Lecture 5- Surgery of the Shoulder

Question 1

what are the common shoulder symptoms?

Answer 1

Pain
Stiffness
Weakness
Instability

Question 2

Why is the shoulder prone to injuries?

Answer 2

-Inherently unstable joint

Question 3

What makes the glenohumeral joint to be stable?

Answer 3

• Rotator cuff muscle

- Capsule and Labrum

Question 4

Name the 4 rotator cuff muscles?

Answer 4

• Supraspinatous muscle
• Infraspinatous muscle
• Subscapularis muscle
• Teres minor

Question 5

what force does the following muscle produce on the GHJ?

Answer 5

Deltoid: upward
Supraspinatous: medial force
Subscapularis and infraspinatus: Lateral force

Question 6

what are the function of the rotator cuff muscles?

Answer 6

stabilises GHJ

-Provides a FULCRUM for power muscles to move the arm

Question 7

What are the power muscles that enable the arm to move?

Answer 7

Deltoid
Pec major
Trapezius
Lat dorsi
Teres Major

Question 8

which are the superficial power muscles of GHJ?

Answer 8

• Deltoid
• Pec Major
• Serratour anterior

Question 9

What are the risk factors for shoulder pian?

Answer 9

• Sports related injuries
• Traumatic injuries
• Degenerative conditions
• Work related conditions

Question 10

What are the causes of shoulder pain?

Answer 10

Subacromian problem:

1) Acromoin joint arthritis
2) Rotator cuff tear
3) Calcific tendonitis

Question 11

What is subacromial impingement?

Answer 11

common injury
pain on abduction & rotation of arm
Felt over deltoid

Question 12

What are the causes subacromial impingement?

Answer 12

-Extrinsic: bony spurs

Intrinsic: Tendinopathy/cuff weakness

Question 13

Name the three rotator cuff disorders?

Answer 13

• subacromial impingement
• Rotator cuff tears
• Calcific tendinitis

Question 14

what are the treatments for rotator cuff disorders?

Answer 14

Non-surgical

1) activity modification
2) Physiotherapy

Surgical:

1) Subacromial decompression
2) Debridement of bony and soft tissue impinging area

Question 15

what are the causes of rotator cuff tears?

Answer 15

• tears: supraspinatus and infraspinatus
  causing: weakness and pain
• tendon degeneration is normal
• Repair if symptomatic

Question 16

what are GHJ problems?

Answer 16

• Osteoarthritis
• Frozen shoulder
• Instability

Question 17

Name the glenohumeral arthritis?

Answer 17

• Osteoarthritis
• RA
• Post traumatic arthritis

Question 18

what are the symptoms of arthritis?

Answer 18

• stiffness
• crepitus and grinding
• pain at rest and at night
• pain with activity

Question 19

What are the symptoms of frozen shoulder?

Answer 19

• Stiffness and pain
• Loss of passive motion (external rotation)
• X-ray normal

Question 20

who is most likely to affected by frozen shoulder?

Answer 20

40-60 years old
female
diabetic

Question 21

What are the treatment options for frozen shoulder?

Answer 21

Non- surgical: natural history to resolve over 2 years
-Injections
-Hydrodilatation
Surgical:
-Capsular release and manipulation

Question 22

What are the risk factors for shoulder instability?

Answer 22

• Collision sport

- Hyperlaxity

Question 23

what are the surgical treatment options for the frozen shoulder?

Answer 23

• Arthroscopic stabilisation - labral repair
• Open stabilisation: capsule tightening
• Bony procedures: augmenting glenoid

Question 24

what are the traumatic shoulder conditions?

Answer 24

• Bony trauma
  1) fractures
  2) dislocations

Soft tissue trauma

1) bicep problems
2) pec major rupture

Question 25

Name some of the shoulder fractures?

Answer 25

• Proximal humeral fractures

- Acromioclavicular Joint Dislocations