Shoulder disorders Flashcards
Shoulder - GH subluxation/dislocation - what is most common for dislocations
95% occur in anterior-inferior direction
Shoulder - GH subluxation/dislocation - how does anterior/inferior dislocation usually occur
Abducted UE is forcefully ER - causing tear of inferior GH ligament, anterior capsule, and occasionally labrum
Shoulder - GH subluxation/dislocation - Posterior dislocation would happen how
Horiztonal adduction and IR
RARE
Shoulder - GH subluxation/dislocation - following surgical repair - should avoid
apprehension position (flex 90 or greater, abd 90 or greater, ER to 80)
Shoulder - Instability - categories
atraumatic and traumatic
Shoulder - Instability - characterized by
popping/clicking and repeated dislcoation/subluxation of GH joint
Shoulder - instability - when is surgery required
Unstable injuries require surgery to reattach the labrum to glenoid
Bankart’s lesions require surgery
Shoulder - instability - restrictions after surgery
Sling for 3 to 4 wks
after 6 can do more sport specific stuff
full fitness may take 3-4 months
Shoulder - labral tears - classified as
superior or inferior
Shoulder - labral tears - SLAP lesion is a tear of
the rim above the middle socket that may also involve the biceps tendon
Shoulder - labral tears - Bankart’s lesion is a tear of
the rim below the middle of the glenoid socket
Shoulder - labral tear - characterized by what s/s (6)
1 Pain that can't be localized 2 Worse with overhead and behind back activity 3 Weakness 4 Instability 5 Pain with resisted flexion of biceps 6 Tenderness over front of shoulder
Shoulder - labral tear - when surgery
Unstable require it to reattach labrum to glenoid
Baknart’s require it
Shoulder - labral tear - gold standard for identifying labral tear
Arthroscopic surgery of shoulder
Shoulder - labral tear - following surgery shoulder is
kept in sling for usually 3-4 wks
after 6 can do more sport specific
full fitness may take 3-4 months
Shoulder - TOS - compression of what
Neurovascular bundle - brachial plexus, subclavian artery and vein, vagus and phrenic nerves, sympathetic trunk
Shoulder - TOS - common areas of compression
Superior thoracic outlet
Scalene triangle
Between clavicle and first rib
Between pec minor and thoracic wall
Shoulder - TOS - clinical special tests to help make dx
Adsons test
Roo’s test
Wright test
Costoclavicular test
Shoulder - AC and SC joint disorders - mechanism of injury is usually
a fall onto shoulder with UE add or a collision with another individual
Shoulder AC and SC joint disorders - Traditionally graded how
I to III
Shoulder AC and SC joint disorders - UE is positioned into ____ in acute phase
What to avoid in acute phast
Neutral with use of sling
Avoid shoulder elevation in acute phase
Shoulder AC and SC joint disorders - Clinical special tests that would help diagnose
Shear test
Shoulder - subacromial/subdeltoid bursitis - close relationship to what
RTC mm so susceptible to overuse
Can also become impinged below acromial arch
Shoulder - RTC tendonosis/tendonopathy - tendons of RTC susceptible to tendonitis because why
Poor blood supply near insertion of muscles
Shoulder - RTC tendonosis/tendonopathy - results from
mechanical impingement of distal attachment of RTC on the anterior acromion and/or coracoacromial ligament with repetitive overhead activity
Shoulder - RTC tendonosis/tendonopathy - clinical special tests to help diagnose
Supraspinatus test
Neer’s impingement test
Shoulder - Impingement syndrome - characterized by
soft tissue inflammation of shoulder from impingement against acromion with rep. overhead shoulder motion
Shoulder - impingement syndrome - clinical special tests to help dx
Neer’s impingement
Supraspinatus test
drop arm test
Shoulder - impingement syndrome - surgical repair should avoid what
shoulder elevation greater than 90 degrees
Shoulder - internal (posterior) impingement - characterized by what
irritation between the RTC and greater tuberosity or posterior glenoid and labrum
Shoulder - bicipital tendonosis/tendonopathy - results from
mechanical impingement of proximal tendon, between anterior acromion and bicipital groove of humerus
Shoulder - bicipital tendonosis/tendonopathy - clinical special tests
Speed’s test
Shoulder - proximal humeral fractures - humeral neck fractures - frequently occur from what
fall onto outstretched UE in older osteoporotic women
Usually stable fracture - no surgery or immob
Shoulder - proximal humeral fractures - greater tuberosity fracture - common in who and how
middle aged and elder adults
Usually related to a fall onto the shoulder
Does not usually require immobilization
Shoulder - proximal humeral fractures - PT goals
early PROM to avoid capsular adhesions
Shoulder - adhesiv capsulitis - results from
inflammation and fibrosis of shoulder capsule either from disuse or repetitive microtrauma
Shoulder - adhesive capsulitis - restrictions follow capsular pattern which is what
Greatest limitation in ER, then abduction and flexion and least restricted is IR
Shoulder adhesive capsulitis - commonly seen with what disease
diabetes mellitus
