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Fall Semester DPT > Shoulder Complex- Impingement thru Tendon Healing > Flashcards

Shoulder Complex- Impingement thru Tendon Healing Flashcards

1
Q

Impingement Syndrome is also known as what?

A

Subacromial Pain Syndrome (SAPS)

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2
Q

Impingement syndrome is a _______ of associated S&S

A

cluster

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3
Q

Impingement syndrome _________ indicate definitive signs or cause

A

DOES NOT

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4
Q

What is the prevalence of all shoulder complaints being impingement?

A

44-65%

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5
Q

What is the primary etiology for impingement?

A

limited motion (hypomobility)

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6
Q

What can cause limited motion involving impingement?

A

muscle/capsule shortening

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7
Q

Muscle/capsule shortening can lead to…

A

disuse/immobilization

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8
Q

Persistent FHP leads to….
- shortened ______’s/_________ capsule tightness and limits ER

A

IR/ anterior

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9
Q

Persistent FHP leads to shortened scapular….

A

protractors/elevators/upward rotators

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10
Q

With limited motion in impingement ________ or ________ of the acromion can occur

A

spurring or hooking

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11
Q

What is the secondary etiology for impingement?

A

excessive motion (hypermobility)

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12
Q

What can cause excessive motion involving impingement syndrome?

A

Ligamentous laxity from trauma, activities with excessive motion, and overhead throwing sports (baseball)

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13
Q

What are the 4 causes of muscle inhibition?

A

pain, swelling, joint laxity, disuse

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14
Q

What is the third etiology of impingement syndrome?

A

combination of primary/secondary (ex. scapular hypomobility and GH hypermobility)

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15
Q

Which is the MOST common tendon involved with impingement?

A

Supraspinatus

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16
Q

With the supraspinatus tendon, ________ is involved and may tear __________

A. tendinitis; suddenly
B. tendinopathy; gradually
C. tendinosis; gradually

A

B.

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17
Q

There is limited _______ in the distal supraspinatus and affects healing

A

vascularity

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18
Q

Which head of the biceps is associated with impingement and may tear gradually?

A

long

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19
Q

__________ is associated with the biceps long head and impingement

A. Tendinopathy
B. Tendinosis
C. Tendinitis

A

A.

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20
Q

The labrum in impingement may tear ______

A. suddenly
B. gradually

A

B.

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21
Q

Impingement at the subacromial bursa can lead to ______

A

bursitis

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22
Q

When the sub and coracoacromial space are compromised it results in __________ or ___________ of the tendons

A

impingement/compression

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23
Q

Pathomechanics of impingement:

Increased ________ on the tendons when they are loaded and as they wrap around the bone, results in ______

A

tension; compression

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24
Q

What does PSGI stand for?

A

Posterior-superior glenoid impingement

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25
Q

PSGI is more common in who?

A

overhead athletes

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26
Q

With PSGI, which motions are excessive?

A

ER ROM and anterior GH slide

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27
Q

With impingement syndrome, P! is typically localized to the ….

A

tip of the shoulder and referred into the lateral shoulder and arm

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28
Q

With impingement syndrome, there will be P! or limitation with…

A

elevation

lifting/pushing.pressing activities

reaching behind the back

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29
Q

What are possible scapular compensations for GH restrictions?

A

increased elevation

inconsistent upward rotation ( increased and decreased)

scapular dyskinesia (symptomatic and asymptomatic)

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30
Q

Which scapular test will test for passive upward rotation?

A

Scapular Assistance Test (SAT)

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31
Q

Which scapular test will tests for passive upward ROT and post tilt?

A

Scapular Repositioning Test

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32
Q

Which scapular test will test for voluntary retraction?

A

Scapular Retraction Test

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33
Q

Functionally, what will a pt. with impingement syndrome have issues with?

A

limited and P!ful reaching overhead, behind back, and lifting

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34
Q

What actions will be limited and P!ful with impingement?

A

FLX, ABD, and ER (IR may be as well)

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35
Q

Post shd. P! with ER indicates what kind of impingement?

A

posterior impingement

36
Q

With Resisted/MMT for impingement, there will be inhibited….

A

scapular and cuff muscles

37
Q

Propioceptive impairment is greatest at __________ elevations

A

higher

38
Q

What should you perform in your biomechanical exam for shoulder hypomobility?

A

accessory motion

39
Q

Hypomobility typically involves ______ shd tightness and limited post. ______

A

posterior and glide

40
Q

With GIRD, the ratio is _____/______ at 90° abd > 1

A

IR/ER

41
Q

ER typically _________ as IR ________ in overhead athletes

A

increases; decreases

42
Q

With the infraspinatus tests or ER test in 0° ABD, a positive would indicate…

A

P! or giving away

43
Q

With the IR Resisted Strength Test, _____ would be weaker than ______ @ 90° ABD

A

IR/ER

44
Q

Which special test provides minimal to no support for impingement?

A

Speeds and Hawkins/Kennedy

45
Q

The ______ _________ test provides moderate speculation for impingement

A

Empty Can

46
Q

RC pathology related to age

Youngest: _____%
Middle: _____%
Oldest: ______%

A

32

48

78

47
Q

Is RC pathology associated with impingement symptoms?

A. yes
B. no

A

B.

48
Q

Dense regular connective tissue is
Type __ collagen

____ elastin

______cytes

_______ fibers for more indirectional loads

A

I

Low

Fibro

Parallel

49
Q

A tendon ______ tension and releases _______ with muscle actions

A

resists; energy

50
Q

More _______ = better force transmission or storing of potential energy

A. collagen
B. elastin
C. stiffness

A

C.

51
Q

The mid portion of the tendon is…

A

hypovascular and hyponeural

52
Q

The insertion of the tendon is…

A

hypervascular
hyperneural

53
Q

Tendinopathy is _______% of general MSK injuries

A

30

54
Q

Tendinopathy is involved with ____-____% of sports injuries

A

30-50

55
Q

Which tendon condition is UNCOMMON?

A. Tendinitis
B. Tendinosis

A

A.

56
Q

________ is the inflammation of the tendon without structural changes due to overuse

A. Tendinosis
B. Tendinitis

A

B.

57
Q

With _______ it is typically has an acute and classic presentation

A. Tendinitis
B. Tendinosis

A

A.

58
Q

Which tendon condition will have the pt.

TTP
P! and limitation with lengthening
P! with resisted testing/MMT (lengthened position)- amy be weak

A

Tendinitis

59
Q

Which tendon condition is MOST common?

A. Tendinosis
B. Tendinitis

A

A.

60
Q

_________ occurs with degenerative changes and some inflammation

A

Tendinosis

61
Q

Tendinosis involves degenerative changes with some inflammation due to…

________ stress and tendinitis (irregular or repetitive)

_________ pathomechanics (influence or impingement)

________/vascular insufficiency (neural or tactile)

________ induced hyperthermia (non-exercise or exercise)

________ age (younger or older)

_________ fluctuations (degenerative or hormonal)

A

repetitive

impingement

neural

exercise

older

hormonal

62
Q

With tendinosis, if it is acutely irritated what condition can the S&S present as…

A

tendinitis

63
Q

With tendinosis, it is persistent for > ____- ____ weeks often with previously failed PT

A

4-6

64
Q

Tendinosis is often mislabeled as ________ and has _______ tendon tolerances

A

tendinitis/decreasing

65
Q

An _______ tendon may be visible with tendinosis

A

enlarged

66
Q

With tendinosis, ROM and resistance testing/MMT are likely _________

A

WNL

67
Q

With tendinosis, special tests are specific to tendon _________ and _________

A

etiologies/pathomechanics

68
Q

With tendinosis, palpation will be

__________ with decreased P! thresholds (tender or pain-free)

________ in-growth of vessels and nerves (decreased or increased)

_________ P! neurotransmitters (increased or decreased)

A

tender

increased

increased

69
Q

__________ has little to no inflammation

A. Tendinitis
B. Tendinosis

A

B.

70
Q

Degeneration and disorganization is involved with

A. Tendinosis
B. Tendinitis

A

A.

71
Q

Is it tendinitis or tendinosis associated with weakened and greater likelihood of overload?

A

tendinosis

72
Q

Increased non-collagen matrix and fatty infiltration are associated with what tendon condition?

A

tendinosis

73
Q

With tendinosis, corticospinal (voluntary movement) influences….

increased _________
increased __________- aberrant/excessive firing
________ influence as well

A

inhibition

excitability

bilateral

74
Q

An __________ tendon tear is RARE

A. acute
B. chronic

A

acute

75
Q

With acute tendon tears, it has _________ and oblique forces during fast ________ loading

A

higher; eccentric

76
Q

An acute tendon tear is most likely with ______ and _______

A. youth; overuse
B. age; repetitive stress
C. age; overuse

A

C.

77
Q

With acute tendon tears, _________ and vascularity decrease

A. collagen
B. elastin

A

B.

78
Q

Atrophy and drying occurs with what kind of tear?

A

acute

79
Q

With an acute tendon tear, a ________ smaller tendon is less pliable and durable

A

shorter

80
Q

With tendinitis, you want to focus primarily to resolve what?

A

inflammation in 4-6 weeks

81
Q

With tendinosis, you want to focus primarily to resolve what?

A

proliferating the tendon

82
Q

With tendinosis, tensile strength initially improves @ ____-____ weeks

A

3-5

83
Q

With tendinosis, greater tensile strength initially improves ____-_____ weeks

A

8-12

84
Q

What kind of tendon tears can improve with PT?

A

gradual and partial

85
Q

Traumatic and full tears of the tendon require what?

A

surgery

86
Q

How many months post. op does it take to return to normal strength after a traumatic and full tear of the tendon?

A

10-12

87
Q
A

Fall Semester DPT (11 decks)

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