Exam 3: Rotator Cuff Tears

Question 1

A Rotator Cuff tear occurs where?

Answer 1

near the insertion on the greater tuberosity

Question 2

What is the primary mechanism of RC tears?

Answer 2

acute trauma or chronic impingement

Question 3

Impingement of the cuff against the _ in a sudden _ movement without proper _ of the humeral head

Answer 3

acromion; abduction; ER

Question 4

What movements are weak with a RC tear?

Answer 4

abduction and ER

Question 5

Patients with a RC tear will have difficulty _ movement

Answer 5

initiating

Question 6

With a complete RC tear you will see loss of _

Answer 6

abduction (and/or ER)

Question 7

Which type of diagnosis has the highest specificity?

Answer 7

MRI

Question 8

What two types of surgeries an be done for partial thickness tears?

Answer 8

arthroscopic debridement and acomioplasty

Question 9

Prognosis of a full thickness tear depends on _ and _ of the tear

Answer 9

history and size

Question 10

Repair of a full thickness tear is warranted if _ and _ are prime objectives

Answer 10

strength and function

Question 11

What factors play into decision making for a full thickness tear?

Answer 11

severity and duration of symptoms
functional limitations
patient demands and expectations
tear size and location

Question 12

This type of RC repair is when they detach the deltoid off the acromion to repair the tear

Answer 12

Open repair

Question 13

This type of RC repair is when they split along the lines of the fibers of the deltoid to repair the tear

Answer 13

mini-open or mini-cuff repair

Question 14

This type of RC repair is when sutures are passed through the cuff before the deltoid is split to repair the tendon to bone

Answer 14

arthroscopic assisted

Question 15

This type of RC repair is when the repair is performed totally arthroscopically

Answer 15

arthroscopic repair

Question 16

Which type of arthroscopic has a steep learning curve but less morbidity with quicker recovery and cosmesis

Answer 16

Arthroscopic SAD

Question 17

Minor tears may be treated as for _

Answer 17

tendinitis

Question 18

Partial tears do not _ and may need _

Answer 18

heal, surgery

Question 19

Full active _ shoulder _ and _ should not be initiated until 6-8 weeks after surgery

Answer 19

overhead shoulder flexion and abduction

Question 20

What is seen with a degenerative RC disease?

Answer 20

painful arc
reduced ROM (abd, ER, ext, hand behind back) 
reversed scapula-humeral rhythm 
pain and weakness with resistance 
tenderness on palpation

Question 21

When should a total shoulder replacement be done?

Answer 21

with shoulder joint pain from destructive arthritis secondary to OA, RA, or traumatic arthritis
avascular necrosis
severe loss of UE strength
limitations of ADL

Question 22

What position should the shoulder be held in post total shoulder?

Answer 22

adduction, IR and slight flexion

Question 23

When can AAROM be progressed to AROM with a total shoulder?

Answer 23

mod protection (3-6 weeks)

Question 24

ER can be done in moderate protection with _ of abduction and flexion

Answer 24

0