Ref pain

Question 1

levels of cervical spine w/ referred pain @ shoulder region

Answer 1

C3-C4
C4-C5,
Nerve roots C4 or C5.

Question 2

Referred Pain
Dermatome C4:

Answer 2

Trapezius
to shoulder tip.

Question 3

Referred Pain
Dermatome C5:

Answer 3

Deltoid region
and lateral arm.

Question 4

Referred Pain
Diaphragm:

Answer 4

Pain in upper trapz

Question 5

Referred Pain
*Heart:

Answer 5

Pain in left axilla,
& pectoral region.

Question 6

Referred Pain
Gallbladder:

Answer 6

Pain at shoulder tip,
& scapular region.

Question 7

MC sites of brachial plexus compression at the thoracic outlet? 4

Answer 7

• scalene triangle
• costoclavicular space
• coracoid process
• pectoralis minor

Question 8

Suprascapular Nerve
- MOI and location
- give 1 sample scenario

Answer 8

Compression/stretch @ suprascapular notch
(e.g., heavy book bag)

Question 9

Radial Nerve
- MOI and location:
- give 1 sample scenario

Answer 9

Compression @ axilla,
(e.g., leaning on axillary crutches)

Question 10

5 Pathologies causing
GH jt. Hypomobility

Answer 10

1 RA, (degen. arthritis)
2 OA, (degen. arthritis)
3 Traumatic arthritis,
4 Post immobilization arthritis,
5 Idiopathic frozen shoulder.

Question 11

Idiopathic Frozen Shoulder
Stage 1:
- onset of pain?
- Stage 1 duration?

Answer 11

Stage 1:
- onset of pain: Gradual onset
- <3 months

Question 12

Idiopathic Frozen Shoulder
Stage 2:
- stage “name”?
- describe pain & motion?
- Stage 2 duration?

Answer 12

• “name”: Stage 2 (“Freezing” Stage)
• Intense pain, limited motion
• 3-9 months

Question 13

Idiopathic Frozen Shoulder
Stage 3:
- stage “name”?
- describe pain & motion, plus?
- Stage 3 duration?

Answer 13

Stage 3 (“Frozen” Stage)
- Pain with movement + adhesions
- 9-15 months

Question 14

Idiopathic Frozen Shoulder
Stage 4
- stage “name”?
- describe pain?
- describe capsule
- Stage 4 duration?

Answer 14

Stage 4 (“Thawing” Stage):
- Minimal pain
- no synovitis, capsular restrictions
- 15-24 months.

Question 15

Nonoperative treatment
for Joint Hypomobility in
—– Controlled Motion Phase:
- goal? 2
- treatment? 3

Answer 15

GOAL
- inc jt motion
- Inhibit muscle spasm
treatment
- stretching,
- Passive joint mob, self-mob,
- correct wrong body mechanics

Question 16

Nonoperative treatment
for Joint Hypomobility in
—– Return to Function Phase:
- goal? 2
- treatment? 3

Answer 16

GOAL - Increase flexibility & strength, Prepare for functional demands
* Stretching
* strengthening
* home/self-exercises.

Question 17

Nonoperative treatment
for Joint Hypomobility in
— Postmanipulation Under Anesthesia:
- treatment? 3

Answer 17

• modalities
• joint mobilization
• stretching exercises

Question 18

GH jt rehab treatments (3),
— post-op under Anesthesia:
- goal? 3

Answer 18

• pain management
• controlled motion
• prevention of complications

Question 19

Common Impairments post-op
1. Night Pain and Disturbed Sleep
- when does this happen?
- treatment:? (3)

Answer 19

*acute
- pain control,
joint mob,
and soft tissue mob.

Question 20

Common Impairments post-op
2. Decreased Mobility and Posture Abnormalities:
- what dse can cause these? (3)
- treatment:? (3)

Answer 20

*d/t RA, OA, or idiopathic frozen shoulder.
*joint mob,
stretching,
and strengthening

Question 21

Common Impairments post-op
3.Muscle Performance Issues:
- what area?
- treatment:? (3)

Answer 21

*General ms weakness (shoulder)
*strengthening exercises,
soft tissue mob,
and controlled joint motions.

Question 22

Common Activity Limitations
and Participation Restrictions: (3)

Answer 22

1. Inability to Reach Overhead and Behind:
2. Difficulty Lifting Heavy Objects:
3. Limited Ability for Repetitive Activities:

Question 23

Common Activity Limitations and Participation Restrictions:
1.Inability to Reach Overhead and Behind:
- examples of daily activities? 3
- treatment:? (3)

Answer 23

• dressing, reaching into pockets, self-grooming
• progressive joint mob,
  stretching,
  and strengthening.

Question 24

Common Activity Limitations and Participation Restrictions:
2.Difficulty Lifting Heavy Objects:
- cause:?
- treatment:? (2)

Answer 24

• d/t decreased shoulder mobility
• gradual strength training
  and functional activities training

Question 25

Common Activity Limitations and Participation Restrictions:
3.Limited Ability for Repetitive Activities
- cause:?
- treatment:? (3)

Answer 25

• d/t decrease joint mobility
• Rehab: controlled motion,
  muscle strengthening,
  and ergonomic modifications

Question 26

GH Joint Hypomobility: Management
—Protection Phase:
- treatment:? (3)
- what pjm grade?

Answer 26

1 Manual Stretching Techniques
2 Pendulum (Codman’s) Exercises
3 PJM *Grade I & II, pain-free positions.

Question 27

GH Joint Hypomobility: Management
—Controlled Motion Phase:
-what to do during immob?
-pain mgt?

Answer 27

• increase shoulder movements @ immobilization
• monitor pain & jt response during activities

Question 28

GH Joint Hypomobility: Management
—Controlled Motion Phase:
pointers when increasing joint & Soft Tissue Mobility
- treatment?
- goal?
- how to achieve goal?

Answer 28

• Gradual progression of PJM & AAROM
• goal: to dec adhesion
• gentle oscillations to dec adhesion

Question 29

GH Joint Hypomobility: Management
—Return to Function Phase: (3)
- treatments?

Answer 29

1. Flexibility and Strength Progression
2. Functional training
3. train w/ correct body mechanics