Shoulder

Question 1

What is the role of the fibrocartilaginous labrum in shoulder stability?

Answer 1

increases articulating surface area

enhances stability

Question 2

What are the four muscles of the rotator cuff?

Answer 2

supraspinatus
infraspinatus
teres minor
subscapularis

Question 3

What motions does supraspinatus aid in

Answer 3

depresses and centers the humeral head in the glenoid as the deltoid abducts the arm

Question 4

What motions do infraspinatus and teres minor aid in

Answer 4

external rotation

Question 5

What motion does subscapularis aid in?

Answer 5

internal rotation

Question 6

Describe subacromial impingement

Answer 6

Previous injury to the AC joint, degenerative changes secondary to overuse and/or aging can result in spurring at the undersurface of the AC joint and/or calcification of the coracroamial ligament, decreasing the space beneath the coracoacromial arch, leading to subacromial impingement.

Question 7

What tendon is most commonly involved in rotator cuff injuries?

Answer 7

supraspinatus

Question 8

What group are at greatest risk of acute rotator cuff injury?

Answer 8

over 40 years, activity induced

Question 9

Describe chronic rotator cuff injuries

Answer 9

subacromial impingement
tendinosis
tears
more common with aging, degeneration, overuse, external or internal comrpession

Question 10

Describe the pain associated with rotator cuff pathology

Answer 10

• anterolateral shoulder pain, particularly with reaching overhead or behind the back.
• radiates to the deltoid region, may also radiate to the neck or down the arm to the elbow
• pain worse at night in tears

Question 11

Describe the pain associated with rotator cuff pathology

Answer 11

• anterolateral shoulder pain, particularly with reaching overhead or behind the back.
• radiates to the deltoid region, may also radiate to the neck or down the arm to the elbow
• pain worse at night in tears

Question 12

Patients older than 50 years are likely to have true bony impingement from _______ and thus have pain even at rest, as well as shoulder weakness

Answer 12

subacromial spurring

Question 13

_____ is the gold standard for imaging rotator cuff pathology

Answer 13

MRI

Question 14

Subacromial impingement is an _____ condition wherein there is decreased space between the undersurface of the acromion and supraspinatus leading to pain and dysfunction

Answer 14

extrinsic

Question 15

Rotator cuff _____ is a degenerative process of the tendon including varying degrees of inflammation and degeneration.

Answer 15

tendinosis

Question 16

Rotator cuff tendinosis is commonly associated with ______ __________

Answer 16

subacromial impingement

Question 17

Describe treatment for rotator cuff tears

Answer 17

• smaller tears with minimal functional defects (ex older patients) treated with injections and PT
• surgery for large acute tears, tears of any size in young active patients

Question 18

Surgical intervention for rotator cuff tears must address all associated pathology including:

Answer 18

removal of spurs from acromian/ AC joint
treatment of biceps tendon pathology
treatment of labral or chondral damage

Question 19

Most anterior shoulder dislocations produce a _____ lesion

Answer 19

Bankart- tearing of anterior inferior labrum and capsule

Question 20

Anterior shoulder dislocations can also impact on the posterior superior humeral head and produce a _______ lesion

Answer 20

Hill Sachs- indentation of the humeral head

Question 21

Anterior shoulder dislocations can also impact on the posterior superior humeral head and produce a _______ lesion

Answer 21

Hill Sachs- indentation of the humeral head

Question 22

Shoulder dislocations often involve neuropraxia from traction on the _______ nerve

Answer 22

axillary

Question 23

What sorts of trauma are associated with posterior shoulder dislocations?

Answer 23

electrocution, gran mal seizure

Question 24

Describe the presentation of a patient with an acute anterior shoulder dislocation

Answer 24

arm held in externally rotated, abducted position

shoulder has anterior fullness and loss of normal deltoid contour

Question 25

Describe treatment for shoulder dislocations

Answer 25

• reduce ASAP
• period of immobilization
• PT
• surgery for young athletes with Bankart lesions to reduce risk of repeat dislocation

Question 26

Describe treatment for shoulder dislocations

Answer 26

• reduce ASAP
• period of immobilization
• PT
• surgery for young athletes with Bankart lesions to reduce risk of repeat dislocation

Question 27

AC sprains/ shoulder separations usually occur by what kind of injury?

Answer 27

direct fall on the acromian

Question 28

AC sprains/ shoulder separations usually occur by what kind of injury?

Answer 28

direct fall on the acromian

Question 29

Describe treatment for shoulder separations

Answer 29

• conservative- sling and ice if mild

- surgical repair if severe