Shoulder Complex Flashcards
Many problems for the shoulder can be related to ____.
age
RC degeneration/tears commonly occur in pts ___-____ years of age.
40-60
Primary impingement is seen in pts greater than ____ years old.
35
Secondary impingement is commonly seen in pts in their teens to _______.
early 20s
Chondrosarcomas usually occur in pts older than ____.
50
Calcium deposits may occur between ages ___-___.
20-40
Frozen shoulder is seen in pts ___-___ y/o if resulting from atraumatic origin.s
45-60
Kibler type: Inferior angle prominence, anterior tipping (commonly seen in pts with RC impingement).
Type I
Kibler type: Medial border scapula dysfunction; IR rotation of the scapula in the transverse plane; often seen in pts with GH instability.
Type II
Kibler type: Superior scapula dysfunction; involves early and excessive superior elevation during arm
Type III
Describe the normal movements of the scapula during elevation:
Scapular upward rotation, posterior tilting and ER.
Based on the pain symptoms, what is the likely cause?
Dull, toothache-like pain that is worse at night.
RC impairment
Based on the pain symptoms, what is the likely cause?
Hot, burning type pain
Calcific tendonitis
Based on the pain symptoms, what is the likely cause?
Numbness, tingling, shooting pain
Radiculopathy
Based on the pain symptoms, what is the likely cause?
Sharp, localized pain with elevation
RC impairment, impingement
Based on the pain symptoms, what is the likely cause?
Clunk, catch, click, sharp but subsiding
Labral impairment
List some red flags for shoulder impairment (10 total)
Age over 50
Night pain
Weight loss
Fever
Pain unrelated to activity
Pain not relieved by rest
Prior hx of cancer
Hx of smoking
Cardiac risk factors
Pleuritic pain
What does FHRSP stand for:
Forward head, rounded shoulder posture
Conditions and S/Sx to screen for include (6):
Non-mechanical pain
Cancer
Weight loss
Trauma
Neuro S/Sx
CVD/SOB
Primary scapular winging is a result of what?
Muscle weakness of scapular muscle stabilizers
Negative impact of primary scapular winging.
Disrupts normal muscle force couple balance of scapulothoracic complex.
Secondary scapular winging is a result of what?
An underlying pathology affecting the GH joint.
Dynamic scapular winging is caused by what?
A lesion to the long thoracic nerve (can also see with spinal accessory)
What does TUBS stand for?
Traumatic unilateral dislocations with a Bankart lesion requiring surgery.
What is the SPADI outcome measure?
Shoulder pain and disability index
What is the DASH outcome measure?
Disabilities of the arm shoulder and hand
5 things included in the observation portion of a shoulder exam.
Hands on hips
Symmetry of muscle tone
Swelling
Gait
Posture
What are the two most commonly involved rotator cuff muscles?
Supraspinatus
Infraspinatus
Increasing weakness with repeated contractions is termed ______.
Palsy
What range is considered normal laxity as a percentage?
0-25%
Describe grade I laxity and the percentage range:
A feeling of the humeral head riding up to the glenoid rim (25-50%).
Describe grade II laxity and the percentage range:
A feeling of the humeral head overriding the rim, but spontaneously reduces (>50%).
Describe grade III laxity and the percentage range:
A feeling of the humeral head overriding the rim, but remains dislocated (50%).
What is a hallmark sign of a rotator cuff pathology?
Weakness with elevation
RC Tendinopathy is usually caused by a ____________.
Repetitive mechanism / overuse (overhead activities)
Identify 3 symptoms of RC tendinopathy
Localized pain in Acromiohumeral space
May extend to lateral shoulder or elbow
Aggravated by elevation
___% of individuals who have RC tear are asymptomatic.
67
RC tear is similar to RC tendinopathy, but with greater ______________.
Loss of function
3 tests and measures for a RC pathology/tear.
Strength testing
Palpation
Special tests
Subacromial impingement syndrome may be cause by ________ or ________ of the structures occupying the acromiohumeral space.
Compression
Hypersensitivity
Subacromial impingement syndrome presents like ________, with positive impingement signs.
Tendinopathy
When subacromial impingement syndrome is caused by an anatomical predisposition, it’s termed _________.
Primary compressive disease.
Three things that can cause primary compressive disease:
Outlet stenosis
Hooked acromion
Bony spurring of the acromion
Primary impingement causes a _____ within the joint.
Lack of mobility
Secondary impingement causes ________ within the joint.
Reduced dynamic stability
Changes in the osteology of the joint causes _______.
Primary impingement
What is important to consider when testing for secondary impingement?
Similar to primary impingement tests, BUT must be looking at function and capacity of the RC and scapular stabilizers, as well as overall available mobility.
Identify 3 MOIs for Labral pathology
FOOSH
Extreme abduction
Forceful eccentric biceps contraction
2 S/S of labral pathology:
Clicking, popping, catching,
instability
Most common labral pathology
SLAP: superior labrum anterior (to) posterior