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(1) MS: Orthopedic and Rheumatic Conditions 🩺 > S1_L4: Shoulder and Cervical Spine Conditions > Flashcards

S1_L4: Shoulder and Cervical Spine Conditions Flashcards

1
Q

TRUE OR FALSE: The shoulder is the fulcrum for arm elevation. It provides sufficient fixation for motion of UE and cervical spine to occur

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

C. Only the 1st statement is true

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2
Q

TRUE OR FALSE: The Scapulothoracic joint is a “pseudojoint”.

A

True

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3
Q

Match the following classification of clavicular fractures.

  1. Fractures of proximal third (where sternum is)
  2. Fracture of middle third
  3. Fracture of middle third
  4. Most common
  5. Can cause disruption of the coracoclavicular / acromioclavicular ligament

A. Group I
B. Group II
C. Group III

A
  1. C
  2. A
  3. B
  4. A
  5. B
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4
Q

The (1)_______ is the first bone to ossify & has the last ossification center to fuse at the (2)_______

A
  1. Clavicle
  2. sternal end
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5
Q

TRUE OR FALSE: The Clavicle
is a strut connecting upper extremity to the axial skeleton. It is the only bone connecting the UE to the trunk

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

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6
Q

Match the following special test to its procedure.

  1. Pt tries to supinate and flex elbow more from a 90 degree flexed elbow, and PT resists the movement
  2. PT elevate/abducts arm or internally rotates then elevates arm of pt
  3. External rotate and abduct to touch superior medial angle of the opposite scapula

A. Yergason’s Test
B. Speed’s test
C. Apley’s Scratch
D. Neer’s Test
E. None

A
  1. A
  2. D
  3. C
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7
Q

The following statements are true about Rotator Cuff Tears, EXCEPT:

A. Tenderness palpated below the acromion
B. Inability to initiate and maintain abduction
C. Presents with a painful arc
D. Atrophy of Teres minor in late cases
E. None of the above

A

D. Atrophy of Teres minor in late cases

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8
Q

This is a congenital synostosis of cervical spine, where fusion of all or of only the lower cervical vertebrae into one homogenous mass of bone occurs.

A

Klippel Feil Syndrome

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9
Q

CASE: A patient was diagnosed with a cervical disc herniation at the level of C6-C7. As a knowledgeable PT, what nerve root is affected?

A

C7

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10
Q

CASE: A patient was diagnosed with a cervical disc herniation at the level of C6-C7. As a knowledgeable PT, what deep tendon reflex will most likely be diminished?

A

Triceps Reflex

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11
Q

CASE: A patient was diagnosed with a cervical disc herniation at the level of C6-C7. As a knowledgeable PT, where would the sensory deficit be most prominent?

A

Dorsal midforearm and 3rd digit

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12
Q

CASE: A patient was diagnosed with a cervical disc herniation at the level of C4-C5. As a knowledgeable PT, what muscles will be affected?

A
  1. infraspinatus
  2. supraspinatus
  3. Deltoid
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13
Q

CASE: A patient was diagnosed with a cervical disc herniation at the level of C4-C5. As a knowledgeable PT, where would the pain be distributed?

A
  1. shoulder
  2. lateral arm
  3. Neck
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14
Q

A prolapsed disc can sometimes be called?

A

bulge disc or protruding disc

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15
Q

Match the following terms.

  1. annulus and moves into the spinal canal
  2. changes causes slight impingement of the spinal canal or spinal nerves
  3. nucleus pulposus breaks through the annulus fibrosus but remains within the disc

A. prolapse
B. sequestration
C. disc extrusion

A
  1. B
  2. A
  3. C
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16
Q

This is also known as ”arthritis of the neck”

A

Cervical spondylosis

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17
Q

Disc protrusion or subluxation (slip disc) in the cervical region is most common between?

A

C6-C7

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18
Q

Spurring of cervical spine is common between what spinal levels?

A

C4-5 and C5-6

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19
Q

This is a deformity of the neck that includes both rotation and flexion and affects the sternocleidomastoid.

A

Torticollis or Wry Neck

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20
Q

The following is true about a congenital torticollis, EXCEPT:

A. also known as muscular torticollis
B. non-tender, cylindrical enlargement of SCM
C. spontaneous regression takes place 3 to 6 months
D. more common in boys
E. can cause flattening and shortening of face on side to which the head is tilted

A

D. more common in boys

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21
Q

How many muscles insert at the scapula?

A

17

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22
Q

The following is true about adhesive capsulitis, EXCEPT:

A. Also known as obliterative bursitis
B. Also known as diffuse rotator cuff tendinitis
C. Women > Men
D. Without treatment, resolves in 3-5 years
E. None

A

D. Without treatment, resolves in 3-5 years

NOTE: It may spontaneously resolve within 2-3 years

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23
Q

When Apley’s scratch test is done with internal rotation and adduction, what structure must be aimed to be touched during the test?

A

inferior angle or the opposite scapula

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24
Q

When Apley’s scratch test is done with external rotation and abduction, what structure must be aimed to be touched during the test?

A

superomedial angle of the opposite scapula

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25
Q

This tells of a triangular swelling of the posterior thorax over the scapula suggesting hematoma resulting in compartment pressure

A

Comolli sign

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26
Q

A scapula fracture may also involve which 2 injuries?

A
  1. thoracic spine injuries
  2. pulmonary contusion
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27
Q

This occurs if there is disruption of 2 or more of the superior shoulder suspensory complex

A

Floating shoulder

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28
Q

The superior shoulder suspensory complex (SSSC) is a bone-soft tissue ring composed of which 6 structures?

A
  1. Glenoid process
  2. Coracoid process
  3. Coracoacromial ligament
  4. Distal clavicle
  5. AC joint
  6. Acromion process
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29
Q

In which condition or injury is the comolli sign seen?

A

scapula fracture

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30
Q

This is functionally a joint but lacks anatomic characteristics of a true synovial joint

A

Scapulothoracic joint

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31
Q

The glenohumeral joint is a ______ joint.

A

true synovial ball and socket

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32
Q

This shoulder ligament is the primary restraint for anterior and posterior dislocation

A

Inferior glenohumeral ligament

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33
Q

Between the superior and middle glenohumeral ligament is what foramen?

A

foramen weitbrecht

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34
Q

Between the middle and inferior glenohumeral ligament is what foramen?

A

foramen rouviere

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35
Q

The (1)______ ligament is the primary support for AC joint, but the (2)_______ ligament prevents separation of AC joint

A
  1. Coracoclavicular
  2. Coracoacromial
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36
Q

Determine whether the following muscles are scapular pivoters or humeral propellers.

  1. Subscapularis
  2. Serratus anterior
  3. Latissimus dorsi
  4. Teres major
  5. Rhomboids

A. Scapular Pivoters
B. Humeral Propellers

A
  1. B
  2. A
  3. B
  4. B
  5. A
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37
Q

Enumerate the rotator cuff muscles.

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

38
Q

Who created the classification for proximal humeral fractures?

39
Q

TRUE OR FALSE: A three part fracture of the surgical neck with shaft displacement is the most common type of proximal humeral fracture

A

False

NOTE: It only splits into 2 parts

40
Q

What artery and nerve most commonly becomes a complication after humeral fractures?

A

axillary artery and nerve

41
Q

TRUE OR FALSE: If necrosis happens after humeral fractures, amputate the whole shoulder. A shoulder replacement must not be performed as the vessels are already nonfunctional.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

B. Both statements are false

42
Q

This is the most common inflammatory problem in the shoulder

A

Supraspinatus Tendinitis

NOTE: This is because it is the most superficial of the SITS muscles

43
Q

The following is true about Supraspinatus Tendinitis, EXCEPT:

A. Women < Men
B. Commonly seen in athletes
C. Commonly seen in individuals doing a lot of overhead activities
D. Most common cause of shoulder pain
E. Results from degeneration at the musculotendinous region of the cuff

A

A. Women < Men

44
Q

The painful arc in supraspinatus tendinitis is between (1)______ degrees on resisted (2)______.

A
  1. 60-120
  2. abduction
45
Q

Which age range is supraspinatus tendinitis commonly seen?

A

35-50 years old

46
Q

TRUE OR FALSE: Supraspinatus tendinitis may occurs when the circulation about the supraspinatus tendon insertion gets impaired intermittently over the greater tuberosity.

47
Q

What is seen in roentgenograms in cases of Supraspinatus Tendinitis?

A

calcific tendonitis

NOTE: Roentgenograms are X-ray photographs. This sees the amorphous calcium phosphate salt in the supraspinatus

48
Q

What is the most effective treatment of severe acute Supraspinatus Tendinitis?

A

Aspiration of calcium deposit + steroid

49
Q

The following is true about Bicipital Tenosynovitis, EXCEPT:

A. inflammation of the tendon-tendon sheath gliding mechanism
B. results in adhesion of the tendon to the bicipital groove and rotator cuff
C. may be a cause of abnormal physiologic wear and tear
D. associated with impingement syndrome
E. none of the above

A

C. may be a cause of abnormal physiologic wear and tear

NOTE: In cases of constant flexion, this is a normal physiologic response t wear and tea.

50
Q

Give 2 special test for Bicipital Tenosynovitis

A
  1. Yergason’s Test
  2. Speed’s Test
51
Q

TRUE OR FALSE: Adhesive Capsulitis is associated with CVA, myocardial infarction (MI), and cervical root affectation

52
Q

The Thawing stage during Adhesive Capsulitis lasts for how many months?

A

12-24 months

53
Q

Which stage in Adhesive Capsulitis is stiffness present in all planes?

A

Freezing stage

54
Q

The Frozen stage during Adhesive Capsulitis lasts for how many months?

A

4-12 months

55
Q

The Freezing stage during Adhesive Capsulitis lasts for how many months?

A

3-9 months

56
Q

What is the gold standard to diagnose Rotator Cuff Tears?

57
Q

The following is seen in Rotator Cuff Tears, EXCEPT:

A. Weak shoulder abduction
B. Sulcus may be appreciated between acromion and RC tendon
C. Tenderness below the acromion
D. Transient sharp pain lasts for months
E. None of the above

A

D. Transient sharp pain lasts for months

NOTE: Transient sharp pain only lasts for days. Severe pain lasts for months

58
Q

A PT tells a patient to abduct their shoulder and asks the pt to slowly put it down. As it reaches 30 degrees down, it immediately fell.

What test is being done in the scenario?

A

Drop arm test

59
Q

This often develops secondary to injury, impingement, muscle overuse, muscle degeneration, GH instability, RCT or calcium deposits.

A. Shoulder-Hand Syndrome
B. Subacromial Bursitis
C. Rupture of the Biceps Brachii
D. Bankart Lesion
E. Hill Sachs Lesion

A

B. Subacromial Bursitis

60
Q

The following is true about Shoulder-Hand Syndrome, EXCEPT:

A. Shoulder Pain with bilateral hand pain and swelling
B. Sequelae of MI, stroke (CVA), trauma, cervical arthritis
C. (+) Atrophy and finger flexion deformity and extension contracture of MCP joint
D. Sympathetic dysfunction due to injury or compression
E. None

A

NOTE It is a Shoulder Pain with homolateral hand pain and swelling

61
Q

In Shoulder-Hand Syndrome, a reflex-like response to pain sensation by sympathetic nerves triggering a reactive (1)______ which reduces (2)______ to the tissues involved in the pain pattern

A
  1. vasomotor reaction
  2. blood flow
62
Q

TRUE OR FALSE: In Shoulder-Hand Syndrome, Osteoporosis is seen on X-rays. In lab tests, ESR is elevated.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

C. Only the 1st statement is true

63
Q

TRUE OR FALSE: Rupture of the Biceps Brachii occurs in men between 30-40 years old. The cause is usually a single traumatic event where an unexpected extension force is applied to an elbow flexed to 90°.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

D. Only the 2nd statement is true

NOTE: Common age range is between 40-60.

64
Q

What sign is commonly seen during a Rupture of the Biceps Brachii?

A

Popeye sign

65
Q

The following ae sites where Rupture of the Biceps Brachii may occur, EXCEPT:

A. at or near the origin
B. musculotendinous junction
C. bicipital groove
D. insertion site
E. none

66
Q

TRUE OR FALSE: In Rupture of the Biceps Brachii, there is weakness in elbow flexion and forearm supination. X-rays will show a small avulsion fracture of glenoid rim.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

67
Q

What is the most common direction for shoulder dislocations?

A

Anterior or anteroinferior

68
Q

Anterior dislocations are usually caused by an indirect force in the shoulder while it is (1)_____, (2)_____ and (3)______.

A
  1. abduction
  2. extension
  3. external rotation
69
Q

This condition is an osseous defect on the posterolateral aspect of the humeral head resulting from forceful impaction to the anteroinferior glenoid rim during anterior dislocations

A

Hill Sachs Lesion

70
Q

This is an injury to the antero-inferior glenoid labrum due to repeated anterior shoulder dislocations

A

Bankart Lesion

71
Q

Recurrent Dislocation is characterized by (1)_____ and (2)______ when arm is abducted and ER.

A
  1. Sudden pain
  2. Audible click
72
Q

Shoulder Arthroplasty is indicated when the following conditions are present, EXCEPT:

A. axillary nerve injury
B. rheumatoid arthritis
C. recurrent dislocations
D. bone tumors
E. osteonecrosis of the humeral head

A

A. axillary nerve injury

73
Q

These are the key muscles to examine preoperatively in Shoulder Arthroplasty, EXCEPT:

A. latissimus dorsi
B. pectoralis major and minor
C. trapezius
D. serratus posterior
E. None

A

D. serratus posterior

74
Q

A total shoulder arthroplasty (TSA) is a surgical option typically reserved for (1)_____ patients with (2)______ & (3)______

A
  1. elderly
  2. cuff-deficiency
  3. arthritic shoulders
75
Q

In Partial Shoulder Arthroplasty, what is replaced?

A

head of the humerus

76
Q

There are 4 types of replacement components have traditionally been used in Shoulder Arthroplasty. Enumerate all 4 types.

A
  1. Unconstrained
  2. Constrained
  3. Semi-constrained
  4. Reversed ball and socket
77
Q

Determine which type of replacement component is being described.

  1. glenoid and humeral components are coupled and fixed to bone
  2. consists of a small humeral socket that slides on a larger ball-shaped glenoid component
  3. most widely used component

A. Unconstrained
B. Constrained
C. Semi-constrained
D. Reversed ball and socket

78
Q

Determine which type of replacement component is being described.

  1. tends to absorb the majority of joint stresses, which increases the potential for loosening or fracture of prosthesis or the surrounding bone
  2. involves the use of a smaller and spherical humeral head with a head–neck angle of 60 degrees
  3. designed for patients who had severe deterioration of the rotator cuff but with a functioning deltoid

A. Unconstrained
B. Constrained
C. Semi-constrained
D. Reversed ball and socket

79
Q

Determine which type of replacement component is being described.

  1. consists of a humeral component that exists with scapular component
  2. reproduces the anatomy of the joint as much as possible
  3. no physical connection holds the components together

A. Unconstrained
B. Constrained
C. Semi-constrained
D. Reversed ball and socket

80
Q

In Wry Neck, tilting of the head toward the (1)_____ side and rotation of chin to the (2)______ side occurs.

A
  1. same/ affected
  2. opposite
81
Q

The following are causes of Acquired Wry Neck, EXCEPT:

A. Arthritic
B. Cicatricial
C. Hysterical
D. Neoplastic
E. None

82
Q

What are the risk factors for spontaneous atlanto-axial subluxation?

A
  1. Down’s syndrome
  2. Morquio’s syndrome
  3. Bone dysplasia
  4. Osteogenesis imperfecta
83
Q

Spontaneous atlanto-axial subluxation is caused by the laxity of the (1)_____ ligament of the (2)______ and other ligaments and (3)______ inclination of the facet surfaces

A

1.transverse
2. atlas
3. forward

83
Q

Spontaneous atlanto-axial subluxation is caused by the laxity of the (1)_____ ligament of the (2)______ and other ligaments and (3)______ inclination of the facet surfaces

A

1.transverse
2. atlas
3. forward
4.

84
Q

What are the 2 s/sx for

85
Q

What are the 2 s/sx for spontaneous atlanto-axial subluxation?

A
  1. Unexplained neck stiffness or pain in a child with or without torticollis
  2. Hyperactive reflexes
86
Q

A disorder of the cervical spinal nerve root and, most commonly, is caused by a __________

A

cervical disk herniation

87
Q

TRUE OR FALSE: The farther your head goes away from the fulcrum, the heavier it gets

88
Q

This is a group of disorder associated with pressure on nerves and vessels in the region of the thoracic outlet

A

Thoracic Outlet Syndromes

89
Q

TRUE OR FALSE: Thoracic Outlet Syndromes are more common in men. Weakness and atrophy starts with the muscles of the chest and back.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

B. Both statements are false

NOTE: It starts with the intrinsic muscles of hands, then later involving entire limb.

90
Q

Costoclavicular syndrome is a (1)______ that may occur in space between the (2)____ and the (3)_____

A
  1. neurovascular compression
  2. clavicle
  3. first rib
91
Q

A Whiplash injury is associated with a (1)_____ and affects the (2)____ and (3)____ of the neck.

A
  1. motor vehicular accident
  2. muscles
  3. ligaments

(1) MS: Orthopedic and Rheumatic Conditions 🩺 (13 decks)

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