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COMP ORTHO > Shoulder > Flashcards

Shoulder Flashcards

1
Q

clavicle - acromial extremity

A

convex posteriorly

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2
Q

clavicle - sternal extremity

A

convex anteriorly

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3
Q

Sternoclavicular joint - capsule

A

strong - ant, post, sup

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4
Q

Sternoclavicular joint - ligaments - sternoclavicular

A

ant, sup

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5
Q

Sternoclavicular joint - ligaments - costoclavicular

A

limits scapula laterally

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6
Q

Sternoclavicular joint - ligaments - interclavicular

A

depression/inf glide of head of clavicle

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7
Q

Motion at sternoclavicular joint

A 
45 elevation
15 depression
15 protraction
15 retraction
30-45 up/down rotation
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8
Q

Acromioclavicular joint - movement

A

does not move freely

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9
Q

Acromiocalvicular joint - type

A

gliding joint with flat articular surfaces

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10
Q

Sternoclavicular joint - type

A

triaxial, ball and socket
saddle like
diarthritic

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11
Q

Acromioclavicular joint - supporting structures

A

weak capsule
AC ligaments - horizontal stability
Coracoclavicular ligaments - horizontal stability

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12
Q

Acromioclavicular joint - motion

A

20 elevation/tipping
25 up/down rot
35 protraction/winging
35 retraction

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13
Q

Acromioclavicular joint - winging

A

Medial edge of scapula lifts off the ribcage

forward rotation is included

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14
Q

Scapulothoracic joint

A

not a true joint

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15
Q

Scapulothoracici joint - motion

A

60 elevation
10 depression
60 up rotation
10 down rot

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16
Q

Motion - scapulothoracic - what occurs when

A

retraction before adduction

abduction before protraction

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17
Q

Scapular elevation - mm

A

Upper trap
Levator scap
Rhomboid major and minor

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18
Q

Scapular depression - mm

A 
Lower trap
Lower SA
Pec minor
Lat dorsi
Lower pec major
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19
Q

Scapular abduction - mm

A

pec major/minor

SA

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20
Q

Scapular add - mm

A

rhomboids

trap

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21
Q

Scapular up rotation

A

upper/lower trap

upper/lower SA

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22
Q

Scapular downward rotation

A

levator scap
rhomboids
pec minor

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23
Q

GH joint - type

A

ball and socket

3 DOF

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24
Q

GH joint - capsule

A

large, loose capsule

tight superiorly

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25
Q

GH ligament

A

FILL IN

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26
Q

GH ligament - coracohumeral

A

FILL IN

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27
Q

GH ligament - coracoacromial

A

FILL IN

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28
Q

GH - motion

A 
flex 120
ext 30
80 IR
90 ER
30 horizontal abd
140 horizontal add 
60 abd with IR 
120 abd with ER
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29
Q

Rotator cuff

A

Supraspinatus
Infraspinatus
Subscapularis
Teres Minor

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30
Q

Humeral retroversion

A

30-40 degrees is norm
Greater = more ER, less IR
Increased angle means more mobility at SC joint - injury to RTC will impact this angle

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31
Q

Coracoacromial arch - made up of

A

CA lig
CC lig
CH lig
Transverse humeral ligament

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32
Q

Coracoacromial arch - what passes through

A

Biceps tendon and supraspinatus

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33
Q

Coracoacromial arch - impingement

A

Can become impinged when head of humerus goes against the acromial part
If you dont glide down with roll up during abduction

34
Q

Coracoacromial arch - load in abduction

A

HIGH! need teres minor and subscap and infraspinatus to help

35
Q

Force couples means what

A

2 forces that are equal but opposite in direction - produce rotation

36
Q

Force couples - Upper trap with

A

Low trap and SA

37
Q

Force couple - humeral abd

A

deltoid and supraspinatus, infraspinatus, teres minor, subscap

38
Q

Force couple - fownward rot

A

lat dorsi and teres major, pec major, rhomboids

39
Q

Single joint mm

A

Needs other mm to supply stability on the scapula

40
Q

2 joint mm

A

can act directly on the arm without needing other help to stabilize the scap

41
Q

Scapulohumeral rhythm

A

GH joint moves 2 degrees for every 1 degree of scapular motion

42
Q

Scapulohumeral rhythm - phases

A

phase 1 = setting - 30 degrees GH
phase 2 = setting to 90 degrees, 30-45 degrees GH and 30 degrees SC
phase 3 = 90 to 180 degrees, 50-60 GH, 30 AC, 10-20 spine

43
Q

Arthrokinematics - superior rolling is directed by the

A

Supraspinatus

44
Q

Bursae - largest

A

Subdeltoid - largest in body

45
Q

Bursae - subscapularies

A

between subscap tendon and neck of scapula

46
Q

Bursae - infraspinatus

A

between inrspintus tendon and joint capsule

47
Q

To avoid subluxation due to gravity - need what

A

upward slope of glenoid cavity

48
Q

To avoid upward subuxation of humerus - what do you need

A

RTC mm contraction and coracoacromial lig

49
Q

Impingement syndrome

A

Compresion of subacromial contents due to encroachment of the humerus nto the coracoacromial arch

50
Q

Impingement syndrome - space should be

A

9-10 mm

pathologic if less than 6

51
Q

Impingememnt syndrome - 1st degree

A 
due to non mechanical reasons
FOOSH
tight post capsule 
bone spur
rubbing along supraspinatus with elevation
52
Q

Impingment syndrome - 2nd degree

A

due to instability, poor force couple balance, posture, poor motor control, training rrors

53
Q

Impingement - stage 1

A 
edema and hemorrhage
less than 25 
due to overuse
painful arc 60-120
anterior lateral shoulder pain
sharp with elevation
no functional limtiations
54
Q

Impingement - stage 2

A

fibrosis and tendonitis
25-40 yo
dec ROM ER and Abd

55
Q

Impinge - stage 3

A 
derangement of tendon (RTC) 
over 40
Weak in abd/ER 
significant functional limitations
bone spurs
less than 1cm RTC tear
56
Q

Impingem - stage 4

A

complete thickness RTC tear
over 40
weakness, mm atrophy
cannot initiiate abd without substitutions

57
Q

Special tests for impingement

A

Hawkins Kennedy
Neers
Cross over
Yokum

58
Q

Special tests - hawkins kennedy

A

for impingement
passively flex GH to 90
Passively IR
Supraspinatus, biceps tendon, bursa

59
Q

ST - Neers

A

for impingement
Stabilize scapular, passively elevate arm with thumb down
Supraspinatus, LH of biceps, burs

60
Q

ST - cross over test

A

for impingement
stabilize scap, horiz add shoulder
Ant pain - subscap, supraspin, biceps tendon
Post pain - infraspinatus, teres minor, post capsule

61
Q

Tendonitis

A

supraspinatus, LH of biceps are most common

Pain with ecc contraction, tender with palpation, strong but painful mm testing

62
Q

Special tests for tendonitis

A

Empty can
Speeds
Yergason

63
Q

ST - empty can

A

tendonitis
Active scaption to 90, thumbs down, resist downward force
Supraspinatus

64
Q

ST - speeds test

A

tendonitis
Active flex to 90, elbow ext, forearm supinated, palpate bicipital groove, apply downward force
Biceps

65
Q

ST - Yergason

A

tendonitis
90 elbow flex, full forearm pronation, resist against ER and supination
Biceps

66
Q

ST for RTC tear

A

Drop arm test
Empty can test
Hornblowers
IR lag

67
Q

Drop arm test

A

for RTC tear
Passively abd to 90
pt tries to slowly lower arm
supra and infra

68
Q

Empty can test

A

for RTC tear
weak and painful
active scaption to 90, thumb down
supraspinatus

69
Q

Hornblower sign

A

for RTC tear
passively 90 scap
resist ER
Teres minor

70
Q

Adhesive capsulitis - who more common

A

F more than M
40-60 yo
non dominant arm more than dominant

71
Q

Adhesive capsulitis - clinical presentation

A

Dec scapulohumeral rhythm
less than 90-135 elevation
50-60% of normal ER

72
Q

Adhesive capsulitis - stages

A

Preadhesive - often misdiagnosed with impingement
Freezing - 10-36 wks
Frozen - 4 to 12 months
Thawing - 5 to 42 mo

73
Q

AC joint sprain - types

A 
1 = AC spran, joint intact
2 = AC and CCL sprain, unstable but intact joint
3 = AC and CCL torn, unstable joint, delt/trap disrupted, distal calvicle migration
4 = "..." post dislocated clavicle 
5 = inf dislocated clavicle
74
Q

Labral ST

A

Compression rotation test
Crank test
Obriens

75
Q

Compression rotation test

A

Labral
90 abd
90 elbow flex
axial force to humerus with rotation and curcumduction

76
Q

Crank test

A 
Labral 
pt supine 
160 scaption
axial load through humerus
IR/ER shoulder
77
Q

Obrien

A 
Labral 
pt seated 
90 flex with elbow ext 
10 horizontal add
full IR/ER
apply downward force 
IR pain greater than ER pain
78
Q

Adsons test

A

Palpate radial pulse
ER, extend shoulder, turn head to test arm, extend head, hold breath
(+) if pulse goes away within 10 sec

79
Q

Costoclavicular test

A

Palpate radial pulse
Retract/depress scapula
(+) if pulse goes away

80
Q

Hyperabduction test

A

palpate radial pulse
passively hyperabd arm
(+) f pulse goes away
pec minor

81
Q

Roos test

A

90 abd, full ER, open and close hands for 3 min

(+) asymmetrical swelling, pallor, pain, numbness

COMP ORTHO (11 decks)

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