Shoulder Complex- General Shd. Prognosis

Question 1

What are the normal asymmetries in the shoulder complex?

Answer 1

Ipsilateral shoulder depression

Less shd IR/ reaching behind the back

Ipsilateral thoracolumbar SB and ROT

More hyperextended knee

Flatter foot

Question 2

If a patient was having trouble washing themselves, how many functional degrees of FLX would they need to wash their hair and body?

Answer 2

120° for hair and 75° for trunk

Question 3

If a patient was having trouble putting on/taking off a shirt, how many functional degrees of FLX would they need?

Answer 3

90°

Question 4

Your patient is having trouble reaching in the cabinet to grab spices to cook a meal, how many degrees of FLX will she need to do task functionally?

Answer 4

150° (reaching on a high shelf)

Question 5

How many functional degrees does a patient need to fasten their bra behind their back?

Answer 5

50+° EXT and 70° of horizontal ADD, and full IR

Question 6

Movement of the humerus is accompanied by movements of what two structures?

Answer 6

scapula (primarily)

other smaller joints (Ex: SC, AC, upper thoracic and upper costotransverse jts.) - secondarily

Question 7

Companion motions assists with _________ motion

Answer 7

optimal

Question 8

Companion motions help to prevent __________

Answer 8

impingement

Question 9

Companion motions keeps ________ and _________ overlap efficient to prevent active insufficiency

Answer 9

actin/myosin

Question 10

What muscles make up the rotator cuff?

Answer 10

Subscapularis
Supraspinatus
Infraspinatus
Teres Minor

Question 11

In 0-150° of overhead reaching, the humerus performs which 3 actions?

Answer 11

FLX
ABD
ER

Question 12

With 0-150° of overhead reaching, the concentric control of the humerus involves which 3 groups of muscles?

Answer 12

Flexors

ABDuctors

ERs

Question 13

With 0-150° of overhead reaching, the eccentric control of the humerus involves which 3 groups of muscles?

Answer 13

Extensors

ADDuctors

IRs

Question 14

In 0-150° of overhead reaching, the scapula performs which 3 actions?

Answer 14

Elevation

Upward Rotation

Protraction (primarily at AC jt.)

Question 15

With 0-150° of overhead reaching, the concentric control of the scapula involves which 3 groups of muscles?

Answer 15

Elevators

Upward Rotators

Protractors

Question 16

With 0-150° of overhead reaching, the eccentric control of the scapula involves which 3 groups of muscles?

Answer 16

Depressors

Downward Rotators

Retractors

Question 17

With 0-150° of overhead reaching, the scapula has maximum tension where?

Answer 17

Brachial Plexus @ 150° as the clavicle posteriorly rotates

Question 18

In 150-200° of overhead reaching, the humerus performs which 3 actions?

Answer 18

FLX

ABD

ER

Question 19

With 150-200° of overhead reaching, the concentric control of the humerus involves which 3 groups of muscles?

Answer 19

Flexors

ABDuctors

ERs

Question 20

With 150-200° of overhead reaching, the eccentric control of the humerus involves which 3 groups of muscles?

Answer 20

Extensors

ADDuctors

IRs

Question 21

In 150-200° of overhead reaching, the scapula performs which 3 actions?

Answer 21

Depression

Retraction

Post. tilt primarily at SC joint

Question 22

With 150-200° of overhead reaching, the concentric control of the scapula involves which 3 groups of muscles?

Answer 22

Depressors

Retractors

especially Lower Trap if: 150° with GH ST motion and upper T-spine EXT

Question 23

With 150-200° of overhead reaching, the eccentric control of the scapula involves which 3 groups of muscles?

Answer 23

Elevators

Protractors

Question 24

With 150-200° of overhead reaching, the Upper T-spine performs which actions?

Answer 24

Ipsilateral SB, ROT, and EXT

Question 25

What will happen if the upper T-spine is hypomobile with 150-200° of overhead reaching?

Answer 25

It will inhibit LT activity and lead to impaired scapular motion

Question 26

With a hypomobile upper t-spine, it limits LT activation for upward ROT up to _____ ° and depression > 150° during _______ __________

Answer 26

150 overhead reaching

Question 27

With a hypomobile upper t-spine, compensation and ___________ may develop at which joints?

Answer 27

hypermobility AC and GH

Question 28

With upper T-spine hypomobility, it allows excessive _______ clavicular rotation and excessive tension on which cord of the brachial plexus?

Answer 28

posterior median cord

Question 29

With the median nerve of the brachial plexus having tension with overhead reaching, which other nerve can cause parasthesia's? It is often misdiagnosed as what?

Answer 29

Ulnar TOS

Question 30

With reaching the behind the back, there is movement at which two jts and what clavicular rotation?

Answer 30

AC and SC anterior

Question 31

With reaching behind the back, the humerus is involved which 3 actions?

Answer 31

Hyper-EXT ADD IR

Question 32

With reaching behind the back, the concentric control of the humerus is involved with which 3 muscle groups?

Answer 32

HyperEXTenders ADDuctors IRs

Question 33

With reaching behind the back, the eccentric control of the humerus involves which 3 muscle groups?

Answer 33

HyperFlexors ABDuctors ERs

Question 34

With reaching behind the back, the scapula is involved with which 3 actions?

Answer 34

Elevation Downward ROT Retraction

Question 35

With reaching behind the back, the concentric control of the scapula is involved with which 3 muscle groups?

Answer 35

Elevators Downward rotators Retractors

Question 36

With reaching behind the back, the eccentric control of the scapula is involved with which 3 muscle groups?

Answer 36

Depressors Upward Rotators Protractors

Question 37

JM's (effective intervention) provide relief for a variety of common shoulder complex conditions such as:

Answer 37

RC disorders shoulder disorders adhesive capsulitis soft tissue disorders

Question 38

JM'S are good for all shoulder complex joints, which are:

Answer 38

AC, SC , ST, and GH

Question 39

With RC tendinopathy, you _________ rely on manual therapy alone a. CANNOT b. CAN

Answer 39

A.

Question 40

With the shoulder complex, Ther Ex. works with various shoulder conditions, is an effective intervention, BUT has no additional benefit when _______ was added with non-specific shd p!, _______, and __________

Answer 40

STM ROM and function

Question 41

To activate the local muscles, your pt. should active the _________ then ___________ mm.

Answer 41

scapula; RC

Question 42

Your pt. will have better activation of the SA with _________ chain activities

Answer 42

closed

Question 43

Wall slides are good for the ___ muscle, and has lower activation of the LT, MT, LS, RM

Answer 43

SA

Question 44

After wall slides to activate the SA, you should advance your pt. to ...

Answer 44

UE weight shifts, push ups, off.on unstable surface like physioball

Question 45

What's a good prone scapular exercise for the shoulder complex?

Answer 45

ITWY's

Question 46

With ITWY's it limits compensation of a protective ____ and activates other needed mm. (RC)

Answer 46

UT

Question 47

Making a fist/tighter grip activates which mm.?

Answer 47

RC

Question 48

If you ER during shoulder complex exercises as appropriate, it will result in greater…

Answer 48

scapula muscle activity (LT/MT/LS/RMaj/Min)

Question 49

Some global mm. include:

Answer 49

Pec Major Lat Deltoid

Question 50

What are some higher level goals for MET and the shd complex?

Answer 50

LE exercises, Trunk exercises, and Multi-planar exercises (PNF diagonals)

Question 51

With JM's and Ther Ex the combination was ________ effective to ther ex alone

Answer 51

equally

Question 52

With RC tendinopathy, _________ is more beneficial than manual therapy

Answer 52

exercise

Question 53

With cervical manipulation it ________ shoulder and neck mobility

Answer 53

improved

Question 54

With C5-C6 JM, it caused an immediate _________ in muscle force of the ________

Answer 54

increase; ERs

Question 55

C/T JM- mobilizing c/t spine ________ symptoms and function

Answer 55

improved

Question 56

____- _____ innervates all shoulder complex mm.

Answer 56

C3-T1

Question 57

Any evidence of cervical trauma, hyper mobility/instability, age-related changes, or prolonged FHP is a...

Answer 57

shoulder condition waiting to happen

Question 58

With regional interdependence, __________ dysfunction can alter shoulder muscle activity

Answer 58

cervical

Question 59

With regional interdependence, there is not a loss of ________

Answer 59

conduction

Question 60

With FHP, you need to address _______ stiffness

Answer 60

thoracic

Question 61

With FHP it inhibits shd ______ and scapular retractors and _______

Answer 61

ERs depressors

Question 62

Dry-needling is for ____-______ shoulder P! and disability

Answer 62

non-traumatic

Question 63

With dry needling, there is ________ quality of evidence of a small and _____-______ effect A. minimum; long-term B. maximum; short-term C. moderate; short-term

Answer 63

C.

Question 64

With dry needling there is ______ risk of bias A. high B. low C. no

Answer 64

B.

Question 65

What are 4 positive factors for those referred to PT with shd symptoms?

Answer 65

Lower baseline disability Lower symptoms at rest Higher patient expectation with PT Higher self-efficacy despite symptoms