Shoulder Flashcards
SLAP tear Type 1
Labrum only, frayed and degenerated
SLAP tear Type 2
labrum plus bicep detachement
SLAP tear Type 3
bucket handle tear of labrum
SLAP tear Type 4
bucket handle labrum + bicep peel back
Bankart lesions: soft tissue
- anterior/inferior labrum avulsion
- posterior capsule stretched
- inf glenohumeral ligament torn
Bankart lesions: Bony
fracture of ant/inf glenoid rim
Most specific labrum test
Speeds (67-99%)
Most sensitive labrum test
O’Brien’s Test (47-78%)
SLAP cluster
- Crank
- anterior apprehension
- O’Brien’s Test
- Speeds/yergeson/bicep load
75% sensitivity
90% specificity
Posterior Inferior Labrum testing
Jerk Test
Kim Test
Hill Sachs lesion
Fracture of posterior lateral humeral head
Grade 1: articular surface lesion
Grade 2: subchondral
Grade 3: larger
Testing for hill sachs lesino
Sensitive: bony apprehension, olecranon manubrium percusion
Specific: relocation
RTC testing
Sensitive: Empty can
Specific: full can
Both: lateral jobe test
RTC signs
age >45, men>women, hx smoking, systemic disease, pain at night with horizontal add and IR
Limited AROM vs PROM
Painful arc
80-120 = RTC higher = AC jt
Impingement Testing
Neer
Hawkins-Kennedy
(tests have better sensitivity – rule out)
Instability testing
- Sulcus sign
- subluxation/relocation
- apprehension
- anterior/posterior translatin/provication
ER/IR strength ratio
66% (lower in shoulder pathology patients)
Primary Shoulder Impingement
direct result of compression of RTC tendons between humeral head and AC/coracoid.
Secondary Shoulder Impingement
Resulting from underlying instability of GH jt
TUBS
Traumatic Unilateral Bankart Surgery
AMBRI
Atraumatic Multidirectional Bilateral Rehab Inferior capsular shift
rehab usually works but they may need inf capsular shift
MDI
Multidirectional instability
unstable in at least 2 directions
Ligament affected with anterior dislocation
Anterior/Inferior GH lig: compromised in abd and ER
Best imaging view for hill sachs
striker notch or shoulder IR views
Best for viewing glenoid (dislocation)
Scapular Y/Lateral scapular view
Rockwood Classification for AC jt injury
type 1: AC lig sprained type 2: AC lig torn, sprain of coracoclavicular ligaments type 3: everything torn type 4: post displacement of clavicle Type 5: elevation of clavicle Type 6: inf displacement of clavicle
Radiograph for AC injury
B AP view
lat axillary view
Zanca view
Adson’s test
interscalene triangle TOS test
vein not in there
Costoclavicular test
costoclavicular space TOS test
Passive shoulder shrug test
TOS - relieve symptoms
costoclavicular space test
Wrights test, Roos test, hyperabd
implicate pec minor and subcoracoid space
Bankart Repair prognosis
Full ROM in 10-12wks
