Shoulder disorders

Question 1

Shoulder - GH subluxation/dislocation - what is most common for dislocations

Answer 1

95% occur in anterior-inferior direction

Question 2

Shoulder - GH subluxation/dislocation - how does anterior/inferior dislocation usually occur

Answer 2

Abducted UE is forcefully ER - causing tear of inferior GH ligament, anterior capsule, and occasionally labrum

Question 3

Shoulder - GH subluxation/dislocation - Posterior dislocation would happen how

Answer 3

Horiztonal adduction and IR

RARE

Question 4

Shoulder - GH subluxation/dislocation - following surgical repair - should avoid

Answer 4

apprehension position (flex 90 or greater, abd 90 or greater, ER to 80)

Question 5

Shoulder - Instability - categories

Answer 5

atraumatic and traumatic

Question 6

Shoulder - Instability - characterized by

Answer 6

popping/clicking and repeated dislcoation/subluxation of GH joint

Question 7

Shoulder - instability - when is surgery required

Answer 7

Unstable injuries require surgery to reattach the labrum to glenoid
Bankart’s lesions require surgery

Question 8

Shoulder - instability - restrictions after surgery

Answer 8

Sling for 3 to 4 wks
after 6 can do more sport specific stuff
full fitness may take 3-4 months

Question 9

Shoulder - labral tears - classified as

Answer 9

superior or inferior

Question 10

Shoulder - labral tears - SLAP lesion is a tear of

Answer 10

the rim above the middle socket that may also involve the biceps tendon

Question 11

Shoulder - labral tears - Bankart’s lesion is a tear of

Answer 11

the rim below the middle of the glenoid socket

Question 12

Shoulder - labral tear - characterized by what s/s (6)

Answer 12

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

Question 13

Shoulder - labral tear - when surgery

Answer 13

Unstable require it to reattach labrum to glenoid

Baknart’s require it

Question 14

Shoulder - labral tear - gold standard for identifying labral tear

Answer 14

Arthroscopic surgery of shoulder

Question 15

Shoulder - labral tear - following surgery shoulder is

Answer 15

kept in sling for usually 3-4 wks
after 6 can do more sport specific
full fitness may take 3-4 months

Question 16

Shoulder - TOS - compression of what

Answer 16

Neurovascular bundle - brachial plexus, subclavian artery and vein, vagus and phrenic nerves, sympathetic trunk

Question 17

Shoulder - TOS - common areas of compression

Answer 17

Superior thoracic outlet
Scalene triangle
Between clavicle and first rib
Between pec minor and thoracic wall

Question 18

Shoulder - TOS - clinical special tests to help make dx

Answer 18

Adsons test
Roo’s test
Wright test
Costoclavicular test

Question 19

Shoulder - AC and SC joint disorders - mechanism of injury is usually

Answer 19

a fall onto shoulder with UE add or a collision with another individual

Question 20

Shoulder AC and SC joint disorders - Traditionally graded how

Answer 20

I to III

Question 21

Shoulder AC and SC joint disorders - UE is positioned into ____ in acute phase
What to avoid in acute phast

Answer 21

Neutral with use of sling

Avoid shoulder elevation in acute phase

Question 22

Shoulder AC and SC joint disorders - Clinical special tests that would help diagnose

Answer 22

Shear test

Question 23

Shoulder - subacromial/subdeltoid bursitis - close relationship to what

Answer 23

RTC mm so susceptible to overuse

Can also become impinged below acromial arch

Question 24

Shoulder - RTC tendonosis/tendonopathy - tendons of RTC susceptible to tendonitis because why

Answer 24

Poor blood supply near insertion of muscles

Question 25

Shoulder - RTC tendonosis/tendonopathy - results from

Answer 25

mechanical impingement of distal attachment of RTC on the anterior acromion and/or coracoacromial ligament with repetitive overhead activity

Question 26

Shoulder - RTC tendonosis/tendonopathy - clinical special tests to help diagnose

Answer 26

Supraspinatus test

Neer’s impingement test

Question 27

Shoulder - Impingement syndrome - characterized by

Answer 27

soft tissue inflammation of shoulder from impingement against acromion with rep. overhead shoulder motion

Question 28

Shoulder - impingement syndrome - clinical special tests to help dx

Answer 28

Neer’s impingement
Supraspinatus test
drop arm test

Question 29

Shoulder - impingement syndrome - surgical repair should avoid what

Answer 29

shoulder elevation greater than 90 degrees

Question 30

Shoulder - internal (posterior) impingement - characterized by what

Answer 30

irritation between the RTC and greater tuberosity or posterior glenoid and labrum

Question 31

Shoulder - bicipital tendonosis/tendonopathy - results from

Answer 31

mechanical impingement of proximal tendon, between anterior acromion and bicipital groove of humerus

Question 32

Shoulder - bicipital tendonosis/tendonopathy - clinical special tests

Answer 32

Speed’s test

Question 33

Shoulder - proximal humeral fractures - humeral neck fractures - frequently occur from what

Answer 33

fall onto outstretched UE in older osteoporotic women

Usually stable fracture - no surgery or immob

Question 34

Shoulder - proximal humeral fractures - greater tuberosity fracture - common in who and how

Answer 34

middle aged and elder adults
Usually related to a fall onto the shoulder
Does not usually require immobilization

Question 35

Shoulder - proximal humeral fractures - PT goals

Answer 35

early PROM to avoid capsular adhesions

Question 36

Shoulder - adhesiv capsulitis - results from

Answer 36

inflammation and fibrosis of shoulder capsule either from disuse or repetitive microtrauma

Question 37

Shoulder - adhesive capsulitis - restrictions follow capsular pattern which is what

Answer 37

Greatest limitation in ER, then abduction and flexion and least restricted is IR

Question 38

Shoulder adhesive capsulitis - commonly seen with what disease

Answer 38

diabetes mellitus