Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MPT 2 > Shoulder > Flashcards

Shoulder Flashcards

1
Q

what is the issue with the medical model?

A
  • no reliable correlation with symptoms
  • does not guide rehab clinical decision making
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does the medical model exam/treatment consist of?

A
  • take history
  • perform exam
  • assign a diagnosis
  • prescribe treatment based on that diagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T or F: there are special tests that are 100% sensitive and specific

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

special tests are most useful for ruling _______ conditions

A

out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T or F: treatment based on the medical model works well for most rehab patients

A

F: patients with the same medical diagnosis can present very differently and therefore need different treatments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

two cases in which the medical model is valid

A

fracture management
surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

you have a patient with subacromial pain syndrome suffering an exacerbation (9/10 pain) after painting. what is the optimal management for this patient

A

rest, NSAIDs, isometrics, education on prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

you have another patient with SA pain syndrome who only experiences intermittent pain, especially with elevation. he has 0/10 pain at rest. what is the optimal management for this patient?

A

sleeper stretch
eccentric posterior RC exercises
long term endurance training depending on goals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are two major things that guide intervention?

A

impairments and SINS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

SINS (acronym)

A
  • Severity (how functionally limiting)
  • Irritability
  • Nature (trauma/overuse)
  • Stage (acute/chronic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the two most important questions to ask during subjective

A

age and onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

examples of common overall impairments

A
  • motion restriction
  • strength
  • endurance
  • fear avoidance
  • central sensitization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

ultimate goal of PT is to identify the most relevant _________- and apply the optimal ________ for it

A

impairment
intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T or F: the rehab model can include a medical diagnosis

A

T: patients want a label and other medical providers are familiar with them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

the main focus of the rehab model is…

A

impairments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T or F: most atraumatic MSK pain is linked to a pathoanatomical (medical) diagnosis

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are two approaches to always avoid with atraumatic MSK pain?

A

1 - linking image finding to pain presentations
2 - linking interventions to a “fix”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T or F: imaging findings are common without symptoms

A

T: disk degeneration, cuff tears, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

you want patients to have an _________ locus of control. What does this mean?

A

internal
they are in control of the situation *image findings can shift them to external

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

it is important to talk about lifestyle changes with your patients. these can include… (3)

A

tobacco use
weight loss
managing pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

screening determines what?

A

if a patient is appropriate for PT?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

your pt is a 71 y/o who c/o R shoulder pain. there was not MOI. he has weakness with RC muscle testing. is this pt appropriate for PT?

A

yes, based on how rehab goes he may benefit from imaging or surgical eval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

your pt is a 23 y/o who c/o R shoulder pain after falling down the stairs and catching himself on an outstretched hand. he is very guarded and you were not able to complete a full exam due to pain. is this pt appropriate for PT?

A

no, you need an ortho opinion first, he may be appropriate after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

you pt is a 50 y/o male complaining of L shoulder pain that also radiates to the jaw. he is short of breath. you are unable to reproduce the pain with shoulder testing. is this patient appropriate for PT?

A

no - these are red flags. 911

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

red flags

A

serious pathology (cauda equina, heart attack, cancer, fracture, infection, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

orange flag

A

psychiatric symptoms (depression and anxiety)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

yellow flags

A

beliefs and pain behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

blue flags

A

work related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

black flags

A

system or contextual obstacles (insurance, litigation, overly helpful/unhelpful family)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

cervical radiculopathy special tests

A

compression, spurlings, quadrant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

thoracic outlet special tests

A

roos, wrights, adsons, tinels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

myelopathy
- what is it?
- signs/symptoms?

A
  • compression of spinal cord
  • UMN, bowel/bladder issues, clumsiness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

SINS guide the ________ of the treatment whereas impairments guide ______ of the treatment

A

intensity
location

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

how many levels of irritability

A

3 (high, moderate, low)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

signs of high stage of irritability

A
  • high pain (7/10 or more)
  • consistent night/rest pain
  • pain before end range
  • AROM < PROM
  • high disability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

signs of moderate stage of irritability

A
  • mod pain (4-6/10)
  • intermittent night/rest pain
  • pain at end range
  • AROM - PROM
  • mod disability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

signs of low stage of irritability

A
  • low pain (<3/10)
  • no night/rest pain
  • min pain w/ overpressure
  • AROM = PROM
  • low disability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

treatment approach for high level of irritability

A
  • modify activity to not stress affected tissue but don’t stop all activity
  • therex and manual to reduce symptoms
  • isometrics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

in patients with _______ irritability, is may be difficult to reproduce comparable signs

A

low
if you can’t replicate the aggravating task in the clinic have them do it before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

treatment for pain from injury

A
  • rest
  • avoid aggravating activities but don’t stop moving
  • NSAIDs
  • RICE
  • isometrics
  • maintain motion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

TORDS (central sensitization s/s)

A
  • Tenderness to diffuse palpation
  • Overreaction
  • Regional disturbances
  • Distraction testing
  • Simulation testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

treatment for central sensitization

A
  • motivational interviewing
  • SMART goals
  • PNE
  • meditation
  • exercise
  • diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

T or F: central sensitization can be acute or chronic

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what are some causes of limited ROM? (5)

A

pain
healing
tightness
fear
weakness
*identify cause to determine treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

treatment options for ROM

A

PNF, AAROM, mobilizations, strengthening

46
Q

what are some causes of excessive motion?

A
  • behavioral
  • strength
  • endurance (sx after hours of activity)
  • proprioception
47
Q

T or F: there is an optimal level of strength

A

F: it depends on what the patient needs to get back to

48
Q

in addition to pt education and strengthening to treat hypermobility what could you also possible recommend for the pt during activity

A

bracing

49
Q

painless weakness could be due to…

A

a neurological issue

50
Q

disuse atrophy could be due to… (2)

A

compensation patterns
poor conditioning

51
Q

reduced motor control could be due to _____ entrapment

A

nerve

52
Q

weakness of what muscle can cause scapular winging

A

serratus anterior

SA is an upward rotator of the scapula

53
Q

T or F: strengthening above 90 degrees is indicated for most patients

A

F: but it is for overhead athletes

54
Q

T or F: activity intolerance is always an issue of overuse

A

F: it is more likely inconsistent use

55
Q

treatment for activity intolerance

A
  • structured return to activity program
  • progress according to symptoms
  • modify but increase overall exercise
56
Q

T or F: all patients are likely to respond to manual therapy

A

T: but magnitude of response is variable

57
Q

is a cavitation required for manual therapy

A

no

58
Q

is one technique of manual therapy better than another

A

no

59
Q

are a specific number of treatments required for manual therapy

A

no

60
Q

T or F: manual therapy should be used alone

A

F: always combine with active interventions

61
Q

5 grades of joint mobilization

A

1 = small amplitude, no resistance
2 = large amplitude, no resistance
3 = large amplitude into resistance
4 = small amplitude into resistance
5 = high velocity thrust

62
Q

ROM progression

A

active range in protected arc > full AROM > AAROM > PROM > PROM w/overpressure > end range mobilizations > muscle energy technique

63
Q

strength progression

A

submax isometric > max isometric > multi-angle isometrics > limited range concentric > full range concentric > heavy slow resistance > eccentrics > heavy load eccentrics > pylometrics

64
Q

T or F: patients tend to overuse supervised rehab

A

T

65
Q

what do they reconstruct for AC joint reconstruction

A

cc lig complex

66
Q

two possible causes of shoulder instability

A

soft tissue
bone

67
Q

what is important to prevent during AC injury management

A

stiff shoulder

68
Q

sling use puts you shoulder in what position

A

protracted scapula
rounded shoulders
*this can create pain and tightness

69
Q

which grade of AC joint injury has no consensus on management?

A

Grade 3 (some operative, some non-operative)

<3 = non operative
>3 = operative

70
Q

conservative management of grade 3 ac joint injury includes

A
  • maintain/return ROM
  • pain free strengthening
  • address scap diskinesia
71
Q

most pts with grade 3 AC joint injuries that are managed conservatively return to work in ______ days

A

9

72
Q

pts with grade 3 AC joint injuries that are managed conservatively may have limits with what movements

A

bench press strength (manual laborers, weightlifters)

73
Q

T or F: operative management to repair AC joint (weaver-dunn) has a high failure rate

A

T

74
Q

T or F: there are many complications with AC joint operations

A

T: fracture risk, malposition, persistent pain/instability due to graft tensioning

75
Q

AC ligaments resist _______ movement and cc ligaments resist ________ movement

A

anterior-posterior
superior-inferior

76
Q

pts with AC joint reconstruction are in a shoulder immobilizer for __________ weeks

A

4-6

77
Q

at 4 weeks post-op AC joint reconstruction, you can do AAROM _______ to 90 degrees and ________ as tolerated

A

flexion
ER

78
Q

At _______ weeks post-op AC joint reconstruction, you can do full motion

A

6-12

79
Q

_______ months post-op AC joint reconstruction you can begin strengthening and after _______ months you can return to sports

A

3, 6

80
Q

what is the definition of failure after AC joint reconstruction

A

loss of reduction

81
Q

you pt really wants to stop wearing his sling 2 weeks after AC joint reconstruction. you explain that is not a good idea. why is it important to follow guidelines for sling usage?

A

having the arm hanging at your side causes a lot of stress on the AC joint and can lead to a loss of reconstruction

82
Q

what is the primary complication of shoulder dislocation

A

recurrence

83
Q

risk factors for shoulder dislocation recurrence

A

age (younger)
contact sports
severity of injury

84
Q

what is the most common dislocation of the shoulder?

A

anterior-inferior

85
Q

what nerve should you test after shoulder dislocation and how?

A

axillary
palpate deltoid and have then push out into your hand… feel for contraction

86
Q

what is the primary goal after shoulder dislocation?

A

no instability
*also avoid stiff shoulder

87
Q

T or F: there are studies that show bracing is effective for shoulder instability

A

F

88
Q

what position does a sully shoulder stabilizer prevent

A

apprehension position

89
Q

bankhart procedure

A

soft tissue
*sling use is variable

90
Q

laterjet

A

bone transfer procedure (coracoid to glenoid)
*sling use for about 6 weeks and restricted ER

91
Q

a laterjet is indicated with > _____% of glenoid bone loss

A

25%
*also performed if Bankart fails

92
Q

does a bankhart or laterjay procedure have a harder recovery?

A

laterjay… b/c you are screwing bone into bone

93
Q

other names for subacromial pain syndrome (SAPS)

A

RC tendonitis, SA bursitis, impingement

94
Q

T or F: most SAPS responds w/o surgery

A

T

95
Q

what is the primary goal when treating SAPS

A

avoid painful position

96
Q

common interventions for SAPS

A
  • cuff strengthening
  • scap stabilization
  • posterior capsule stretching
97
Q

subacromial decompression

A
  • attempt to cut out the pain caused by SAPS
  • debridement, acromioplasty, LH biceps tenodesis/tenotomy, distal clavical excision
98
Q

LH biceps tenodesis vs tenotomy

A

tenodesis = attaching biceps tendon to humerus
tenotomy = cut the biceps tendon and let it retract
*tenodesis can fail!

99
Q

treatment for post op subacromial decompression

A
  • allowing healing
  • prevent stiff shoulder
  • sling use outside home/maybe at night
100
Q

T or F: most RC tears require surgical consultation

A

F

101
Q

T or F: most RC tears do not cause shoulder symptoms and are a normal part of an aging shoulder

A

T

102
Q

what is the most common RC tear? why?

A

supraspinatus
- hypovascular zone, location, high activity (it works even at rest)

103
Q

most RC tears benefit from ______ weeks of trial rehab

A

6

104
Q

2 reasons to get a surgical consult with a RC tear

A

1 - full thickness tear (b/c risk of retraction)
2 - tear with increasing symptoms

105
Q

what is Bakody’s sign?

A

placing arm on top of head reduces peripheral symptoms in the UE
*suggestive of cervical radiculopathy

106
Q

what are some treatment you could do for radiating pain due to cervical radiculopathy?

A

supine maual traction
SB opening home exercise

107
Q

what are some scapular exercises?

A

high rows
mid rows
low rows
robber?
face pull

108
Q

what motion should you avoid during face pulls?

A

IR

109
Q

what are some treatments you could provide for limited IR due to posterior capsule tightness?

A
  • A/P glides
  • sleeper stretch
  • wall slides
110
Q

what kind of ROM do you do if ROM loss is due to pain?

A

PROM and AAROM

111
Q

exercises that produce high levels of activity for supraspinatus and infraspinatus

A

1 - push up plus
2 - prone horizontal abduction
- prone ER at 90
4 - full can scaption

112
Q

exercises that produce high levels of activity for subscapularis (4)

A

1 - resisted elevation
2 - standing row
3 - IR at 90 of ABD
4 - resisted shoulder extension

MPT 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions