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CATA 337 - fall 2022 > Lecture 7 - Shoulder ax > Flashcards

Lecture 7 - Shoulder ax Flashcards

1
Q

Type of joint at shoulder

A

Multiaxial ball and socket synovial joint

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2
Q

At the shoulder, you sacrifice __ to gain __ compared to the hip which is a deeper joint

A

Stability for mobility

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3
Q

GH joint - resting position + close packed position + capsular pattern

A

rest. pos = 40-55d ABD, 30d horiz ADD (scapular plane)
close packed = full ABD + lat rot
capsular pattern = ext rot, ABD, int rot

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4
Q

Shoulder is a shallow socket, what increases it?

A

Labrum by 50%

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5
Q

Type of joint for AC joint

A

Plane synovial joint

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6
Q

Purpose of AC joint

A

Augments the ROM of the humerus in the glenoid

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7
Q

AC joint - resting position, close packed position, capsular pattern

A

rest pos = arm resting by side
close packed = 90 ABD
capsular patt = pain at extremes of ROM (hor add + full elevation)

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8
Q

Role of SC joint

A

along with AC joint, enables the humerus in the glenoid to move through a full 180d of ABD

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9
Q

Mvt of SC - horizontal ABD

A

Moves forward

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10
Q

Mvt of SC - shoulder depression

A

Moves superior

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11
Q

Mvt of SC - Horizontal ADD

A

Moves posterior

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12
Q

SC joint - resting position, close packed position, capsular pattern

A

rest pos = arm resting by side
close packed = full elevation + protraction
capsular pattern = pain at extremes of ROM (horiz ADD + full elevation)

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13
Q

No capsular pattern
Is a stable base for the RC
20-30d forward of sagittal plane

A

Scapulothoracic

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14
Q

Scapulothoracic rhythm
at 0-30d
at 30-90d
at more than 90d

A

should have no scapular mvt
2:1
1:1

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15
Q

Special thing to check in posture anterior view at shoulder

A

Head and neck are in the midline of the body and observe their relation to the shoulders

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16
Q

In most people, dominant shoulder is __ than the nondominant side

A

lower

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17
Q

Injured shoulder, when protecting/guarding, will be __ than the other side

A

Higher

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18
Q

What to note in posterior view of shoulder (4)

A
  • Scapular dyskinesia
  • Primary scapular winging
  • Secondary scapular winging
  • Dynamic scapular winging
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19
Q

Scapular dysfunction - type 1

A
  • Inferior medial border being prominent at rest
  • Inferior angle tilts dorsally with movement (scapular tilt)
  • Acromion tilts anteriorly over the top of the thorax
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20
Q

Type 1 scap dysk. indicates what

A

Presence of weak muscles or tight pecs pulling or tilting the scapula forward

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21
Q

Scapular dysfunction - Type 2

A
  • Classic winging, whole medial border
  • Prominent, lifting from the posterior chest wall
  • Statically and dynamically
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22
Q

Type 2 scap dysk. indicates what

A

Presence of SLAP lesion
Weakness of SA, Rhomb, UFT/MFT/LFT, long thoracic n. problem, or tight RC

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23
Q

Scapular dysfunction - Type 3

A
  • Superior border elevated at rest and during movement
  • Minimal winging
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24
Q

Type 3 scap dysk. indicates what?

A

Over activity of letavor scapulae and UFT
Imbalances in UFT/LFT force couple
Impingement and RC lesions

25
Q

Scapular dysfunction - Type 4

A
  • Symmetrical scapulae
  • Rotatory winging (inferior angles rotating laterally)
26
Q

Type 4 scap dysk. indicates what?

A

during movement and may indicate the scapular control muscles are not stabilizing the scapula (WHAT YOU WANT- but could be both not normal even though they both move symmetrically)

27
Q

Primary scapular winging

A

Due to muscle weakness of one of the scapular muscle stabilizers

28
Q

Secondary scapular winging

A

Normal movement of scapula is altered because of pathology in glenohumeral joint

29
Q

Dynamic scapular winging

A

may be due to lesion of the long thoracic nerve affecting serratus anterior, trapezius palsy (spinal accessory nerve), rhomboid weakness, multidirectional instability, voluntary action, or a painful shoulder resulting in splinting of the glenohumeral joint, which in turn causes reverse scapulohumeral rhythm

30
Q

4 causes of scapular dyskinesia

A
  • Bony
  • Joint
  • Soft tissue
  • Neurological
31
Q

Scapular dyskinesia - bony

A

thoracic kyphosis
clavicular fracture or malunion

32
Q

Scapular dyskinesia - Joint

A

AC instability/arthrosis
GH internal derangement

33
Q

Scapular dyskinesia - Neurological

A

Cervical radiculopathy
Long thoracic n. palsy
Spinal accessory n. palsy

34
Q

Scapular dyskinesia - soft tissue

A
  • intrinsic m. pathology
  • hypomobility
  • GH int. rot deficit
  • altered m. activation patterns
35
Q

What is the popeye sign

A

Bicep long head tendon rupture

36
Q

What is the lennie test

A

Measure the distance between scapula and compare dominant vs nondominant side

37
Q

See slide 47 for abnormal active ROM

A

4 causes

38
Q

What is GERG and GIRD

A

Glenohumeral external rotation gain
Glenohumeral internal rotation deficit

39
Q

If GIRD/GERG ratio is >1

A

Patient will probably develop shoulder problems

40
Q

What is snapping scapula

A

Comes from the scapular retraction/protraction cycle
Caused by the scapular rubbing over the underlying ribs

41
Q

Explain apley’s scratch test

A

Med rot + adduction
Lat rot + abduction

42
Q

Functional ADLs at shoulder

A

Brush teeth
Brush hair
Tuck in shirt
Reach to shelf
Sport-specific movts

43
Q

Define characteristics of laxity

A

Nonpathological “looseness”
Greater ROM in one or more directions
SHD complex functions normally
Found bilaterally

44
Q

Define characteristics of instability

A

Inability to control or stabilize a joint
Dynamic or static
Static restraints have been injured
Weak muscles or unbalanced force couples

45
Q

Anatomical instability

A

Static restraints have been injured

46
Q

Translational instability

A

Weak muscles or unbalanced force couples

47
Q

2 types of sh instabilities

A

TUBS or AMBRI

48
Q

TUBS

A

Traumatic, unidirectional, Bankart, SLAP
Surgery required

49
Q

AMBRI

A

Autraumatic, multidirectional, bilateral, rehabilitation/inferior capsular shift

50
Q

Jobe classification - Grade 1

A

Pure impingement with no instability (often seen in older patients)

51
Q

Jobe classification - Grade 2

A

Secondary impingement and instability caused by chronic capsular and labral microtrauma

52
Q

Jobe classification - Grade 3

A

Secondary impingement and instability caused by generalized hypermobility or laxity

53
Q

Jobe classification - Grade 4

A

Primary instability with no impingement

54
Q

Types of SLAP tears - Type I

A

Degenerative fraying with no detachment of biceps insertion

55
Q

Types of SLAP tears - Type II

A

Most common type and represents a detachment of the superior labrum and biceps from the glenoid rim

56
Q

Types of SLAP tears - Type III

A

Bucket-handle tear of the labrum with an intect biceps tendon insertion to the bone

57
Q

Types of SLAP tears - Type IV

A

Least common type represents intra-substance tear of the biceps tendon with a bucket-handle tear of the superior aspect of the labrum

58
Q

See chart document for special tests

A

+ practice charting slide 130

CATA 337 - fall 2022 (16 decks)

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