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Fall Semester DPT > Rotator Cuff Tear > Flashcards

Rotator Cuff Tear Flashcards

1
Q

Risk factors/etiology for RC tears:

_______ or __________ (tendinosis) tears including with repetitive overhead activities

A

gradual; degenerative

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2
Q

What are the 3 ways acute RC tears happen?

A
  1. High UE velocity (throwing)
  2. heavy lifting
  3. impact on fall with outstretched hand
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3
Q

What is the order of most common RC tears?

A

Supraspinatus>Infra pinatus>Subscapularis> Teres Minor

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4
Q

The ______ and _______ are 40-73% involved with RC tears

A

labrum; biceps

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5
Q

What is a SLAP tear? How do you fix it?

A

Superior Labral Anterior/Post

surgically fixate Bicep’s tendon (aka tenodesis)

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6
Q

RC symptoms are _________

A

acute

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7
Q

With RC tear, the pt. will have history of what….? This is high speculation of what?

A

popping, clicking, catching

Labral tear

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8
Q

With RC tear, your pt. will have increased P! with what kind of activities?

A

overhead

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9
Q

Are RC tears hyper or hypomobile?

A

hypermobile

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10
Q

What are hypermobile signs in a SCAN?

  • A/PROM?
  • Combined Motion?
  • Resisted/MMT?
    -Stress test?
A

PROM> AROM

Inconsistent block with combined motion

Resisted/MMT will be weak and P!ful
- FLX
-RC (ABD/ER, possibly IR)

Stress test +

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11
Q

With hypermobility and RC tear, there will be a P!ful arc around ___° of elevation

A

90

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12
Q

All tears special test (cluster) consist of:

A

> 65 years of age

Weak ER

Night P!

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13
Q

Full thickness tear consist of:

A

≥ 60 years of age

+ P!ful arc, drop arm, and Infra. test

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14
Q

What special test would you perform for speculation of a Supra/Infraspinatus?

A

ER Lag Sign

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15
Q

If your pt. has drop arm, what is the concern?

A

There could be a supraspinatus tear

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16
Q

2 non-specific tear test?

A

Empty Can

Jobe Test

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17
Q

3 Test for Subscapularis?

A

Lift Off

Bear Hug

Belly Press

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18
Q

What is the appropriate PT Rx for RC tear?

A

MET!

Specifically:
- STABILIZATION
- tissue proliferation
- address any joint hypomobility

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19
Q

What is the biggest predictor of a tear going to sx?

A

patient’s negative perception

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20
Q

What is the evidence of effectiveness for corticosteroid injections?

A

No evidence of effectiveness within 4 weeks of shot

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21
Q

____________ is when the surgeon sews the fibers back together and reattaching to bone

A

reconstruction

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22
Q

________ tears have a good clinical outcome with P!, ROM, strength, quality of life, and sleep after surgery

A

degenerative

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23
Q

What kind of tear has successful outcomes with PT, like surgery, and especially for those with small or partial tears or those unfit for sx

A

degenerative

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24
Q

RC tear: What is the outcome for PT with acute small to medium tears?

A

it may help, if no good progress, delays can be associated with poor surgical outcomes

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25
Q

RC tear: What is the outcome for surgery with acute small to medium tears?

A

no difference from PT, more critical in younger patient

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26
Q

With Multi-tendon and/or Massive Full Thickness Tears, PT may help, but in what kind of patients?

A

low-demand or ppl unfit for sx

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27
Q

Name a few probable factors for prognosis after sx

A

young age

no diabetes

small tear

higher bone density

28
Q

Shoulder joint replacements are MOSTly used with ________ tears and less with ___-_____ changes

A

irreplaceable; age-related

29
Q

What is the joint relationship with Total Shoulder Arthroplasty?

A

concave/convex

30
Q

With total shoulder arthroplasty, what motion should you avoid?

A

HYPEREXT

31
Q

The first 6 weeks after rTSA should include what kind of PT Rx?

A

POLICED including immobilization with sling

no pushing, pulling, or lifting

32
Q

What are some AAROM activities for 0-6 weeks after tRSA?

A

Pendulums

Standing pulley or supine flx

Supine IR/ER

Stretch into ER

Scapular PREs

33
Q

After 6-8 weeks with rTSA should include what kind of PT Rx?

A

DC sling

add… sitting pulley, standing AROM into flex

34
Q

With tRSA: ____-_____ weeks you should do progressive isotonic shoulder PREs

A

8-12

35
Q

What are the results of tRSA?

A

Good to excellent outcomes

36
Q

Frozen Shoulder Contraction Syndrome is also called what?

A

adhesive capsulitis

frozen shoulder

37
Q

________ _________ is frequently misdiagnosed with any multi-directional limitation in ROM

A

Frozen Shoulder

38
Q

What is the primary etiology of FSCS?

A

autoimmune conditions

39
Q

What are risk factors for FSCS?

A

hypothyroidism

diabetes

40-65 years old

biological female

previous adhesive capsulitis

family Hx

40
Q

What is the secondary etiology of FSCS?

A

concomitant injury, i.e., humeral fx, and period of extended inflammation and immobilization

41
Q

With FSCS, it is more often ___________ of _____ capsule and ligaments

A

inflammation; GH

42
Q

What structures are involved with FSCS?

A

GH capsule and ligaments

joint space

43
Q

With FSCS, the symptoms are typically _______ and _________P! with loss of motion

A

gradual; progressive

44
Q

What are hypomobile signs in a SCAN with FSCS?

A

Combined motion- consistent block

Resisted/MMT- possibly weak and or P!ful (depends on stage)

Stress test- distx probably + depends on stage

Accessory motion- hypomobile

Special test+ for impingement

45
Q

4 stages of Frozen Shoulder

A

I- Initial

II- Freezing

III- Frozen

IV- Thawed

46
Q

What stage of Frozen Shoulder is….

  • Gradual onset
    Achy at rest
    Sharp with use
    Night P! common
    Unable to lie on involved side
  • high irritability
  • Losing ROM
  • End feel: Empty and P!ful
A

Stage I

47
Q

What stage of Frozen Shoulder is….

  • Worsening and constant P!, particularly at night
  • high irritability
  • Moderate to severe limitations
  • Empty and P!ful
A

Stage II

48
Q

What stage of Frozen Shoulder is….

  • Stiffness > Intermittent
  • moderate irritability
  • Moderate to severe limitations with P! at end range, AROM like PROM
  • Firm
A

Stage III

49
Q

What stage of Frozen Shoulder is….

  • Minimal to no P!
  • low irritability
  • ROM gradually improves
  • Firm end feel
A

Stage IV

50
Q

What is the PT Tx for FSCS?

A

POLICED

Pt. education: describe 4 stages, promote p! free functional activity, and match intensity of stretching JM’s with S&S always

51
Q

Which modality for FSCS is an additional benefit to JM and modalities for P!/ROM/Function?

A

cryotherapy

52
Q

Which modality for FSCS has evidence for short term and long term functional changes?

A

LASER

53
Q

What is the weakest modality for frozen shoulder?

A

E-stim

54
Q

What level of JM has moderate evidence for short and long term benefits with FSCS?

A

Grade III-V

55
Q

_______ have an inconsistent benefit for ROM when added to exercise in shoulders with gradual onset

A

JM

56
Q

STM for ROM/flexibility has what kind of evidence for FSCS?

A

moderate

57
Q

What is the primary MET focus with FSCS?

A

elasticity and mobility ; but also to offset disuse

58
Q

With MD Rx: ________ steroids have moderate evidence for short term

A

oral

59
Q

Cortisone injection with FSCS has a ______ and ______-_______ benefit

A

short and mid-term

60
Q

How long does Stage I of Frozen Shd. last?

A

1-2 months

61
Q

How long may the P! and mobility deficits last with frozen shd?

A

12-18 months

62
Q

What is the capsular pattern?

A

ER> ABD> FLX> IR

63
Q

With tRSA: ____-_____ weeks: add in gym type exercises

A

12-16

64
Q
A
65
Q
A

Fall Semester DPT (11 decks)

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