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Anatomy + Biomechanics + Ortho Tests > Shoulder > Flashcards

Shoulder Flashcards

1
Q

What orthopedic tests are used to determine a SLAP lesion?

A

Crank test
Biceps load 2
Pain provocation test
O’breins (pain in 1st position relieved in 2nd position)
Speeds
Yergasons (pain w.o pop)

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2
Q

What orthopedic tests are used to determine subacromial impingement?

A

Neer impingement
Empty can
Hawkins Kennedy
External Resistance

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3
Q

What orthopedic tests are used to determine shoulder instability?

A

Apprehension
Relocation
Surprise
Sulcus sign
Posterior apprehension

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4
Q

What orthopedic tests are used to determine posterior labral tears?

A

Kim’s Test
Jerk Test

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5
Q

What orthopedic tests are used to determine rotator cuff issues?

A

Empty can
Drop arm
Painful arc
Bear hug
Lift off
Belly press
External rotation
Hornblowers

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6
Q

Describe the 4 types of SLAP lesions?

A

Type 1: labral + bicep fraying (anchor intact)
Type 2: labral fraying with bicep tendon detachment
Type 3: Bucket handle tear with biceps tendon intact
Type 4: Bucket handle tear with bicep tendon detachment

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7
Q

What is a Bankart lesion? Name common causes.

A

Injury to the anteroinferior glenoid labral complex. A common complication of anterior shoulder dislocation or repeated anterior shoulder subluxations.

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8
Q

What are the two types of Bankart Lesions?

A

Type 1 (Soft): labrum tears from glenoid (only involves soft tissue) MC*
Type 2 (Hard): Labrum tears and breaks part of the glenoid off with it.

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9
Q

What muscles make up the rotator cuff and what is their action and innervation?

A

Supraspinatus - suprascapular N (C5-C6) - abducts the arm 0-15 degrees then assists delts
Infraspinatus - suprascapular N (C5-C6) - externally rotates shoulder + assists in shoulder extension
Teres minor - Axillary (C5-C6) - externally rotates the shoulder + assist in shoulder extension
Subscapularis - subscapular N (C5-C6) - internal rotation of the humerus

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10
Q

Name all the shoulder ROM and their degrees

A

Flexion = 180
Extension = 50
Abduction = 180
Adduction = 35
External Rotation = 80
Internal Rotation = 90

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11
Q

What is open/closed packed position of the shoulder?

A

Open: 50 degrees of abduction + slight horizontal adduction + external rotation
Closed: Abduction + External Rotation

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12
Q

What is the capsular pattern of the shoulder?

A

External rotation most affected followed by abduction, internal rotation, and flexion

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13
Q

What are the 4 visero-somatic referral sites for shoulder pain and their specifc locations?

A
  1. Diaphragm: (via the phrenic) (supraclavicular area, traps and superior angle of scapula
  2. Gallblader: scapular + deep epigastric tenderness
  3. Lungs: pulmonary infarct or upper lobe pancoast tumor
  4. Cardiac: myocardial ishcemia = infraclavicular area Aortic arch = right side of neck Transverse/Descending arch = left medial shoulder
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14
Q

What is the most common cause of non-tramuatic shoulder pain and name the 3 types?

A

**Tendonitis **
1. Degenerative
2. Traumatic
3. Calcific

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15
Q

What is the critical zone of the shoulder? Whats significant about this area?

A

A highly vascularized zone at the anastomosis of muscular and ossesous vessels. This zone has great tensile strength. Its the site of tendon rupture and calcium deposits.

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16
Q

The most likely diagnosis, its mc causes & how long til it resolves?

  • Rarely ever primary condition almost always secondary to degeneration
  • All ROM restricted & painful
  • Patient holding arm at side like its in a sling
  • Acute pain +/- redness & swelling
  • Tenderness at lateral GH joint
A

**Subacromial bursitis **
mc caused by vigorous training on untrained muscles or a sudden pull down on the arm
Total resolution 1-2 weeks, 50% better in 48 hrs

17
Q

Whats the most likely diagnosis? Goals for therapy?

  • Diffuse pain at anterior shoulder
  • External rotators weaker than internal rotators
  • Fatigue/weakness of dynamic stabilizers
  • Increased motion with associated instability
  • Pain with overhead activities
  • Increased pain at night from laying
  • Point tenderness between AC + coracoid
  • Limited ROM, + hawkins kennedy & neers & painful arc from 60-120 degrees
A

**Subacromial Impingement **
Initially: rest, ice, IFC (for inflammation)
Gradually restore ROM + strengthen rotator cuff
Look at scapular stability + pec flexibility
Rehab away from pain

18
Q

Whats Jacks diagnosis & what is MC structures involved in this injury

Jack a 60 yr old man FOOSH and had immediate severe anterior shoulder pain but then pain went away for a few hours. His AROM is very difficult especially abduction. All RROM are weak and painful. Eccentric movements more painful than concentric movements.

A

Rotator Cuff tear
The supraspinatus tendon where it attaches to the greater tuberosity of the humerus

  • rotator cuff tears mc in people over 50, repetitive overhead occupations
  • partial tears are often a lot more painful than complete tears
19
Q

What muscles accelerate the shoulder and what does mean in terms of training?

A
  1. pec minor
  2. ant delt
  3. lats
  4. teres major
  5. triceps
  6. pec major
  7. serratus anterior
  8. subscapularis

Accelerators should be trained concentrically

20
Q

What muscles decelerate the shoulder and what does mean in terms of training?

  • Loss of eccentric control leads to signifcant rotator cuff dysfunction in overhead activities **
A
  1. infraspinatus
  2. teres minor
  3. supraspinatous
  4. posterior deltoid
  5. brachialis
  6. rhomboids

Decelerators should be trained eccentrically

21
Q

What are 90% of shoulder dislocations caused by and Name the 4 types of dislocations

A

Anatomic weakness
1. Subcoracoid (mc)
2. Subclavicular
3. Subglenoid (2nd mc)
4. Subspinous (post)

22
Q

What is the most common movements for dislocations?
Mc MOI for anterior dislocations?
Mc MOI for posterior dislocations?

A

Most common movement is external rotation and abduction
Mc MOI: FOOSH
Mc MOI: blow to front of shoulder

Anatomy + Biomechanics + Ortho Tests (5 decks)

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