SHANKA SHOULDER CHAP PG 348 TO 363 Flashcards
What are the 3 main joints of the shoulder?
Glenohumeral
AC
sternoclavicuar
scapulothoracic
How many muscles directly or indirectly provide stabiltiy of the entire shoulder complex?
18
In this disorder the tendons of the rotator cuff are crowded, buttressed, or compressed under the coracoacromial arch, resulting in mechanical wear, stress and friction
subacromial rotator cuff impingement
this impingement refers to mechanical compression of the rotator cuff tendons, primarily the supraspinatus tendon as they pass under the coracoacromial ligament between the acromion and coracoid process
Primary
this impingement is related to glenohumeral instability that creates a reduced subacromial apace because the humeral head elevates and minimizes the area under the coracoacromial ligament
sencondary
This stage of rotator cuff impingement occurs in younger pts (younger than 25)
- edema
- hemorrhage
- pain w/ abd ^ than 90*
- reversible lesion
Stage I
This stage of rotator cuff impingement is the fibrosis and tendonitis stage. (25-40 yrs old).
- irreversilbe
- supraspinatus tendon, biceps tendon, and subacromia bursa become fibrotic
- pain sleeping
Stage II
This stage of rotator cuff impingement Affects pts more than 40 yrs.
- tendo degeneration
- rotator cuff tears
- rotator cuff ruptures
- from long term symptoms
- muscle weakness and atrophy
Stage III
two tests used to elicit an impingement sign
Neer painful arc test
Hawkins-Kennedy test
- Test for impingement in which pain is reported while the shoulder goes through elevation with internal rotation.
- impingement is secondary to compression of the rotator cuff against the coracoacromial arch
Neer painful arc test
- This test for impingement is performed by elevating the shoulder to 90* in the scapular plane with internal rotation over pressure.
- In most cases , elevation of more than 80* or 90* elicits pain.
Hawikins-Kenndy test
What are the scapular muscles
serratus anerior
upper, mid, lower traps
levator scapulae
rhomboids
What are the 3 phases of nonoperative treatment of impingement?
Phase I- pre functional
Phase II- return to function
Phase III- return to activity
This phase of non operative impingement tx concentrates of relief of symptoms and initiating exercises to improve or maintain motion
Phase I- pre functional
This phase of non operative impingement tx is progressed with advanced scapular stabilization exercises that are encouraged as part of a comprehensive glenohumeral and scapulothoracic strengthening program. It use PRE using OKC
Phase II- return to function
This phase of non operative impingement tx is when strength has improved and motions increase. It may be gradual.
Phase III- return to activity
What are 4 basic scapular exercises that strengthen the upper, middle,and lower traps, levator scapulae, rhomboid major, pec minor and middle and lower serratus anterior ?
- Overhead press- “book calls press-ups”
- push-ups
- rowing
- scaption
What does SAD stand for - its a surgical procedure.
Subacromial decompression
An injury to the labrum that occurs from a force great enough to dislocate the humerus from its confines within the glenoid. It is defined as “an avulsion of the capsule and glenoid labrum off of the anterior rim of the glenoid.
Bankart lesion
An injury that is a compression or “impaction fracture” of the posterolateral aspect of the humeral head as a result of anterior shoulder instability
Hill-sachs lesion
How long is the protection phase in the initial management of acute shoulder dislocations (ant and post)
Can last up to 4 to 6 weeks
small cuff tear is how big
less than 1cm
medium cuff tear is how big
2 to 3 cm
large cuff tear is how big
grater than 4 to 5 cm
with this size tear active motion and pain-free exercise can begin: in conjunction with a decompression procedure.
small
