

A

Subscapular nerve

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55
Q

What is Impingement Syndrome?

A

When the Supraspinatus becomes compressed between the head of the humerus and the acromion process

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56
Q

Which stage of shoulder impingement is this?
-Edema and hemorrhage
-Pain with shoulder abduction >90
-Reversible lesion

A

Stage I

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57
Q

Which stage of shoulder impingement is this?
-Fibrosis and tendonitis
-Pain, especially at night and with ADL
-Less chance of reversing condition due to fibrosis

A

Stage II

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58
Q

Which stage of shoulder impingement is this?
-Tendon degeneration
-Hx of shoulder P! and dysfunction
-Muscle atrophy and weakness
-Usually a candidate for surgery

A

Stage III

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59
Q

At what point does the GH joint have the greatest amount of articular contact?

A

60-120 degrees of elevation

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60
Q

What is the difference in GH Dislocation and Subluxation?

A

-Dislocation: Full dislocation
-Subluxation: Partial dislocation

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61
Q

In which direction is the GH joint most commonly dislocated?

A

Anterior and Inferior

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62
Q

Will Extrinsic or Intrinsic Forces most likely cause a full dislocation?

A

Intrinsic

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63
Q

What is the term for when the shoulder labrum tears away from the anterior/inferior glenoid?

A

Bankart Lesion

64
Q

What occurs in 85% of traumatic shoulder dislocations?

A

A Bankart Lesion

65
Q

What happens in a Bankart repair?

A

The Labrum is sutured directly to the bone

66
Q

What usually accompanies a Bankart Lesion?

A

A Hill-Sachs Lesion

67
Q

What is a Hill-Sachs Lesion

A

An osteochondral depression (compression fx) in the posterior humeral head due to impact on glenoid rim during anterior dislocation

68
Q

What is a Reverse Hill-Sachs Lesion?

A

An osteochondral depression in the Anterior humeral head due to impaction on glenoid rim during posterior location

69
Q

Where do SLAP tears occur?

A

Where the biceps tendon anchors to the labrum

70
Q

What position of the shoulder is most comfortable for post-surgery patients?

A

Scaption

71
Q

What is Scapulohumeral Rhythm?

A

2 degrees of GH motion to 1 degree of scapular motion

72
Q

When does Scapulohumeral Rhythm begin?

A

After the first 30 degrees of shoulder motion

73
Q

At what phase of rehabilitation does Restoration of Functional Motion typically occur?

A

Phase III

74
Q

Which muscle is usually involved with a Bankart Repair?

A

Subscapularis

75
Q

What is the technical term for Frozen Shoulder?

A

Adhesive Capsulitis

76
Q

What are the types of RC repairs?

A

-Arthroscopy
-Mini Open
-Open

77
Q

Is Primary or Secondary Adhesive Capsulitis…
-Idiopathic
-Spontaneous
-Post Menopausal
-Diabetes related

A

Primary

78
Q

Is Primary or Secondary Adhesive Capsulitis…
-Following a trauma

A

Secondary

79
Q

What is the Capsular Pattern?

A

Loss of shoulder ER, then Abduction, then IR

80
Q

What is loss of or a decrease in the capsular pattern indicative of?

A

Adhesive Capsulitis

81
Q

How many phases of Adhesive Capsulitis is there?

A

4

82
Q

Which phase of Adhesive Capsulitis is…
-Adhesions are significant
-Loss of axillary fold
-Maturation phase
-Inferior capsule is extremely tight

A

Phase III

83
Q

Which phase of adhesive Capsulitis is…
-Mild signs and symptoms
-Minimal restriction in ROM
-Preadhesive phase

A

Phase I

84
Q

Which phase of adhesive Capsulitis is…
-Motion is restricted and painful
-Synovitis is present
-Adhesive phase

A

Phase II

85
Q

Which phase of adhesive capsulitis is…
-Range of motion severely restricted
-Axillary fold severely contracted
-Synovitis no longer present

A

Phase IV

86
Q

Which phase of adhesive capsulitis is the most painful?

A

Phase II

87
Q

Which area of the shoulder girdle is most commonly fractured in those under the age of 16?

A

The Clavicle

88
Q

What is a positive Sulcus Sign indicative of?

A

An AC tear

89
Q

Which shoulder ligaments are sprained the most?

A

-Acromioclavicular
-Coracoclavicular

90
Q

Which AC sprain classification is…
-Complete tear AC ligaments
-Complete tear of coracoclavicular ligament
-Marked P!
-Severe limitation of shoulder motion

A

3rd Degree

91
Q

Which AC sprain classification is…
-Complete tear AC ligament
-Partial tear coracoclavicular ligament
-Gap between acromion and clavicle
-P! with elevation and horizontal adduction

A

2nd Degree

92
Q

Which AC sprain classification is…
-Partial tear AC ligament
-No instability
-Minimal functional loss
-Point tenderness over AC joint

A

1st Degree

93
Q

Which stage of injury to the AC ligaments are these rehab goals…
-Gradual restoration of ROM
-Strengthening in pain-free ROM
-Joint accessory motion for restrictions

A

Subacute

94
Q

Which stage of injury to the AC ligaments are these rehab goals…
-Taping to promote correct joint mechanics
-Joint accessory motion
-Progressive restoration of function
-Orthotics during “at-risk” activity

A

Chronic

95
Q

Which stage of injury to the AC ligaments are these rehab goals…
-Manage P! and edema
-P! free ROM
-Avoid elevation >90 degrees and horizontal adduction
-Brace as needed

A

Acute

96
Q

What are the surgical options for AC tear?

A

-Resection of distal clavicle
-ORIF to AC joint

97
Q

Why are Intra vs. Extra-articular joint fractures a cause for rehab concern?

A

Intra-articular fractures do not heal as well as extra-articular fractures

98
Q

Which part of the scapula is most commonly fractured?

A

The body

99
Q

How is the glenoid neck usually fractured?

A

FOOSH

100
Q

How are scapular fractures most commonly treated?

A

A sling and early mobilization (after 1-2 weeks)

101
Q

What is the most common site for clavicular fracture>

A

Mid-clavicle

102
Q

Who Fx’s their clavicles the most?

A

Men <25

103
Q

What type of orthotic is worn for clavicle Fx’s and for how long?

A

Figure 8 harness for 4-6 wks

104
Q

What should shoulder elevation be limited to for 4-6 wks after a clavicle Fx?

A

50/70 degrees

105
Q

What are the four parts of a four part humeral Fx?

A

-Humeral head
-Humeral shaft
-Greater Tuberosity
-Lesser Tuberosity

106
Q

What type of humeral Fx is most common?

A

One-part type

107
Q

Which nerve is most commonly injured in proximal humerus Fx’s and what may this cause?

A

-Axillary
-Lateral deltoid parasthesia

108
Q

What is the most common reason for a Shoulder Arthroplasty?

A

Uncontrolled P! secondary to arthritis in the shoulder

109
Q

What is a Non/Un-constrained TSA?

A

The most common type of shoulder arthroplasty which resembles an actual shoulder joint and provides the greatest ROM

110
Q

What is a Reverse TSA?

A

A type of TSA which reverses the arthrokinematics are the shoulder.
-Used when there is an inability to repair the rotator cuff

111
Q

Which stage of rotator cuff impingement occurs in patients younger than 25 years of age?

A

Type 1

112
Q

Stage III rotator cuff impingement normally affects patients more than ______ years of age.

A

40

113
Q

A reduction in available space in the shoulder is known as…

A

Anatomic Crowding

114
Q

T or F: Active muscle contractions of the deltoid are contraindicated during the prefunctional phase after rotator cuff repair.

A

True

115
Q

What is the name of the medial end of the humerus that articulates with the ulna?

A

Trochlea

116
Q

What is the name of the lateral end of the humerus that articulates with the radius?

A

Capitulum

117
Q

What is the medical term for someone who claims to have golfer’s elbow?

A

Medial Epicondylitis

118
Q

What is it called when the angle of the elbow is increased to wear the forearm points medially?

A

Cubitus varus

119
Q

What kind of joint is the elbow?

A

Hinge

120
Q

What are the 3 main ligaments of the elbow?

A

-LCL (Radial Collateral)
-MCL (Ulnar Collateral)
-Annular Ligament

121
Q

Which muscles flex the elbow?

A

-Biceps
-Brachialis
-Brachioradialis

122
Q

Which nerve innervates the Biceps and Brachialis?

A

Musculotaneous

123
Q

Which nerve innervates the Brachioradialis?

A

Radial

124
Q

Which muscles extend the elbow?

A

-Triceps
-Anconeus

125
Q

Which nerve innervates the Triceps and Anconeus?

A

Radial

126
Q

What are the main differences between Tendinitis and Tendinosis?

A

-Tendinitis only lasts for <2 wks and heals in 4-6 weeks
-Tendinosis lasts for 6-10 weeks and heals in 3-6 mnths

127
Q

What is the prognosis for full recovery of Tendinitis?

A

90%

128
Q

What is the prognosis for full recovery of Tendinosis?

A

80%

129
Q

These are the mechanisms of which injury?
-Repetitive stress/microtrauma
-Extensor carpi radialis brevis
-Hyperpronation
-Excessive wrist extension

A

Tennis Elbow

130
Q

Is Transverse Friction a better Tx for Tendinitis or Tendinosis?

A

Tendinosis: to realign fibers

131
Q

Which type of contraction is best for treating epicondylitis?

A

Eccentric

132
Q

Does Medial or Lateral Epicondylitis occur more frequently?

A

Lateral

133
Q

Which injury is described by…
-Transverse fracture
-Caused usually by trauma
-Most common in children
-Risk of Volkmann’s ischemic contracture

A

Supracondylar Fx

134
Q

What is a Volkmann’s ischemic contracture?

A

A contracture causing vascular compromise/obstruction to the supracondylar region of the elbow

135
Q

Describe a Type I Supracondylar Fx and what causes it.

A

-Distal humerus displaced posteriorly
-FOOSH

136
Q

Describe a Type II Supracondylar Fx and what causes it.

A

-Distal humerus displaced anteriorly
-Direct trauma to posterior elbow

137
Q

Is Type I or Type II Supracondylar Fx most common?

A

Type I

138
Q

Which kind of elbow fracture is the most common in adults and accounts for 1/3 of all elbow fractures?

A

Radial Head Fx

139
Q

What causes a Radial Head Fx?

A

FOOSH

140
Q

What accounts for 20% of all elbow trauma?

A

Radial Head Fx

141
Q

Which type of Radial Head Fx is non-displaced?

A

Type I

142
Q

Which type of Radial Head Fx is a marginal Fx with displacement?

A

Type II

143
Q

Which type of Radial Head Fx is a comminuted Fx of head?

A

Type III

144
Q

Which type of Radial Head Fx is any Fx with elbow dislocation?

A

Type IV

145
Q

Which type of Radial Head Fx is immobilized short term and doesn’t require surgery?

A

Type I

146
Q

Which type of Radial Head Fx requires surgery?

A

Types II, III, IV

147
Q

During the US Open, which most likely diagnosis would you expect those particular athletes to be treated for when off the courts?

A

Lateral epicondylitis

148
Q

You are treating a patient with a diagnosis of epicondylitis and the PT POC indicates a prognosis for full recovery is expected in 3-6 months. This information helps you to realize you are dealing with…

A

Tendinosis

149
Q

What is the most common Tx for supracondylar Fx’s?

A

Closed reduction and immobilization for 4-6 wks

150
Q

What is normal elbow ROM?

A

0-145 degrees

151
Q

T or F: In severe cases of tennis elbow, the use of a wrist cock-up splint is advocated for the management of inflamed wrist extensor tendons.

A

T

152
Q

T of F: During the subacute recovery phase of rehabilitation for lateral epicondylitis, initial instruction for patients to perform forearm pronation and supination must include the use of a hammer while holding the end of the shaft away from the head of the hammer.

A

F

153
Q

T or F: Passive stretching is advocated during the early recovery phase of healing after supracondylar fractures.

A

F

154
Q

T or F: A type IV intercondylar fracture, which is severely comminuted with significant separation, always is treated with an ORIF procedure

A

F

155
Q

T or F: Displaced or comminuted fractures of the olecranon can be treated with an ORIF procedure or, in cases of severely comminuted fractures, excision of up to 80% of the olecranon

A

T

PTA 201 (5 decks)

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