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MST > Shoulder > Flashcards

Shoulder Flashcards

1
Q

Instability tests

A

Sulcus sign 0* - 2 or more fingers = abnormal
Sulcus sign 90* - 2 or more fingers = abnormal
Anterior load and shift
Posterior load and shift

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2
Q

Labrum enhances stability (5)

A

-Expands the overall size and depth of glenoid
-Increases the superior/inferior diameter by 75%
-increases the posterior diameter by 50%
-serves as primary attachment of capsule & GH ligaments
- superior is LHB attachment

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3
Q

Biceps important for what in GH joint?

A

Anterior stability

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4
Q

Positive on all 4 GH instability tests means what?

A

Multi-directional instability

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5
Q

SLAP lesion tests

A

Compression-rotation
Anterior slide
Posterior slide
Speeds test
O’Brien’s compression - not sensitive to specific structures, thumb down - AC, thumb up - SLAP
Yergason’s

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6
Q

Subacromial Pain Syndrome Tests

A

Neer impingement
Hawkins-Kennedy
Painful Arc test
Scapular assist test

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7
Q

AC joint tests

A

Cross-body adduction
AC shear
O’Briens active compression

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8
Q

Slap Lesion Grade 1

A

SLAP degenerative
Marked fraying w/degenerative appearance
Periphery attached
LHB firmly attached

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9
Q

Slap Lesion Grade 2

A

Degenerative & fraying
Superior labrum & biceps tendon stripped off underlying glenoid
Results in labral-biceps anchor being unstable & pulled away from glenoid
Most common tear

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10
Q

Slap Lesion Grade 3

A

Bucket handle type tear
Central portion displace into the joint while periphery firmly attached to glenoid

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11
Q

Slap Lesion Grade 4

A

-Bucket handle tear w/extension into biceps
-Labral flap tends to displace into joint

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12
Q

Slap Lesion Type 1 Treatment parameters

A

ROM
As tolerated, no restrictions
Protection phase: Biceps (7-10 days)

Return to sport
Dependent on strength & biomechanics of shoulder
Prognosis: 2-4 weeks

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13
Q

Slap lesion type 2 Treatment Parameters

A

Sling x 4 weeks at all times
Gentle PROM only for week 1.

Full ROM by 6 weeks w/combined ER and abduction the LAST motion achieved

Protection
Avoid biceps resistance ex for 10-12 weeks, no ER beyond neutral x 4 weeks, 40 degrees x 6 weeks
Gentle elbow/wrist/hand ex start day after surgery & continue throughout
After 7-10 days, PT focusing on gentle PROM w/in pain-free range; avoid ER beyond neutral & ext behind body x 4 weeks

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14
Q

Slap Lesion Type 3 Treatment Parameters

A

ROM: similar to type II BUT 1-2 weeks slower
Protection: same as type II
Return to activity: same as type II

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15
Q

Slap Lesion Type 4 Treatment Parameters

A

ROM: dependent of surgery. Excision sling for 3 weeks. Full ROM by 6 weeks
Protection: avoid biceps for 6 weeks if tenodesis or 10 weeks if repaired
Return to sport: 8-10 weeks
Return to throwing: 3-4 months

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16
Q

AC joint injuries

A

Grade 1: AC lig sprain
Grade 2: AC tear and CC ligament sprain
Grade 3: AC and CC ligament rupture

17
Q

Sites of impingement

A

AC Joint
Undersurface of Acromion
CA Ligament
Coracoid Process

18
Q

Subacromial pain syndrome signs

A

Limited AROM ABD and ER
Painful Arc 70-120
PROM full w/o pain
+ impingement tests
supraspinatus painful and weak

19
Q

Primary impingement

A

Degenerative changes to acromion/coracoid
Capsular tightness
Faulty posture

20
Q

Secondary impingement

A

Change in F couple/muscle
Abnormal movement patterns of GH/ Scapulothoracic joint
Instability of Scapula or GH joint

21
Q

3 types of AC morphology

A

Type 1 Human hanging off a rock, 90% surgery success rate
Type 2: more hooked, 60-70%
Type 3: supah hooked, 50-60%

22
Q

3 Stages of shoulder impingement

A

1: Bursitis/Tendonitis: Edema, hemorrhage
2: Partial tear and/or tissue fibrosis
3: Full Thickness Tears

23
Q

Type 1 Shoulder impingement objective findings

A

Painful arc
RC and or Scapular Weakness
Positive tests

24
Q

Stage 2 Shoulder impingement objective findings

A

Crepitus and Catching
Limited ROM

25
Q

Stage 3 Shoulder impingement objective findings

A

Atrophy of supraspinatus/infraspinatus
More limited ROM and weakness

26
Q

Obligate Translation

A

Tightness of posterior capsule forces anterior displacement of center of rotation

27
Q

Internal Impingement Syndrome

A

Mechanical compression of RC insertion point

28
Q

Internal vs External impingement

A

Internal is due to humerus (greater tuberosity) moving posteriorly and superiorly on glenoid

External is structures being compressed under AC joint

29
Q

RCT tear - factors that significantly affect healing (2)

A

Age and tear size

Small = <1cm
Medium= 1-3cm
Large= 3-5cm
Massive= >5cm

30
Q

Hallmark of RCT

A

Night time pain

31
Q

98% chance of full thickness RCT w/ these 3-4 criteria met

A

Age >60
Shoulder abduction weakness
Positive (Neer’s or Hawkins-Kennedy)

32
Q

Painful arc sign for RCT? Combined with what 2 things leads to 90% chance of RCT full thickness tear?

A

60-120*

Drop arm sign
ER weakness

MST (8 decks)

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