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Patho Exam 2 > Module 6 > Flashcards

Module 6 Flashcards

1
Q

What ligament attaches to corocoid process and distal clavicle and prevents superior displacement of clavicle

A

Corococlavicular ligament

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2
Q

What two ligaments make up corococlavicular ligament

A

Conoid and trapezoid

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3
Q

How does a ac joint separation occur?

A

Fall or impact direct force on acromion

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4
Q

What grade AC jet separation is a sprain to the AC ligament, corococlavicular ligaments intact, no deformity, no instability during AC jt stress test

A

Grade 1 (sprain)

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5
Q
A
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6
Q

What grade AC jt separation is the AC ligament ruptured, corococlavicular ligaments intact, no deformity, and instability with AC joint stress test

A

Grade 2 (subluxation)

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7
Q

What grade ac joint separation are the ac and corococlavicular ligaments ruptured, deformity, and severely unstable during ac joint stress test

A

Grade 3 (dislocation)

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8
Q

What grade ac joint separation are more severe displacement injuries

A

Grade 4 - 6

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9
Q

What is the clinical management to grade 1-3 ac joint separation?

A

Sling/brace and PT
Protect and optimize tissue healing then functional rehab

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10
Q

What is the clinical management of grade 3 AC joint separation

A

Surgical management sometimes considered
Brace and PT recommended

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11
Q

What clinical management for grade 4-6 ac joint separation

A

Surgical management and PT

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12
Q

What type of clinical management for AC joint separation does return to normal activity occurs normally around 2-4 weeks

A

Type 1

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13
Q

What type of clinical management of ac joint separation to return to normal activity occur 4-6 weeks?

A

Type 2

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14
Q

What type of ac joint separation management do pt return to normal activity in 6-12 weeks?

A

Type 3

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15
Q

Where the does the short head biceps attach?

A

Corocoid process

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16
Q

Where does long head biceps attach

A

Supraglenoid tubercle

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17
Q

Where is biceps brachii distal attachment

A

Radius

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18
Q

What is the inflammation of the long head tendon beneath transverse humeral ligament?

A

Bicipital tendonitis

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19
Q

In a biceps tendon rupture what kind does the long head tendon rupture and form a lump

A

Proximal

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20
Q

What type of bicipital tendon rupture does the distal attachment rupture

A

Distal rupture

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21
Q

Does bicipital tendonitis or rupture have a gradual onset of repetitive use and is not traumatic

A

Bicipital tendonitis

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22
Q

What type of bicipital tendon injury is traumatic and acute

A

Proximal biceps tendon rupture

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23
Q

In what population does the biceps tendon fail due to hard FOOSH or very heavy loading forces on biceps

A

Younger adult

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24
Q

In wha tpopulation does the biceps tendon weaken with age and may fail from less severe loading?

A

Middle age/ older adult

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25
In a proximal rupture where is the lump closer to
Elbow
26
In a distal rupture where is the lump closer to
Shoulder
27
Your patient presents with localized pain directly on bicipital groove. Palpitation pain over bicipital groove, rom is not limited, elbow flexion is weak.
Bicipital tendonitis
28
Speeds test and yergasons test are special tests for what pathology?
Bicitpital tendonitis
29
What special test is the arm flexed to 90 with arm ER and supinated and downward pressure applied?
Speeds test
30
What special test is the elbow flexed to 90 forearm pronated and pt ER and supinates against PT
Yergasons
31
True / false most pt with proximal biceps rupture are treated surgically
False
32
What procedure do the cut the biceps tendon and do not reattach it
Biceps tenotomy
33
What procedure do they cut tendon and reattach it to humerus
Biceps tenodesis
34
What is recommend for treatment of bicipital tendonitis (PT or surgery)
PT
35
95% of GH dislocations are in what direction
Anterior
36
How do GH dislocations occur? Motion?
Abduction and ER 90 90
37
What type of lesion does the humeral heads get dented as dislocation occurs?
Hills Sachs lesion
38
What type of lesion occurs on the lower rim of labrum when it is torn as humeral head dislocates and axillary artery & brachial plexus are injured?
Bankart lesion
39
How long should a sling be worn for GH dislocation?
Up to 6 weeks
40
What are the goals of PT for GH dislocations
Restore stability of GH joint Precautions with ER and ABD Gradual progression Stabilization Pt education
41
What two structures glide under the subacromial arch?
Subacromial bursa and supraspinatus tendon
42
What is abduction compresses the subacromial bursa and supraspinatus tendon which leads to inflammation and pain of those structures?
Subacromial impingement syndrome
43
What is when abduction compresses and irritates the bursa and supraspinatus tendon
Subacromial impingement syndrome
44
Why types of impingements occur in SAIS
External and internal
45
What type of external impingements occur in SAIS
Biomechanics (scap thoracic kinematics) and congenital (acromion shape)
46
What type of acromion shape is flat
Type1
47
What type of acromion shape is curved
Type 2
48
What type of acromion shape is hooked
Type 3
49
What type of internal impingement occurs in SAIS
Posterior / superior aspect of labrum is impinged by greater tuberosity in ABD and ER
50
Your pt presents with pain in sub acromial space, palpation tenderness on supraspinatus and subacromial space. ROM painful arc (70 and 120 elevation). Elevation strength is weak and painful. What is it
Subacromial impingement syndrome
51
What are special tests Hawkins Kennedy, painful arc, and infraspinatus ER test for
SAIS
52
What 3 special tests for SAIS need to be positive for SAIS diagnosis
Infraspinatus test, Hawkins kennedy, painful arc
53
What special test if negative rules out SAIS
Neers test
54
Is surgical or non surgical management for SAIS recommended
Non surgical
55
What are goals in PT for SAIS
Protect tissue healing Optimize scapulothoracic kinetmatics Stabilization Bio mechanical assessment of overhead activity
56
Subacromial decompression surgery is when
Shave under acromion
57
What RC muscles attach to greater tuberosity
Supraspinatus infraspinatus and teres minor
58
What RC muscles attach to lesser tuberosity
Subscapularis
59
What are the RC main job for GH joint
Dynamic stabilizer that pulls humeral head to glen oil fossa
60
What RC muscle does abduction
Supraspinatus
61
What RC muscle does ER
Teres minor and infraspinatus
62
What RC muscle does IR
Subscapularis
63
Describe partial thickness tear of RC
Torn tendon is still attached to bone
64
Describe bursa side partial tear
Bursa side is torn and articular side tendon is intact
65
Describe articular side partial tear RC
Articular side is torn and bursa side is intact
66
Describe full thickness tear of RC
Tear detaches all or part of the tendon from bone which exposes humeral head and creates hole in tendon
67
Where is the most common RC tear
Supraspinatus
68
What are two main risk factors for RC tear
Age and poor posture (mostly kyphotic/lordotic)
69
Surgery is indicated for RC repair for what reasons
Younger Acute onset of pain from trauma and have healthy RC muscle and tendon
70
PT is indicated for RC repair for what reasons
Gradual onset of pain without trauma regardless of healthy RC muscles Young and old Surgery indicated if no response after 6-12 wks
71
True/false pt with acute or gradual onset RC tears whose tendons are unlikely to heal the MRI shows degeneration and older age
True
72
Your patient presents with radiating lateral shoulder pain, night pain, unable to sleep or lay down, tenderness to RC attachment, AROM ABD is limited, AROM of ER or IR is limited and painful, strength for ABD ER or IR is weak and painful
RC tear (depends on muscles provoked)
73
The empty can test, drop arm test, ER test, ER lag sign, hornblowers sign, IR lag test, belly press test, and bear hug test are all special tests for
RC tear
74
What RC special tests test for supraspinatus
Drop arm, empty can
75
What RC special tests test for infraspinatus
ER test, ER lag sign
76
What RC special tests test for infraspinatus and supraspinatus
Hornblowers sign
77
What RC special test tests for Subscapularis
IR lag, belly press, bear hug
78
What are the two most common labral tears?
SLAP (superior) and bankart lesion (inferior)
79
What does SLAP stand for
Superior labrum anterior to posterior
80
If your pt falls on an outstretched arm, direct shoulder impact, lift heavy object abrupt overheard reaching , high velocity throwing what type of injury is common
SLAP
81
What is dead arm syndrome
Paralyzing pain when in max AB and ER and cant throw
82
What type of SLAP lesion is their fraying of the superior labrum
Type 1
83
What type of slap lesion does the biceps anchor detach
Type 2
84
What type of SLAP lesion does the bucket handle tear of labrum occur with biceps tendon still intact
Type 3
85
What type of SLAP lesion does the bucket handle tear occur and pulls the biceps long tendon with it
Type 4
86
The biceps loading tests produce deep pain where?
Deep GH joint pain where long head attaches
87
What do the speeds test, yergasons test, and biceps load II test special tests for
Labral tear
88
What test do you flex your arm to 90 with arm ER and supinated and examiner pulls down
Speeds
89
What type of test do you flex elbow to 90 and pronate and PT resists so pt ER and supinates
Yergasons
90
What type of test is the pt supine with shoulder in 120 elevation and full ER elbow flexted and the pt flexes elbow against resistant
Biceps load II test tests
91
What test does the PT manually circumduct GH jt in different positions to produce clunk click and deep joint pain
Crank clunk test
92
With arm in abdication and ER what ligament protects from anterior dislocation
Inferior GH
93
With arm in 30-45 abduction and ER what ligament prevents anterior disc location
Middle GH
94
With arm in adduction and ER what ligament prevents from inferior dislocation
Superior GH
95
When arm flexed and IR wha t ligament prevents posterior dislocation
Posterior GH
96
What is a shoulder condition that causes pain and limited ROM dur to GH joint inflammation and gradually thicken and becomes fibrotic causing jt contracture
Adhesive capsulitis
97
What stage of Adhesvie capulitis does a gradual progression of pain and loss of ROM occur that lasts from 3-9 months, inflammation and thickening of jc
Stage 1 - freezing
98
What stage of Adhesvie capulitis does pain reach plateau and begin to decrease, ROM extremely limited, typically lasts anywhere from 4-6 months extensive fibrosis
Stage 2 frozen
99
What stage of adhesive capsulitis does pain subside and ROM slowly return and normal. 6 months to 2 years
Stage 3 - thawing
100
What age and sex is adhesive capsulitis most common
40-60 Female
101
True / false cause of adhesive capsulitis is not fully understood
True
102
True / false adhesive capsulitis occurs in pt with diabetes
True
103
Your pt presents with pain in their whole shoulder and severe restriction in ER IR and ABD, strength is decreased in all movements, and special tests rule out RC tear impingement and labral tear. What is it
Adhesive capsulitis
104
What is pt management for adhesive capsulitis in freezing stage
Reduce pain and inflammation, gentle ROM and manual therapy
105
What is pt management in frozen stage
AROM and PROM avoiding aggressive movement
106
What is pt management in thawing stage
Ther ex to increase ROM and function
107
True/ false surgery includes manual manipulation under anesthesia
True
108

Patho Exam 2 (3 decks)

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