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SCS > Shoulder > Flashcards

Shoulder Flashcards

1
Q

What are the scapular motions?

A

Upward rotation
External rotation
Posterior tilting

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2
Q

What is normal scapulohumeral rhythm?

A

2:1 relationship btwn GH elevation & scapular upward rotation

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3
Q

Scapular dyskinesia test

A
  • test of manually repositioning the scapula to reduce or eliminate a painful arc
    Similar tests:
  • forward flexion w/ a light dumbbell
  • Light wall push with finger tips
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4
Q

What are the static stabilizers of the AC joint?

A
  • AC ligament
  • Coracoclavicular ligaments
    (2 = trapezoid & conoid)
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5
Q

What 2 ligaments make up the coracoclavicular ligament?

A
  • trapezoid

- conoid

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6
Q

What are the dynamic stabilizers of the AC Joint?

A
  • deltoid

- trapezius

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7
Q

How are AC joint injuries classified?

A

Rockwood grading classification model

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8
Q

Grade I: AC joint sprain

A

Sprain of AC ligaments:

- AC & CC ligaments are intact

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9
Q

Grade II: AC joint sprain

A
  • AC ligaments are ruptured
  • CC ligaments are intact
  • clavicle is unstable to direct stress tests
  • often described as a “subluxation”
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10
Q

Grade III: AC joint sprain

A
  • complete disruption of BOTH the AC & CC ligaments
  • delto-trapezial fascia intact
  • often described as a “dislocation”
  • deformity present w/ clavicle appearing elevated
  • clavicle unstable in both vertical and horizontal plane
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11
Q

Grade IV: AC joint sprain

A

Distal clavicle is posteriorly displaced into trapezius

  • posterior deformity present
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12
Q

Grade V: AC joint sprain

A

More severe form of grade III

  • both AC & CC ligaments disrupted
  • delto-trapezial fascia disrupted
  • Sx:
  • downward displacement of scapula
  • psedo lateral clavicle elevation
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13
Q

Grade VI: AC Joint sprain

A

Inferior displacement of the distal clavicle

  • Severe trauma
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14
Q

What does an AC step deformity indicate?

A

@ least a Type III injury

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15
Q

Management for AC joint Injuries:

  • Type I-II
  • Type III
  • Type IV-V
A
  • Type I-II: Non-operative management
  • Type III: Debated
  • Type IV-V: Surgical repair recommended
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16
Q

What are the return to sport guidelines for AC injuries:

  • Grade I:
  • Grade II:
  • Grade III:
A

Grade I: 2-4 weeks
Grade II: 4-8 weeks
Grade III: 6-8 weeks

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17
Q

Describe a Bankart lesion

A
  • lesion to the anterior part of the glenoid labrum

- commonly seen w/ subluxations or dislocations

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18
Q

What type of Bankart lesion will be seen in a posterior dislocation?

A

Reverse Bankart

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19
Q

What are the 2 types of bankart lesions?

A

Soft tissue:

  • anterioinferior labrum avulsion damage of the glenoid rim
  • inferior GH ligament may be torn
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20
Q

Describe a bony bankart

A

Soft tissue damage + fracture of the anterioinferior glenoid rim

21
Q

What is the primary ligamentous restraint of the GH joint in 90/90 position?

A

IGHL

  • 3 bands
  • superior, anterior and posterior
22
Q

Describe the Internal Rotation Resistance Strength Test (IRRST)

A
  • differentiates an intra-articular pathology from impingement syndrome
  • TEST:
  • tested in 90 deg ABD/ER
    + test if good strength w/ ER and weakness with IR
    + test = bankart lesion
  • test = classic impingement
23
Q

Describe a hill sachs lesion

A
  • dent in the back of the humeral head
24
Q

What is the most common type of SLAP lesion?

A

Type II: detachment of the superior labrum & biceps from the glenoid rim

25
Q

What age are you more likely to see more chances of tears/defects in the superior regions of the labrum?

A

Ages 30-50

26
Q

What are the 2 most common MOIs of SLAP lesions?

A
  • Falling on an outstretched arm

- Traction injury in the inferior direction

27
Q

What is the clinical presentation of a SLAP lesion?

A

Pain:

  • intermittent, overhead movements
  • painful clicking and popping
  • Pitchers may develop “dead arm” syndrome
28
Q

What pathology may be tender within the rotator interval?

What is the rotator interval?

A

SLAP lesions

Rotator Interval:

  • triangular shaped anatomic space btwn the supraspinatus tendon, the subscapularis tendon, and the coracoid process
  • space contains:
    • coracohumeral & SGH ligament
    • bicep tendon
    • anterior joint capsule
29
Q

What tests are specific for SLAP lesion?

A

Speeds = most specific
Yergason’s test
Biceps load test II

30
Q

What tests are sensitive tests for a SLAP lesion?

A

Compression rotation test
OBrian’s test = MOST sensative
Anterior apprehension test

31
Q

What is recommended surgical management for an over 36 year old w/ SLAP lesion?

A
  • Over 36 years old higher chance of failure

- recommend bicep tenodesis

32
Q

What is the definition of shoulder instability?

A

Inability to maintain the humeral head in the glenoid fossa

33
Q

TUBS

A

Traumatic
Unilateral
Bankart
Surgery

98% of the cases are anterior dislocation

Rate of reoccurance higher in younger population

  • 90% chance of reoccurance if less than 20 years old
34
Q

AMBRI

A 
Atraumatic
Multidirectional
Bilateral
Rehab
Inferior Capsular shift (if non-responsive to rehab)
35
Q

What are the primary dynamic stabilizers at the shoulder?

A

Primary:

  • RC muscle
  • Long head of biceps
  • Deltoid

Secondary:

  • Teres Major
  • Lat Dorsi
  • Pec Major
36
Q

Glenoid labrum increases stability by___%?

A

50%

37
Q

What scale is used to evaluate hypermobility?

A

Beighton scale

  • score of 5/9 defines hypermobility
38
Q

What tests would help to confirm a SLAP lexion?

A
  • Crank test

- Resisted supination external rotation test

39
Q

What is the clinical presentation of a rotator cuff tear?

A
  • pain at night
  • painful arc
  • supraspinatus:
    • ttp over greater tuberosity
    • pain in the anterior shoulder
    • sx down the arm
40
Q

What muscle does the hornblower’s sign assess?

A

Teres Minor

  • Axillary Nerve (C5-C6 innervation)
41
Q

In non-op management of an anterior dislocation: how long should activity be restricted?

A

6-8 weeks

42
Q

Primary impingement vs Secondary impingement

A

Primary Impingement: structural impingement

Secondary Impingement: (postural or movement) a relative impingement occurring in the presence of rotator cuff weakness or instability of the capsule

43
Q

Lateral Scapular Slide Test

A

Used to assess weakness of the scapular stabilizers

  • increased measurements on involved side
  • scapula measured w/ shoulder abducted @ 0, 45 and 90 deg
44
Q

What nerve is commonly injured in an anterior dislocation?

A

Axillary nerve:

  • passes through quadrangular space
  • Innervates:
    • Deltoid muscle
    • Teres Minor
    • patch of skin over the lateral side of proximal humerus
45
Q

How will a player present after an anterior dislocation?

A

Holding arm in slight ER & ABD

Sulcus sign maybe evident

46
Q

What special tests are best for posterior instability?

A

Jerk test & Kim test

47
Q

How long should a non-op posterior instability wait prior to performing UE CKC exercises?

A

6-8 weeks

48
Q

What does the infraspinatus do?

A

ER & Extension

49
Q

Which of the ligaments are the primary static restraints to inferior translation of the arm when the shoulder is in 0 degrees abduction and neutral rotation?

A

Superior glenohumeral and coracohumeral ligament

SCS (36 decks)

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