Shoulder

Question 1

how much contact does the humeral head have with the glenoid fossa?

Answer 1

25%

Question 2

how much contact does the humeral head have with the glenoid fossa and the labrum?

Answer 2

75%

Question 3

mechanisms of stability at the shoulder most to least

Answer 3

muscular>ligamentous>structural

Question 4

approximation

Answer 4

compression of a segment/joint surface
increase with pushing/weightbearing

Question 5

centration

Answer 5

optimal joint position with balanced muscle forces
stabilization

Question 6

local muscles

Answer 6

joint support/stabilization muscles

Question 7

global muscles

Answer 7

movers of the joint

Question 8

arthrokinematics of the rotator cuff

Answer 8

subscap: posterior glide in IR
ext rotators: anterior glide in ER

Question 9

GH close packed

Answer 9

90 abd, full ER
or
full abd, full ER

Question 10

GH open pack

Answer 10

55 abd, 30 h. add

Question 11

GH capsular pattern

Answer 11

ER>Abd>IR

Question 12

loss of abduction/flexion could indicate…

Answer 12

SAPS

Question 13

loss of IR could indicate…

Answer 13

adhesive capsulitis (last part of capsular pattern)
or post op adhesions

Question 14

night time awakening w shoulder pain could indiacte…

Answer 14

internal derangement

Question 15

kibler type 1 dysfunction

Answer 15

inferior border protrudes due to anterior tilt of the scapula

Question 16

causes of kibler type 1 dysfunction

Answer 16

pec minor or short head of biceps pulling coracoid anteriorly
weakness in lats, lower traps, serratus

Question 17

kibler type 2 dysfunction

Answer 17

entire medial border off ribs with glenoid fossa pointed anteriorly
increased strain on anterior capsule and instability

Question 18

causes of kibler type 2 dysfunction

Answer 18

weakness: serratus anterior/lower traps

Question 19

kibler type 3

Answer 19

superior border of scapula elevated, especially as part of movement pattern

Question 20

causes of kibler type 3 dysfunction

Answer 20

overactive upper traps, weak lower traps

Question 21

other sources of shoulder pain to consider in differential

Answer 21

C spine nerve impingement
peripheral nerve entrapment
diaphragm irritation
intrathoracic tumor
MI
pancoast tumor

Question 22

ACJ separation MOI

Answer 22

trauma: FOOSH, blow to shoulder, fall on anterior shoulder

Question 23

ACJ separation

Answer 23

more common in men than women

Question 24

types of AC joint separation

Answer 24

type I: partial or complete disruption of AC ligaments, intact coracoclavicular ligaments
type iI: fully torn AC ligaments + coracoclavicular partial tear
III: coracoclavicular ligament complete tear, separation of clavicle from acromion
IV-VI: uncommon, involvement of muscle tear causing wide displacement

Question 25

subjective of ACJ separation

Answer 25

relief with supported/cradled arm
localized pain over AC joint

Question 26

objective fo ACJ separation

Answer 26

may be obvious deformity
pt supporting arm adducted
swelling
pain w passive adduction

Question 27

ACJ special tests

Answer 27

cross body adduction test
AC resisted extension test

Question 28

ACJ intervention

Answer 28

type 1 and 2 can heal with protection and rest, moving into gentle ROM, nonpainful strengthening of deltoid and traps
unrestricted activity 2-4 weeks later
types 3 and 4 may need surgery