Shoulder

Question 1

AC Ligament -sprain
Coracoclavicular ligaments - intact and stable

Answer 1

Type 1

Question 2

AC Ligament - rupture
Coracoclavicular ligaments -sprain
distal clavicle - not stable

Answer 2

Type 2

Question 3

AC Ligament - rupture
Coracoclavicular ligaments - rupture
Joint instability - step off deformity

Answer 3

Type 3

Question 4

AC Ligament -rupture
Coracoclavicular ligaments -rupture
clavicle displaced posteriorly

Answer 4

Type 4

Question 5

AC Ligament - rupture
Coracoclavicular ligaments -rupture
superior displacement of the clavicle

Answer 5

Type 5

Question 6

AC Ligament - rupture
Coracoclavicular ligaments - rupture
subcoracoid or subacromial displacement of distal clavicle

Answer 6

Type 6

Question 7

TUBS

Answer 7

Traumatic, Unilateral, Bankart, Surgery

Question 8

AMBRI

Answer 8

Atrauamtic multidirectional bilateral rehab inferior capsular shift

Question 9

Special Test used to assess for elevated first rib

Answer 9

Cervical rotation lateral flexion test - kappa .84

Question 10

CPR for Thoracic Manipulation for shoulder pain

Answer 10

89% success with 3
4 or more = 100%

Pain free shoulder flexion < 127 degrees
IR < 52 at 90 of abduction
negative neer
not taking pain meds
sx < 90 days

Question 11

Adhesive Capsulitis with a MOI is defined as

Answer 11

Secondary AC

Question 12

Adhesive capsulitis without a MOI / insidious onset is defined as

Answer 12

Primary AC

Question 13

This ligament restrains inferior humeral movement at 0 degrees of shoulder elevation

Answer 13

Superior GH

Question 14

This ligament restrains the GH joint when the shoulder is abducted

Answer 14

Inferior GH

Question 15

This ligament restrains anterior translation / ER of the GH joint

Answer 15

Middle GH

Question 16

Painful arc of 60-120

Answer 16

subacromial impingement

Question 17

painful arc of 120-160

Answer 17

AC joint issue

Question 18

Best position to strengthen the supraspinatus

Answer 18

Full can - minimizes contribution from the deltoid

Question 19

Cluster for RTC Tear

Answer 19

Drop arm
Painful arc
Infraspinatus muscle test / ER weakness
Age > 60

Question 20

There is pain reduction and/or a gain in ROM by assisting the scapula into upward rotation with shoulder flexion, this is an example of a (+) what special test?

Answer 20

Scapular assistance test

Question 21

a (+) Flip sign is what?

Answer 21

The medial border of the scapula will protrude/”flip” up when resisting shoulder ER. This indicates a loss of scapular stability and you need to strengthen the scapula with serratus anterior and trap force couple

Question 22

Whats the test position for Champagne Test? What Muscle is this testing?

Answer 22

Supraspinatus

30degree of abduction, slight ER, 30 degree of flexion

Question 23

Whats the difference between the MMT for Infrspinatus and teres minor testing?

Answer 23

Both ER - Teres Minor at 90 degrees of abd, Infraspinatus ER at neutral

Question 24

Hill Sach Lesion

Answer 24

Compression fix of posterior lateral humeral head when it hits the glenoid rim upon dislocation

Question 25

Bankart Leison

Answer 25

Anterior labral detachment. IGHLC disrupted

Question 26

How would you grade the following GH joint assessment? The humeral head translates over the glenoid rim with spontaneous return on removal of stress

Answer 26

Grade 2 - Also, presence of translation without pain indicates laxity not instability Grade 1 - translation within the glenoid Grade 3 - dislocation

Question 27

What are the 3 views for radiography for the shoulder?

Answer 27

AP Scapular Y Axillary

Question 28

What is primary impingement?

Answer 28

compression of the rotator cuff tendons between the humeral head and the overlying anterior third of the acromion, coracoacromial ligament, coracoid, or acromioclavicular joint

Question 29

What is posterior impingement?

Answer 29

Shoulder at 90-90 position causes the supraspinatus and infraspinatus tendons to rotate posteriorly This more posterior orientation of the tendons aligns them such that the undersurfaces of the tendons rub on the posterior-superior glenoid lip and become pinched or compressed between the humeral head and the posterior-superior glenoid rim Late cocking phase of throwing makes this all worse

Question 30

What is an optimal ER/IR ratio for strength?

Answer 30

66% - 1:2

Question 31

Sizes and grades of RTC tears

Answer 31

small - < 1 cm Medium 1-3cm large 3-5cm massive >5cm full thickness - actual measurment

Question 32

risk factors for post op stiffness following RTC repair

Answer 32

calcific tendinitis, partial articular supraspinatus tendon avulsion lesions, concomitant superior labrum anterior to posterior repairs, preoperative adhesive capsulitis, and single-tendon rotator cuff repairs

Question 33

What is the reasoning for early motion in the rehab process following surgery?

Answer 33

is intended to promote healing, enhance collagen organization, stimulate joint mechanoreceptors, and aid in decreasing the patient’s pain through neuromuscular modulation

Question 34

Types of SLAP Tears

Answer 34

Type I: Debridement Typer 2: Repair Biceps anchor attachment Type 3: Debridement of bucket handle type tear Type 4: same as 3; repair biceps tenodesis or tenotomy

Question 35

Stages of Adhesive Capsulitis

Answer 35

1. Pre Adhesive Stage Demonstrates mild erythematous synovitis and may last up to 3 months while the patient experience sharp pain at end ranges of motion, achy pain at rest, sleep disturbance May be diagnosed with RTC impingement (incorrectly). To avoid this, know that ER is lost with an intact RTC Stage 2: Acute Adhesive or Freezing Stage Thickened red synovitis during a 3-9 month period Patients have acute discomfort and very painful end ranges of all motions. Mild rom loss Stage 3: Fibortic Stage or Frozen Less synovitis. More mature capsuloligamentous fibrosis results in significant stiffness with less pain. Limited motion under anesthesia Stage 4: Thawing No synovitis Painless stiffness and motion improves by remodeling from 15-24 months