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T OCS > Shoulder > Flashcards

Shoulder Flashcards

1
Q

Rotator cuff tear size classifcations

A

s < 1 cm; m- 1-3 cm; L 3-5; massive > 5 cm

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2
Q

RTC tear depth (average cuff depth 9-12m)

A

grade 1 <3mm; 2- < 6mm, 3- +6mm

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3
Q

Characteristics for unfavorable RTC tear outcomes

A
  1. pain > 1 year, cuff tear > 1 cm squared, 3. poor functional impairment at eval (+ emptycan test)
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4
Q

Indications for RTC sx

A
  1. failed 3 months conservative treatment, with 6 weeks PT, subacromial injection, oral NASAIDs; 2. significant pain and or weakness, 3. worsening function
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5
Q

MOI for AC jt injury

A

Trauma, direct pressure; inferior force on superior acromion on fixed clavicle (supported by SC ligaments)

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6
Q

TUBS

A

Shoulder dislocations “ Traumatic, unidirectional, bankart lesion usually present, Surgery (PT <20% effective)

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7
Q

Primary vs Secondary adhesive capsulitis

A

Primary- insidious, Secondary- known cause

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8
Q

Inferior GH ligament

A

restrics anterior, inferior and posterior translation of humerus at higher levels of abd. STRONGEST

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9
Q

Middle GH ligament

A

restrics ant translation in lower ranges of motion

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10
Q

anterior GH ligament

A

restrics anterior/inferior translation

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11
Q

Passive GH stabilizers

A
  1. labrum 2. GH ligaments 3. Capsule
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12
Q

Dynamic GH stabilizers

A
  1. RTC 2. Biceps 3. Scapulothoracic muscles and propricceptors ( Pacinian and ruffinian)
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13
Q

GH jt dysfunction

A

painful arc from 60-120

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14
Q

AC jt dysfunction

A

painful arc from 120-160 shoulder flexion

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15
Q

Which type of AC joint injuries are operative?

A

Type 4,5,6 recommend Op. Type 1,2,3 recommend non-op. Type 3 injury in pitcher/athlere could be op

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16
Q

Type 1 AC joint Seaparation

A

mild trauma, TTP. AC jt stable. no dislocation AC and CC ligaments intact. No deformity

17
Q

Type 2 AC joint Separation

A

mod TTP. Distal clavicle unstable, CC ligament intact. Pain with shoulder AROM

18
Q

Type 3 AC joint Separation

A

Disruption of CC and AC ligaments. Can be less painful than type 2. Shoulder abd causes most pain. manual reduction technique possible.

19
Q

Type 4 AC joint Separation

A

AC and CC ligament disruption+ distal clavicle displaced posteriorly. Manual reduction technique not possible.

20
Q

Type 5 AC joint Separation

A

AC and CC ligament disruption + detachment of deltoid and UT muscle attachments from distal 1/3 of clavicle. Entire UE drops inferiorly.

21
Q

Type 6 AC joint Separation

A

AC and CC ligament disruption. Distal clavicle displaced posteriorly under coracoid process. RARE. Due to traumatic abd force to UE.

22
Q

Upward rotation force couple

A

UT and SA

  1. allows for rotation of the scap
  2. maintains LT relationship for deltoid
  3. prevents SA impingment
  4. provides stable scapular base
23
Q

Scapular upward rotators

A

SA and Lower trap

24
Q

scapular downward rotators

A

rhomboids, levator scap, pec minor

25
Q

Bankart Lesion

A

anterior inferior labral detachment

26
Q

SLAP lesion

A

Superior labral detachment from A-P

- increases anterior band of inferior GH ligament by 100-120%

27
Q

Hill Sachs lesion

A

dent in posteriorlateral humeral head due to trauma with anterior labrum during dislocation

28
Q

Primary Impingment

A

Impingment due to abnormal relationship between coracoacromial arch
- sub acromial irritation to tendon b/w humeral head, ant 1/3 of clavicle, Coracoacromial ligament coracoid or AC joint

29
Q

Secondary Impingement

A

due to underlying Glenohumeral instability and tendon wear. Because of increased anterior humeral head translation (think upper crossed syndrome), biceps tendon and RTC can become impinged

30
Q

Posterior impingement

A

90/90 abd/er position cause tendons of supra and infra to contact postero-superior glenoid lip (tight posterior capsule)

31
Q

RTC guidelines (medium tear)

A

weeks 1-2: PROM, submax isometrics*, joint mobs
Week 6: isotonics
week 8: begin closed chain step up/qped rhythmic stab, UE plyo
week 10: initiation of submax isokinetic IR/ER
week 12: begin interval return programs, max isokinetics

32
Q

Best view for hill sachs lesion

A

Stryker notch view

33
Q

best view for west point modified axillary view

A

avulsion of IGHL
bony bankart
Anterior inferior glenoid deficiency

34
Q

Humeral fx

A
  • early access to PT important
  • jt mobs as early as 2 weeks
  • normal flexion ROM by 24 days
  • immobilization 3 weeks no benefit

T OCS (16 decks)

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