Shoulder Flashcards
What are burners and stingers
Some type of impingement in the arm that injures the nerve network and causes paraesthesia or burning sensation in shoulder, forearm, hand and fingers (usually unilateral)
Describe shoulder dislocation incidence rate and most common type
What are some red flags in the shoulder
Review shoulder functional anatomy
Describe the glenoid labrum
Describe the inferior glenohumeral ligament
Describe the superior glenohumeral ligament
Describe the middle glenohumeral ligament
Describe the rotator cuff interval
What muscles/structures provide primary and secondary stabilization to the shoulder
Describe the brachial plexus
What are the structures that contribute to static and dynamic stability of the shoulder
What is the algorithm for a first time dislocation
What are the classifications of shoulder instability
What is the most common pathologies found at first time dislocation
Describe a Bankart lesion
Describe a bony bankart lesion
Describe a hill sachs lesion
Describe a SLAP lesion
Compare the location of SLAP, posterior, and bankart lesions
Describe an ALPSA lesion
Describe AMBRI
What is the Beighton score
What are the recommendations for shoulder dislocation and the chance of recurrence for individuals
Describe provocative tests (shoulder dislocation)
Describe laxity tests (shoulder subluxation)
The clinical utility of each test
Treatment programs for shoulder subluxation
What are the shoulder instability guidelines for TUBS, AMBRI, and AIOS
When do we need a referral for imaging for shoulder dislocations
What is the prognosis/return to sport for dislocation
According to Brownson et al. what is the common MOI, common presentations and recurrence of shoulder dislocations
What features are important to consider for shoulder dislocation according to brownson et al.
According to Brownson et al. what are the red flags of the shoulder
Diagnosis of shoulder problems in primary care
How long is physio rehab for shoulder dislocation rehab according to Brownson et al.
4-12 weeks
Is imaging indicated for shoulder dislocation for treatment according to Brownson
Should have 2 views on an Xray -> antero-posterior and and an axial view
What is a suggested management for shoulder dislocation according to brownson et al.
According to Brownson et al. what factors can lead to shoulder instability after a dislocation
According to Longo et al. what are the 2 best surgical procedures if rehab management fails for shoulder dislocation
Arthroscopic capsular plication and open capsular shift
Compare direct vs indirect MOI for ligament tear in AC Joint
What is the etiology of the AC Joint
What is the difference between dislocation and separation of the AC Joint
Dislocation: Shoulder comes out of joint
Separation: Clavicle separates from ligamentous tears
**Both very commonly used interchangeably so make sure you clarify what actually happened
What are the ligaments of the AC joint
Describe the Rockwood classification for AC joint tears
What is the intervention for AC joint tears
Describe the treatment strategies based on the Rockwood classification
What are 4 key factors to remember for AC joint injuries
Describe a proximal humerus fracture
What does the examination look like for someone with a proximal humerus fracture
What does the interventions look like for someone with a proximal humerus fracture
NOTE: If in sling for too long can lead to frozen shoulder (capsular and ligament tightness) and lots of atrophy
What are surgical intervention for proximal humerus fracture
Is surgery or a sling recommended for proximal humerus fractures?
Describe clavicle fractures
What are the types of clavicle fractures
What are the classifications of clavicle fractures
What is the operative and non-operative interventions for clavicle fractures
Describe sterno-clavicular injuries
Describe the intervention for SC injuries
Describe the staging for SC injuries
According to Pearl et al. what are some key things with SC injuries
Describe rupture of the long head of the biceps
Describe pec major tears
Describe subscapularis tears
What is the prognosis for shoulder pain
Compare A/C joint vs proximal humerus fracture vs clavicle fracture vs S/C joint
Where does adhesive capsulitis occur (frozen shoulder)
What is the demographic, prevalence, risk factors and presentation for frozen shoulder
Compare a diagnosis of frozen shoulder to secondary stiff shoulder
What is the pathophysiology of frozen shoulder
What are the 3 stages of frozen shoulder and how long do they last
What are 2 key facts to keep in mind for frozen shoulder
How de we diagnose frozen shoulder
What is the pathophysiology of glenohumeral joint OA
Describe the process of glenohumeral joint OA
-Cartilage cracks form over time which then widen from cell proliferation which can cause pieces of cartilage to peel off, exposing bone that rubs on the fossa
What are the demographics, prevalence, risk factors and MOI for glenohumeral OA
What are 4 factors that affect the prognosis for shoulder pain
What factors result in poor prognosis of shoulder pain with non-surgical management
On clinical assessment (history and exam) what would help us rule in frozen shoulder
What are the special tests to use for frozen shoulder
NOTE: Only good for seeing mobility but these tests can also be used as treatment
What are some outcome measures to use for frozen shoulder
What are the recommendations for frozen shoulder intervention based on CBG
What should our dosage be for frozen shoulder
What is the medical management for frozen shoulder and shoulder OA
NOTE: None of these treatments will work without PT
Comparison chart for anterior GH dislocation, reactive tendinopathy, reactive degenerative tendinopathy, adhesive capsulitis (frozen shoulder), and shoulder OA
CPG recommendations for forzen shoulder
According to Mertens et al what is important interventions for frozen shoulder
-Mobilization with exercise
-Patient education with pharmacotherapy
-PNF
-Mirror therapy
Explain the deltoid-rotator cuff force couple
Describe the function of the supraspinatus
Describe the function of the infraspinatus and teres minor
Describe the function of the subscapularis
Describe the function of the long head of the biceps
What are the 3 stages of tendinopathy and describe them
Intrinsic factors that can impact rotator cuff tendinopathy are
Describe a rotator cuff tear in terms of tendinopathy resulting in poor function, pain and its pathology
List extrinsic factor that can impact rotator cuff tendinopathy
Describe acromion type tendinopathy
Summary chart rotator cuff tendinopathy
Describe scapular and humeral head kinematics extrinsic factors
Should surgery be performed on subacromial impingement
Describe the recommendations for subacromial pain syndrome and rotator cuff disease
Describe subacromial impingement syndrome
Compare a symptomatic rotator cuff and its ability to heal based on tendinopathies
Outcome measures to use for shoulder tendinopathies
What should the physical exam look like for rotator cuff tendinopathies
Compare the findings between impingement, rotator cuff pathology, scapular dyskinesis, instability, slap and biceps related pathology
What does chemo do to the muscles (cancer treatment)
Can cause degeneration due to steroids and also less use can lead to atrophy and weakness making more prone to degenerative tendinopathies and potentially rotator cuff tears
Describe the shoulder symptom modification procedure (SSMP)
Exercises for tendinopathy
What kind of functional testing can you do for rotator cuff tendinopathies
What should dosage look like for rotator cuff tendinopathies
List factors that affect the prognosis of shoulder pain
Rehab strategies for the shoulder
What are poor prognostic factors for non-surgical shoulder management
