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DPT MSK - fall 22 > Impingement Syndrome & Tendons - Exam 3 > Flashcards

Impingement Syndrome & Tendons - Exam 3 Flashcards

1
Q

Subacromial Pain Syndrome aka (SAPS)
-a _______ of symptoms
-_____ % of all shoulder complaints

A

cluster
44-65%

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2
Q

Pathomechanics #1:
The sub and coracoacromial space gets compromised resulting in

A

impingement or compression of tendons

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3
Q

Pathomechanics #2:
Increases _______ on tendons when loaded and as they wrap the bone resulting in _______

A

tension; compression

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4
Q

What is the most common structure involved in Impingement Syndrome?

A

supraspinatus tendon

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5
Q

Impingement Syndrome:
Supraspinatus Tendon may ______ tear and limited vascularity in distal part affects _______
-tendinitis or tendinopathy?

A

gradually; healing
tendinopathy

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5
Q

What is another tendon that is likely involved in impingement syndrome?
-tendinitis or tendinopathy?

A

biceps tendon - long head
tendinopathy

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6
Q

Labrum may gradually tear in impingement syndrome and subacromial bursa will lead to bursitis? T or F

A

True

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7
Q
  1. With impingement syndrome, you are more likely to see what type of motion?

-Trauma with _________ changes
-_______________
–muscle/capusule shortening
–muscle inhibition

A
  1. limited motion - hypomobility

-fibrotic capsular
-disuse/immobilization

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8
Q

________ leads to shortened IRs/ant. capsule tightness and limits ER

A

persistent FHP

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9
Q

Insufficient motion by shoulder mm. due to cervical dysfunction is known as:

A

regional interdependence

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10
Q

With an impingement syndrome, you may get _____ or _____ of the acromion

A

spurring or hooking

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11
Q
  1. What are the SECONDARY etiologies/pathomechanics of impingement syndrome?

-trauma or ________ jt. hypomobility resulting in _____
-disuse/immobilization
–mm. _______
–limiting _______

A
  1. excessive motion - hypermobility

adjacent joint ; laxity
–muscle inhibition
–limiting stabilization

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12
Q

Regional Interdependence of SECONDARY etiologies/pathomechanics impingement syndrome?
-_______ shoulder stabilization
-________ impairment greatest at __________
-_________ > ___________ so emphasize _________

A

-insufficient
-proprioceptive ; higher elevation
-kinesthetic impairment > proprioceptive impairment; coordination

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13
Q

What is an example of primary and secondary impingement syndrome etiologies and pathomechanics?

A

Scapular hypomobility and GH hypermobility

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14
Q

______ impingement is MORE common in overhead athletes
-_____ ROM and _________ glide typically excessive
- location on labrum?

A

posterior superior glenoid impingement (PSGI)
-ER ROM; anterior GH glide
-superior glenoid on labrum

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15
Q

P! is typically _______ to ______ and referred into ______ and _______ with impingement syndrome

A

localized; tip of shoulder; lateral shoulder and arm

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16
Q

Pt. with impinging symptoms may include P! and/or limitation with:

A

elevation
lifting/pushing/pressing activities
reaching behind back

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17
Q

Nociplastic P! may develop with impingement syndrome. T or F?

A

True

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18
Q

Impingement Syndrome Signs Observation:
-possible ________ compensation for _________ restrictions
-_________ elevation
-inconsistent w/_________

A

Scapular compensation; GH
-increased
-upward rotation

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19
Q

Symptom alteration tests are unreliable with scapula? T or F

A

false; reliable

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20
Q

What are the 3 Scapular Alteration Test and others?
-details?

A

Scapular Assistance Test (SAT) - passive upward rot.
Scapular Repositioning Test- passive upward rot and pos. tilt
Scapular Retraction Test- voluntary retraction
Taping for LT assistance- reminder (short-term benefit)

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21
Q

Impingement syndrome: Function
-limited and P!ful when:

A

limited and P!ful reaching overhead and behind the back, and with lifting

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22
Q

Impingement syndrome: ROM
-most often limited and P!ful into:
-Post shd P! with ER indicates _________

A

flexion, abduction, external rotation, IR (maybe)
posterior impingement

23
Q

Resisted/MMT of impingement syndrome not ______ enough but will show

A

specific; inhibited scapular and RC muscles

24
Q

Proprioceptive impairment is greatest when?

A

at higher elevations

25
Q

The primary type of impingement regarding the joints is_________
-particularly______________

-________ is secondary type

A

limited motion/ hypomobile;
-post shoulder tightness w/ limited post glide

-hypermobility

26
Q

Limited ROM ALWAYS indicates limited accessory motion T or F

A

false

27
Q

What are the 3 specials tests for impingement syndrome?

A

GH IR deficit (GIRD) ratio
Infraspinatus or ER test in 0º abduction
IR resisted Strength Test

28
Q

Which of the following impingement special test is being described:
-IR/ER at 90º abd >1
-ER typically increases as IR decreases in overhead athletes
-Infucleneces humeral head position on glenoid

A

Glenohumeral IR deficit ratio (GIRD)

29
Q

Which of the following impingement special test is being described:
-ER in 0º abd —> P!ful or giving away
-high specificity

A

Infraspinatus or ER test in 0º

30
Q

Which of the following impingement special test is being described:
-IR weaker than ER @90º abd

A

IR resisted Strength Test

31
Q

Rotator Cuff pathology related to age- MOST affected and LEAST affected?

A

oldest age group 78% ; youngest age 32%

32
Q

RC pathology IS associated with impingement symptoms? T or F?

A

False

33
Q

You should not be misled by imaging (MRI):
14 _______ professional pitchers
______ years of age
____% had RC and labral changes

A

asymptomatic
18-22
80%

  • you can have changes without symptoms
34
Q

What are the characteristics of a tendon? (4)

A

type I collagen
low elastin
fibrocytes
parallel fibers for more unidirectional loads

35
Q

Tendons resist _____ and releases energy with _____

A

tension; muscle actions

36
Q

Tendon:
More _______ = better ________

A

stiffness = better force transmission or storying of potential energy

37
Q

The mid-portion of the tendon is

A

hypovascular and hyponeural

38
Q

The insertion portion of the tendon is

A

hypervascular and hyper neural

39
Q

Tendinopathy prevalence:
______% of general MSK injuries
______% of sports injuries

A

30%
30-50%

40
Q

Tendinitis is common. T or F

A

False

41
Q

Inflammation of a tendon without structural change due to overuse is better known as_________

A

tendinitis

42
Q

What are S&S of tendinitis:

A

-a typically acute and classic presentation
-TTP
-P! and limiting with lengthening
-P! with resisted testing/MMT, particularly in lengthened position- may be weak

  • tendon doesn’t like to be lengthened or used/resisted
43
Q

Tendinosis is the MOST common tendinopathy. T or F

A

True

44
Q

Degenerative changes with some inflammation due to:
-repetitive stress and tendinitis
-impingement pathomechanics
-neural/vascular insufficiency
-exercise-induced hyperthermia
-older age
-hormonal fluctuations

A

tendinosis

45
Q

If tendinosis is acute ________ S&S are present

A

tendinitis

46
Q

What are the symptoms of tendinosis: (2)
-often mislabeled as ________

A

persistent (> 4-6 weeks) often with previously fail PT
decreasing tendon tolerances
-often mislabeled as tendinitis and treated as such

47
Q

Signs of tendinosis:
observation:
ROM:

A

enlarged tendon if superficial
possibly P! and limitation with lengthening if aggravated but may be WNL

48
Q

Signs of Tendinosis:
Resisted testing/MMT

A

possible P! and weakness, lengthened position if aggravated, but may be strong and P!-less

49
Q

Tendinosis special test will be:
Palpation and Pathogenesis:
-localized TTP with _________ P! thresholds
-________in growth of vessels and nerves
-________ P! neurotransmitters

A

(+) specific to region/tendon
-decreased
-Increased
-Elevated

50
Q

Tendonosis has little to no ___________ and fibers changes can be seen on ________

A

inflammation; imagning

51
Q

Tendinosis Pathogenesis:
________ and _________may be present prior to tendinosis symptoms
_____ and _____ likelihood of overload
_______ non-collagen matrix
______infiltration

A

degeneration and disorganization
weakened; greater
increased
fatty

52
Q

Acute tendon tear is common. T or F
_______and ______ forces during fast eccentric loading
Acute tendon tear more likely with ________ & ________
Elastin and vascularity _______
Shorter smaller tendon less _______ and ________

A

False; rare
higher; oblique
Age and disuse
decrease
pliable and durable

53
Q

Tendinitis primarily resolution of _________; at most in _________

A

inflammation; 4-6 weeks

54
Q

Tendinosis and Tears:
-primarily __________
-tensile strength initially improves at ________
-even greater tensile strength when ___________ in at_________

A

proliferating tendon
3-5 wks.
dense fibrous tissue; 8-12 wks.

55
Q

Partial tears and full tears of tendons can be improved with PT? T or F.

A

False: full tear requires Sx

DPT MSK - fall 22 (18 decks)

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