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TRI 3 - MSK 2 > Shoulder > Flashcards

Shoulder Flashcards

1
Q

Describe how the inferior glenohumeral ligament supports the shoulder

A

Support shoulder like like a hammock when the arm is abducted

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2
Q

Describe some characteristics of shoulder laxity

A 
Unilateral or bilateral
Identified with PROM A
Common
May not result in instability
No dysfunction or complaint
May be present but compensated for
May be congenital or secondary to poor movement
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3
Q

Describe some characteristics of shoulder instability

A

Mostly unilateral but not always
Likely to have MOI
Disfunction and complaint
Body has a hard time compensating for these

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4
Q

Define the term SLAP lesion

A

Superior labral injuries that are both anterior and posterior

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5
Q

Describe the MOI of SLAP lesions

A 
Traumatic or chronic
FOOSH
MVA
Sudden deceleration or traction forces
Chronic anterior and posterior instability
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6
Q

Describe the pathophysiology of SLAP lesions

A

Superior labrum is mobile and connected to biceps making it more vulnerable
Biceps tendon is in tact with slap lesions

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7
Q

Describe a type 1 SLAP lesion

A

fraying of edge of labrum

Pain with horizontal ABD and ER of shoulder

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8
Q

Describe a type 2 SLAP lesion

A

Detachment of labrum and biceps tendon anchor
Loss of stabilizing effect of the labrum and biceps
Most common type

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9
Q

Describe a type 3 SLAP lesion

A

Vertical tear in the labrum

Remaining labrum and biceps intact

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10
Q

Describe a type 4 SLAP lesion

A

Bucket handle tear in bicep tendon

Labral flap and biceps displaceable into GH joint

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11
Q

Describe a type 5 SLAP lesion

A

Bankart lesion of anterior capsule extending into the anterior superior labrum

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12
Q

Describe a type 6 SLAP lesion

A

Disruption of biceps tendon anchor with anterior or posterior superior labral flap tear

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13
Q

Describe a type 7 SLAP lesion

A

Extension of a SLAP lesion anteriorly to involve the area inferior to the middle GH ligament

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14
Q

Describe how a slap lesion presents

A

No specific symptoms
Pain with overhead activities
Catching or locking

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15
Q

What are some special tests to test for SLAP lesions

A 
O"brien active compression test
Clunk
Crank
Speed's
Jobe relocation
Biceps load
Anterior slide
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16
Q

How do you manage SLAP lesions

A

Exercises for dynamic stabilization

Surgery has good prognosis

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17
Q

What is the most common type of GH instability

A

Anterior

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18
Q

Describe some general presentation and MOI info on GH instability

A

Complains of slipping or popping out with overhead activities
May be traumatic, repetitive or genetic

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19
Q

Describe the presentation of anterior GH instability

A

Impingement like symptoms

Ill defined global shoulder pain, activity specific

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20
Q

Describe the MOI of GH anterior instability

A

ABD, ER, hori ABD

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21
Q

What do you check for in GH anterior instability

A

Posterior tightness as it may cause anterior translation

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22
Q

Describe some MOIs for GH Posterior instability

A

Rare

Seizure, electrick shock, diving into shallow pool, MVA

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23
Q

Describe the presentation of GH posterior instability

A

Severe pain, limited ER, less than 90 ABD
Vague pain with arm in flexed and adducted position
Clunk with shoulder movement from Flexion to ABD and ER
Posterior prominence of shoulders when observed from above

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24
Q

What are the 4 special tests to confirm GH posterior instability

A

Kim
Jerk
O’Brian
Posterior impingement sign

25
Q

Describe GH inferior instability

A

Very uncommon
From carrying heavy things or extreme hyperabduction
Sulcus sign used to asses inferior stability

26
Q

Describe Multidirectional GH instability

A

Instability present in one or more direction

Usually present with scapulothoracic dyskinesia

27
Q

Describe GH instability management

A

Strengthen dynamic stabilizers
Follow specific instructions bases on method of repair
Immobilize briefly for comfort

28
Q

What types of exercises should be done for GH instability

A

ROM - emphasize posterior capsule with anterior instability
Scapular stability - Scapular pinch, shoulder shrug, taping
Closed chain - all movements of the scapula
Open chain - PNF, diagonals upright rows, ER scapular retraction

29
Q

What populations is shoulder replacement saved for

A

Elders

Those with unremitting pain

30
Q

What Muscles should be examined preoperatively to total shoulder replacement

A

All muscles that attach to the scapula

31
Q

What limb position is to be avoided after shoulder replacement

A

Active IR

Passive or active ER beyond 35-40

32
Q

Describe unconstrained shoulder replacement

A

Most common

Inert humeral component with high density glenoid component

33
Q

Describe constrained shoulder replacement

A

Parts are coupled and fixed to bone

Rarely used

34
Q

Describe reversed ball and socket shoulder replacement

A

Humerus is socket, glenoid shaped to a ball

used when rotator cuff is compromised

35
Q

Describe semi constrained shoulder replacement

A

Increased ROM
Smaller humeral head
head neck angle of 60

36
Q

What are the risk factors for adhesive capsulitis

A 
Thyroid disease
Diabetes
40-65
Previous trauma
Female
having in one arm increases the likelihood of the other
37
Q

How do you diagnose adhesive capsulitis

A

Shoulder pain for longer than 1 month
Pain sleeping on shoulder
Cannot lay on shoulder
ROM restricted in all directions

38
Q

What is ASES

A

OM for adhesive capsulitis
0-100 (best)
MDC - 9.4 (use this)
MCID 6.4

39
Q

What is DASH

A

Disabilities of the arm shoulder and hand
0-100 (best)
MCID - 10.2
MDC 10.5

40
Q

What is SPADI

A

Shoulder pain and disability index
0-100 100 best
MDC 18.1
MCID 8

41
Q

Where is the dorsal scapular nerve impinged and what is the presentation

A

Middle scalene

scapular pain radiating to lateral shoulder and arm

42
Q

Where is the supra scapular nerve impinged and what is the presentation

A

Suprascapular notch, underneath the transverse scapular ligament
Posterior border of SCM
Limited shoulder flexion and abduction
pain with contralateral cervical rotation

43
Q

Describe type 1-3 AC joint rehab

A 
Recovery with conservative management
Modalities
sling 1-2 weeks
Gentle ROM - isometric for clavicular attachments
full activity in 12 weeks
44
Q

Describe interventions for AC injuries grades 4-6

A

Surgical intervention

Pain free ROM - Normalize arthro - functional training

45
Q

What is the most common direction for SC joint dislocations and some MOIs

A

anterior

MVA, sports

46
Q

Describe the types of SA injuries

A 
1 - sprain of SC ligament
2 - Subluxation
 - A - anterior
 - B - posterior
3 - A - anterior dislocation
    - B posterior dislocation
4 - habitual dislocation
47
Q

How long is the shoulder immobilized for after SC joint injury

A

3-4 days

48
Q

Describe this test

A

Biceps load test

Deep pain indicates SLAP lesion

49
Q

Describe this test

A

IRRST test
weak ER - external impingement
Weak IR - weak internal impingement

50
Q

Describe this test

A

Kim test
Posterior inferior labral lesion
posterior shoulder pain

51
Q

Describe this test

A

Jerk test
Posteroinferior labral lesion
Sharp shoulder pain

52
Q

Describe this test

A

Compression rotation
Labral tear
Catching or snapping

53
Q

Describe this test

A

Crank test

SLAP lesion

54
Q

Describe the fulcrum test

A

Arm over head

Instabilities

55
Q

Describe this test

A

O’Brian test
labral tear
Pain with internal rotation bit not external rotation

56
Q

Describe this test

A

Speed test
pain at bicipital groove
Bicipital tendinopathy and SLAP tear

57
Q

Describe this test

A

Jobe relocation
Pain
SLAP lesion

58
Q

Describe this test

A

Anterior slide test
Pain
SLAP lesions

TRI 3 - MSK 2 (7 decks)

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