shoulder

Question 1

what makes up the rotator cuff

Answer 1

SITS

supraspinatus
infraspinatus
teres minor
subscapularis

Question 2

most common causes of shoulder issues

most common complaint?

Answer 2

trauma and overuse

pain and decrease ROM

Question 3

MOI of shoulder dislocation - anterior and posterior

in what direction is the arm often held?

Answer 3

Anterior - fall onto arm (most common)

Posterior - direct force applied to front of shoulder

often held in the adducted position

Question 4

what type of imaging would you want to get for a shoulder dislocation

Answer 4

X ray - Y view

Question 5

anterior reduction of dislocated shoulder:

pt. lies prone, weight to dependent extremity

Answer 5

Stimson

Question 6

anterior reduction of dislocated shoulder:

pt seated, arm slowly externally rotated, then abducted

Answer 6

Hennipen

Question 7

anterior reduction of dislocated shoulder:

pt supine, arm is slowly abducted and externally rotated

Answer 7

Milch

Question 8

AFter reduction what should you do?

Answer 8

ALWAYS: Post-reduction films - check nerve function

Shoulder immobilzer, or sling and swath

Analgesia - NSAIDs, narcotics

ortho follow up

PT

Question 9

When the AC joint is injured (often in contact sports) what would you expect to see in an x ray

Answer 9

widening of AC joint

Question 10

Treatment of an AC sprain/separation (tear of AC or coracoclavicular ligament)?

Answer 10

Grade 1 or 2 - sling for 7-21 days

ortho consult for other grades

Question 11

Tear classification of AC sprain/separation:

incomplete tear, no AC separation

Answer 11

1

Question 12

Tear classification of AC sprain/separation:

complete tear with total separation

Answer 12

3

Question 13

Tear classification of AC sprain/separation:

incomplete tear, separation of distal clavicle and acromion

Answer 13

2

Question 14

Tear classification of AC sprain/separation:

complete tear with anterior and inferior displacement of clavicle

Answer 14

6

Question 15

Tear classification of AC sprain/separation:

complete tear with posterior clavicle displacement

Answer 15

type 4

Question 16

Tear classification of AC sprain/separation:

complete tear with superior clavicle displacement

Answer 16

5

Question 17

in rotator cuff tendonitis (caused by acute trauma or impingement) what movements will cuase pain on PE

Answer 17

forward flexion

internal rotation

Question 18

what would you expect to see on a PE of a rotator cuff tear

Answer 18

muscle atrophy on exam

strength may/may not be diminished

Question 19

testing for rotator cuff injury

treatment

Answer 19

PE or MRI

sling

Question 20

MOI of clavicle fracture

Answer 20

direct blow/fall on outstretched arm

Question 21

treatment for clavicle fracture

Answer 21

sling and swath

or figure 8

Question 22

with a clavicle fracture what may be an indication for surgical consult when looking at the patient externally

Answer 22

tenting of skin

Question 23

condition where the tissues around the joint stiffen, scar tissues form, and shoulder movements become difficult and painful

Answer 23

Frozen should

aka Adhesive capulitis

Question 24

when does frozen shoulder occur?

Answer 24

• after surgery or injury
• people 40-70 y/o most often
• people with chronic disease

Question 25

Dx frozen shoulder by PE

what is the tx?

Answer 25

NSAIDs or steroids

stretching

PT

possible surgery to loosen scar tissue

–> how to avoid: move shoulder!

Question 26

what is good for viewing tears and pathological fractures

Answer 26

MRI

Question 27

what is sensitive for small tears (imaging)

Answer 27

arthrogram

Question 28

most common fracture with childhood

Answer 28

clavicle (80% middle third)

Question 29

inflammation of the rotator cuff tendons (usually supraspinatus) - due to acute trauma or impingement

Answer 29

rotator cuff tendonitis