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Fall Semester DPT > Shoulder Complex- Tendon Rx through Regional Interdependence > Flashcards

Shoulder Complex- Tendon Rx through Regional Interdependence Flashcards

1
Q

With Tendon Rx, what are the treatment options?

A

Pt. education about load management

POLICED

NSAIDS

Bracing/taping

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2
Q

With Tendon Rx, NSAIDS are a ____-_____ relief in _______ presentation

A

short-term

acute

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3
Q

Which tendon Rx has a poor response and no support in persistent presentation?

A

NSAIDS

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4
Q

With NSAIDS, it _______ healing if injury is at the insertion

A

delays

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5
Q

With Tendon Rx, modalities such as : iontophoresis, ultrasound, phonophresis, and low-level laser treatment, it _______ sufficient evidence

A. gains
B. lacks
C. acquires

A

B.

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6
Q

With tendinosis, what is the soreness rule?

A

Soreness begins after 8-12 hours of exercise and can last up to 24-48 hours

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7
Q

With tendinosis, ________ therapy can restore accessory motion as needed

A

manual

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8
Q

What should be the primary goal for tendinosis with MET?

A

proliferating the tendon and possible spinal stabilization (if regional interdependence)

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9
Q

With tendinosis, you should implement MET after any ________ settles and for ALL _______ changes in the tendon (including tears)

A

acuity; structural

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10
Q

Which of the following are the ideal and ultimate sets, repetitions, and loads to improve a tendinosis condition?

A. 2-3 sets of 10-15 repetitions with heavy loads

B. 2-3 sets of 20-25 repetitions with heavy loadS

C. 2-3 sets of 10-15 repetitions with moderate loads

D. 1-2 sets of 10-15 repetitions with moderate loads

A

A.

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11
Q

For tendinosis, ________ eccentrics are encouraged

A

slower

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12
Q

Isometric loading without compression from lengthening, the isometrics are in a ___________ position

A

shortened

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13
Q

Isotonic loading without compression from lengthening, the isotonics from __________ into shortened position

A

neutral

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14
Q

Isotonic loading with compression from lengthening, isotonics loading from a __________ position

A

lengthened

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15
Q

What are examples of isometric loading in weight bearing?

A

UE weight shifting, planks, push ups

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16
Q

What are examples of plyometric loading?

A

ball bounces, tosses, and throwing

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17
Q

With tendinosis, activity response can have a ______ to _______ increase in P! (possibly 5/10)

A

mild; moderate

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18
Q

What is the time frame for MET with tendinosis?

A

8-12 week program

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19
Q

What are some precautions with heavy loads for MET and tendinosis?

A

deconditioned population

young people (growth plates)

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20
Q

What could complicate the healing response for tendinosis?

A

obesity- excessive fat absorbs inflammatory cells way from the tendon

diabetes- excessive glucose impairs collagen production and remodeling

low grade and persistent inflammation- associated with SAD diet and systemic disease/ limits proliferation and remodeling

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21
Q

MD Rx: Cortisone injections are a _____-_____ benefit

A

short-term

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22
Q

MD Rx: Glycerin trinitrate patches effective by increasing ___________

A

circulation

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23
Q

MD Rx: Sclerosing injections help to ________ tendon for P! relief

A

stiffen

24
Q

What is the last option for MD Rx with Tendon conditions?

A

surgery

25
Q

What are the PT Rx for impingement syndrome?

A

POLICED, modalities, and scapular taping

26
Q

US, LASER, Extra-corporeal shockwave _________ evidence with impingement syndrome

A

lack

27
Q

Scapular taping improved _____ ______ P!

A

short term

28
Q

What is the strongest manual PT Rx recommendation at GH joint?

A

JM

29
Q

With JM in the thoracic spine, it had an _________ recovery and ________ P! and disability immediately vs usual care

A

accelerated; reduced

30
Q

JM added with exercise are _______ effective than exercise alone

A

more

31
Q

What is the primary treatment option for impingement syndrome?

A

MET

32
Q

With MET and tendinosis, it has to be > than ____ months of symtoms

A

6

33
Q

With MET and tendinosis, it should include ______ and _______ exercises

A

RC and scapular exercises (MT/LT/Rhom/SA)

34
Q

With MET and tendinosis, your patient should have an ______ with supporting PT visits

A

HEP

35
Q

At 3 months, there should be ____% improved P! function with MET

A

70

36
Q

What is the prognosis typically for impingement syndrome?

A

earlier improvements, if no tendinosis or tears

37
Q

MD Rx: With subacromial decompression, there is partial ______ acromioplasty due to hooking

A

anterior

38
Q

With subacromial decompression, there is distal ________ resection and ________ ligament

A

clavicle; coracocclavicular

39
Q

Subacromial depression should NOT be performed if _______ and present > ___ months

A

atraumatic; 3

40
Q

____________ is when differing body regions are biomechanically and neurophysiologically interdependent and impairment in one region can contribute to impairment in another, particularly if persistent

A

regional interdependence

41
Q

A pt. will have significant lower strength in what 3 areas when persistent with neck pain?

A

neck, shd, and scapula

42
Q

Lower ____ and Lower ______ strength are persistent with neck P!

A

hip; back

43
Q

Remember that co-existing ______ is a risk factor for neck P!

A

LBP

44
Q

With regional interdependence, recruit what you need for __________ ________

A

overhead reaching

45
Q

Where is the most common segment for dysfunction with regional interdependence?

A

C5-C6

46
Q

Imbalanced overhead reaching: Excessively recruited ____’s share innervation from _____ with C5/6 segment and inhibition of _____’s

A

IR

C6

ER

47
Q

With imbalanced overhead reaching, the humeral head is pulled anterior and into _____

A

IR

47
Q

With imbalanced overhead reaching, it creates excess ______ and _______ underneath the _______ head of the biceps tendon

A

tension

compression

long

48
Q

Imbalance with overhead reaching:

Excessively recruited scapular elevators that share innervation from _____ with C2,3 segment

A

C3

49
Q

Imbalance with overhead reaching at C2,3 creates excess tension and compression underneath the _______ tendon

A

supraspinatus

50
Q

With inhibition of the depressors, there will be impingement at how many degrees?

A

150

51
Q

C2,3 jt. dysfunction: The supraspinatus and long head of Biceps tendons will impinge which can lead to __________

A. tendinosis
B. tendinopathy
C. tendinitis

A

B.

52
Q

With the C2,3 jt. dysfunction, which two shoulder joints can lead to hypermobility/instability?

A

GH and AC

53
Q

Inhibited mm. develop protective _______ at rest

A

hypertonicity aka “tightness”

54
Q

With regional interdependence, address _______ and involved _______

A

mechanics; tissues

Fall Semester DPT (11 decks)

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