Shoulder Conditions Flashcards
1
Q
Anterior Glenohumeral Dislocation/Subluxation
A
- 95% of dislocations occur in anterior-inferior
- Occurs when ABD UE is forcefully ER causing a tear of the inferior glenohumeral ligament, anterior capsule, and occasionally glenoid labrum
2
Q
Posterior Glenohumeral Dislocation/subluxation
A
- posterior dislocations are rare and occur with multidirectional laxity of GH joint
- Occurs w. horizontal ADD and IR of glenohumeral jt
- Complications may include
- compression fracture of posterior humeral head (Hill-Sachs Lesion)
- tearing of superior glenoid labrum from anterior (front) to posterior (back) aka SLAP lesion.
- an avulsion of antero inferior capsule and ligaments associated w. glenoid rim (bankarts lesion)
- **bruising of axillary nerve **
3
Q
Glenohumeral Subluxation/Dislocation: Dx
A
plain film imaging, CT scan, MRI
4
Q
Glenohumeral Subluxation/Dislocation: PT
A
- intervention varies depending on surgery
- address biomechanical faults caused by joint restriction
- restoration of normal shoulder mechanics via strengthening/endurance that focuses on scapulothoracic, glenohumeral, and muscular re-ed
5
Q
Glenohumeral Instability: Types and Characteristics
A
- Traumatic: young throwing athletes
- Atraumatic: individuals w/ congenitally loose connective tissue around the shoulder
- Characteristics:
- popping/clicking and repeated sublux/dislocation of GH
- Unstable injuries require surgery to reattach labrum to glenoid
- **Bankharts lesion requires surgery
6
Q
Glenohumeral Instability: Dx
A
- clinical exam comparing results of patient history with AROM, PROM. resistive tests and palpatation
- MRI arthrograms are also very effective
7
Q
Glenohumeral Instability: PT
A
- emphasize RTF w/o pain
- functional training and restoration of ms imb
- address biomechanical faults
- Post surgery:
- should kept in sling for 3-4 weeks
- after 6 weeks: more sport specific training
- Full fitness may take 3-4 months
8
Q
Labral Tears: Etiology
A
- Inferior or Superior, SLAP or Bankharts
- Often occur with other shoulder pathology including dislocations
9
Q
Labral Tears: Signs and Symptoms
A
- shoulder p! that cannot be localized to a specific point
- p! made worse by OH activities or when arm is behind back
- weakness
- instability of the shoulder
- p! on resisted flexion of the bicep (against resist elbow flex)
- tenderness on the front of the shoulder
10
Q
Labral Tears: Diagnosis
A
- clinical exam by comparing results of AROM, PROM, resist tests, and palpation.
- MRI arthrograms
- Arthroscopic surgery = GOLD STANDARD
11
Q
Labral Tears: PT
A
- return to function w/o pain
- funx training and restoration of ms imbalance
- address underlying causes (instability)
- address biomechanical faults
- Post op
- sling 3-4 weeks
- after 6 weeks - sport specific
- full recovery 3-4 months
12
Q
Thoracic Outlet Syndrome:
A
- compression of the neurovascular bundle
- brachial plexus
- subclavian artery/vein
- vagus/phrenic nerves
- sympathetic trunk
- compression occurs when size/shape of TO is altered
- Common areas of compression
- superior thoracic outlet
- scalene triangle
- between clavicle and 1st rib
- between pec min and thoracic wall
13
Q
Thoracic Outlet Syndrome: Dx
A
- plain film imaging to identify bony abnorm
- MRI identify soft tissue
- Electrodiagnostic test - nerve dysfunc
- CLinical exam
- adsons
- roos test
- wright test
- costoclavicular test
14
Q
Thoracic Outlet Syndrome: PT
A
- **Surgery may be required to remove cervical rib or release ant/middle scalene
- postural re-education
- functional training and restoration of ms imb
- biomechanical faults
- manipulations (typically 1st rib articulation) to diminish pain and soft tissue guarding
15
Q
Acromioclavicular and Sternoclavicular Joint Disorders:
A
- MOI: fall on shoulder w/ UE ADD or a collision with another individual during sporting event
- Degree of injury graded I-III (IV-VI)
- Acute phase:
- UE positioned in neutral w. use of sling
- avoid shoulder elevation
