Injuries to the Shoulder Complex Flashcards

1
Q

Anteriorly directed force or Direct blow;
Falling on an outstretched arm;
Displacement usually upward and anterior.

A

SC Joint Sprain

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2
Q

Pain
point tender
disability
no joint deformity

A

Grade I SC Joint Sprain

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3
Q

Pain
Point tender
pain with abduction and bringing arm across the chest (horizontal adduction)
Visible deformity

A

Grade II SC Joint Sprain

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4
Q

pain;
point tender;
disability
swelling;
Gross deformity;

A

Grade III SC Joint Sprain

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5
Q

PRICEMM;
immobilize;
x-ray;
refer to MD

A

SC Joint Sprain TX

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6
Q

Relatively rare injury with the displacement usually being upward and anterior.

If you have a posterior displacement, there are concerns with vascular or respiratory impairment.

A

SC Joint Sprain

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7
Q

SC joint stands for

A

Sternoclavicular Joint

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8
Q

“Separated shoulder”

very common in sports

A

AC Joint Sprain DEF

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9
Q

AC stands for

A

Acromioclavicular Joint

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10
Q

Direct blow to the tip of the shoulder
falling on an outstretched arm causing an upward force along the long axis of the humerus

i.e. Romo & Garoppolo

A

AC Joint Sprain MOI

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11
Q

Mild stretch of AC ligament;
pain;
point tender;
swelling,
discomfort during movement;
no joint deformity

A

Grade I AC Joint Sprain

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12
Q

Rupture of the superior/inferior AC ligaments
Stretch of CC ligaments;
pain;
pain with abduction and horizontal adduction
point tender;
swelling;
some deformity;

A

Grade II AC Joint Sprain

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13
Q

Rupture both AC and CC ligaments;
gross deformity with prominence of outer clavicular head; pain;
point tender;
loss of movement;
instability

A

Grade III AC Joint Sprain

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14
Q

PRICEMM;
immobilize;
x-rays;
refer to MD (conservative versus surgery approach)

A

AC Joint Sprain TX

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15
Q

3 DIAG tests for AC Joint Sprain

A

Piano Key Sign
Shear Test
Compression Test

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16
Q

“Dislocated Shoulder;”

accounts for up to 50% of all dislocations;

85%-90% will reoccur when caused by direct trauma;

anterior dislocation are the most common although posterior and inferior dislocations occur.

A

GH Joint DEF

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17
Q

direct blow;
indirect force with arm abducted and externally rotated

A

Anterior dislocation of GH Joint MOI

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18
Q

direct blow; falling on an outstretched arm that is internally rotated

A

Posterior dislocation of GH Joint MOI

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19
Q

Pain;
obvious deformity (if still out);
loss of function;
swelling

A

S/S of GH Joint

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20
Q

Check distal pulse and circulation;
PRICEMM;
immobilization;
refer to MD (possible reduction)

Anterior dislocations: may recover with proper rehab after first time but may require surgery once they become recurrent.

Posterior dislocations: surgery often required after first episode

A

GH Joint TX

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21
Q

may recover with proper rehab after first time but may require surgery once they become recurrent.

A

GH Joint Anterior Dislocation TX

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22
Q

surgery often required after first episode

A

GH Joint posterior
Dislocation TX

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23
Q

6 DIAG of GH Joint

A
  1. Apprehension Test
  2. Sulcus Sign
  3. Clunk Test
  4. Anterior/Posterior Drawer Test
  5. Relocation Test (Fowler or Jobe)
  6. Feagin Test (Inferior Drawer Test)
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24
Q

6 Associated Conditions of GH Joint

A
  1. Vascular injury Brachial plexus injury
  2. Capsular injury
  3. Glenoid labrum tear (Bankhart lesion; SLAPlesion)
  4. Rotator cuff tear or
  5. avulsion fracture
  6. Fractures (Hill-Sacks lesion)
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25
Q

Affects the subdeltoid or the subacromial bursa**

A

Bursitis DEF

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26
Q

Overuse; direct blow

A

bursitis moi

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27
Q

Pain; point tender;
loss of function;
weakness;
aching pain at rest

A

bursitis s/s

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28
Q

PRICEMM;
NSAID’s

A

bursitis tx

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29
Q

Bursitis DIAG Test

A

Apley’s Scratch Test

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30
Q

Most often involves the supraspinatus

A

Rotator Cuff Strains

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31
Q

Acute (single trauma) or repetitive trauma

most often associated with overhead throwing

A

Rotator Cuff Strain MOI

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32
Q

Pain that increases with activity;
point tender;
loss of function;
loss of ROM;
pain on abduction, ER, and flexion of the shoulder;
loss of strength;
possibly radiating pain

A

Rotator Cuff Strain S/S

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33
Q

PRICEMM;
refer to MD;
appropriate rehab;
gradual return back into activity;
possible surgery

A

Rotator Cuff Strain TX

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34
Q

2 Rotator Cuff Strain DIAG Test

A

Drop Arm test
Empty Can test

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35
Q

Impingement Syndrome Point 1
Injuries involving the soft tissue comprising the subacromial space

A

supraspinatus
biceps tendons
subacromial bursa

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36
Q

Impingement Syndrome is caused by

A

a repetitive use of the arm above the horizontal level
(overuse)

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37
Q

Impingement Syndrome produces a

A

progressive degenerative change

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38
Q

Impingment Syndrome often begins as

A

tendinitis (esp. suprapinatus)

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39
Q

Produces edema and hemorrhage

A

Stage 1 of Impingement Syndrome

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40
Q

Thickening and fibrosis (shortening) of soft tissue

A

Stage 2 of impingement Syndrome

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41
Q

Muscle defect of less than 1 centimeter and possible partial muscle tear

A

Stage 3 of impingement Syndrome

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42
Q

Muscle defect of more than 1 centimeter and possible degeneration of the clavicle

A

Stage 4 of impingement Syndrome

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43
Q

Pain is biggest symptom (initially a dull ache that progresses to discomfort during activity)

A

Impingement Syndrome

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43
Q

Pain is biggest symptom (initially a dull ache that progresses to discomfort during activity)

A

Impingement Syndrome

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44
Q

less than 25 impingement syndrome

A

athletes

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45
Q

25-40 impingement syndrome

A

weekend athletes

46
Q

over the age of 40 impingement syndrome

A

workers

47
Q

Impingement Syndrome prevention includes

A

proper coaching
stretching and strengthening

48
Q

Impingement Syndrome Management includes:

A

PRICEMM initially with appropriate rehab.
May require surgery in later stages

49
Q

High School Pitch Count (Grades 9 through 12):
0-30 pitches

A

0 rest days

50
Q

High School Pitch Count
31-45 pitches

A

1 rest day

51
Q

High School Pitch Count
46-65 pitches

A

2 rest days

52
Q

High School Pitch Count
66-85 pitches

A

3 rest days

53
Q

High School Pitch Count
86-110 pitches

A

4 rest days

54
Q

0-20 pitches 0 days rest
21- 35 pitches 1 day rest
36 - 50 pitches 2 days rest
51 – 65 pitches 3 days rest
66 - 85 pitches 4 days rest

A

Junior High Pitch Count (Grade 7&8)

55
Q

Impingement Syndrome 3 DIAG

A

Active Impingement
Neer’s Sign
Hawkins (Hawkins-Kennedy)

56
Q

subacromial impingement DIAG

A

Neer’s Sign

57
Q

tests for supraspinatus tendon impingement

A

Hawkins (Hawkins-Kennedy)

58
Q

Overuse injuries are common in those who perform repetitive overhead activities.

Injuries will vary according to which phase they occur in (cocking, acceleration, or deceleration phase)

A

Throwing Injuries

59
Q

Anterior shoulder pain due to a strain or inflammation to any of the internal rotators

A

cocking phase of throwing injuries

60
Q

Strain or inflammation of internal rotators

Synovitis of the SC or AC joint

“Little Leaguer’s Shoulder:” stress fracture to the proximal humeral epiphysis

Spontaneous fractures of the proximal humerus

A

Acceleration phase of throwing injuries

61
Q

stress fracture to the proximal humeral epiphysis

occurs in the acceleration phase of throwing injuries

A

“Little Leaguer’s Shoulder:”

62
Q

Impingement syndrome
Rotator cuff strains

A

deceleration phase of throwing injuries

63
Q

“Winging of the scapula”

A

Long thoracic nerve injury

64
Q

long thoracic nerve injury results in general weakness of what muscle

A

serratus anterior muscle

65
Q

which is worse bilateral or unilateral long thoracic nerve injury

A

unilateral

66
Q

Long Thoracic Nerve Injury moi

A

Indirect or direct trauma; overuse

67
Q

Protrusion of the scapula posteriorly

A

Long thoracic nerve injury s/s

68
Q

Long Thoracic nerve injury DIAG

A

Scapular protraction test

69
Q

“Burner or stinger”

A

Brachial Plexus Injury

70
Q

Forced lateral flexion of the neck with the opposite shoulder depressed

A

Brachial Plexus Injury MOI

71
Q

Transitory paralysis of arm with a numbing or tingling sensation

A

Brachial Plexus Injury S/S

72
Q

TX of brachial plexus injury s/s

A

PRICEMM

73
Q

Brachial Plexus Injury DIAG

A

Spurling’s maneuver

74
Q

% of clavicle fracture that occur in the middle

A

80%

75
Q

15% of clavicle injuries occur in outer third

A

15%

76
Q

% of clavicle injuries occur inner third of clavicle
major issues esp. if backwards

A

5%

77
Q

Direct blow; falling on an outstretched arm (Romo)

A

Clavicle Fracture MOI

78
Q

Pain;
point tender;
loss of function;
deformity;
localized swelling

A

Clavicle Fracture s/s

79
Q

Immobilize; ice; refer to MD

A

Clavicle Fracture TX

80
Q

Rare injury in sports

A

Scapular Fractures

81
Q

Direct blow; fall on an outstretched arm; direct trauma

A

Scapular Fracture MOI

82
Q

Pain;
point tender;
loss of function;
possible deformity;
swelling;
holds arm to the side

A

Scapular Fracture S/S

83
Q

Immobilize; ice; refer to MD

A

Scapular Fracture TX

84
Q

Upper arm contusions involve what 3 muscles

A

biceps
deltoid
triceps

85
Q

What nerve is affected by upper arm contusions resulting in temporary paralysis

A

radial nerve

86
Q

Treat like any other bruise but be aware of the possible development of myositis ossificans

A

upper arm contusions

87
Q

Irritation of biceps tendon in the bicipital groove

A

Bicipital Tendonitis DEF

88
Q

Overuse activity (throwing motion)

A

Bicipital Tendonitis MOI

89
Q

Pain; point tender; loss of function; swelling; inflammation

A

S/S of Bicipital Tendonitis

90
Q

PRICEMM; NSAID’s; strengthening

A

TX of Bicipital Tendonitis

91
Q

Bicipital Tendonitis DIAG

A

Speed’s Test

92
Q

Degeneration or tear of transverse ligament that holds the long head of the biceps tendon in place

A

Subluxation of Biceps Tendon DEF

93
Q

Chronic biceps tendinitis; acute tear

A

Subluxation of Biceps Tendon MOI

94
Q

Pain; point tender; snapping sensation

A

Subluxation of Biceps Tendon S/S

95
Q

PRICEMM; refer to MD for possible surgery

A

Subluxation of Biceps Tendon TX

96
Q

Subluxation of Biceps Tendon DIAG

A

Yergason test

97
Q

Degeneration or violent contraction against firm resistance; Strong contraction

A

Biceps Brachii Rupture MOI

98
Q

Pain; point tender; protruding bulge (long head);
loss of strength

A

Biceps Brachii Rupture S/S

99
Q

PRICEMM; refer to MD

A

Biceps Brachii Rupture TX

100
Q

Biceps Brachii Rupture DIAG

A

Ludington’s test (long head)

101
Q

Direct blow; indirect trauma; falling on an outstretched hand

A

Humerus MOI

102
Q

Sudden pain; point tender; loss of function; deformity

A

humerus fracture s/s

103
Q

Immobilize;
refer to MD
(radial nerve resulting in wrist drop or inability to perform supination)

A

humerus fracture TX

104
Q

labrum is intact but evidence of fraying/degeneration

A

SLAP Lesion of GH Joint Type 1

105
Q

Detachment of superior labrum & long head of tendon of biceps from glenoid rim

A

SLAP Lesion of GH Joint Type 2

106
Q

Superior Labrum torn & long head tendon intact

A

SLAP Lesion of GH Joint Type 3

107
Q

Tear in superior labrum & long head tendon intact

A

SLAP Lesion of GH Joint Type 4

108
Q

JH pitch count (7&8)
0-20 pitches

A

0 days rest

109
Q

JH pitch count
21- 35 pitches

A

1 day rest

110
Q

JH pitch count
36 - 50 pitches

A

2-day rest

111
Q

JH pitch count
51 – 65 pitches

A

3 days rest

112
Q

JH pitch count
66 - 85 pitches

A

4 days rest

113
Q

Big phase
large muscles are dominating the muscles in the back

A

Deceleration phase of throwing injuries