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Musculoskeletal Pathophysiology > Shoulder Dysfunction > Flashcards

Shoulder Dysfunction Flashcards

Shoulder dsyfxn through hill-sacks lesion need to finish from dislocation management-end

1
Q

How are rotator cuff diseases classified?

A

Neer Classification of Rotator Cuff Disease: Stage I -III

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2
Q

Tendonopathy with repeated insult that causes decreased integrity of soft tissues resulting in partial or full tendon tear can be classified as:

A

stage III

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3
Q

Theories of RC injury?

A

avascularity
mechanical wear
micro/macro trauma

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4
Q

Explain the avascular component of RC injury

A

“wringing out” occurs with prolongued/repetitive overhead activities resulting in loss of blood flow

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5
Q

What is tendonosis?

A

intra-tendon degeneration

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6
Q

What is sprengels deformity?

A

failure of scapula to defend

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7
Q

What is erb’s palsy?

A

obstetrical brachial plexus traction injury

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8
Q

Describe stage II RC disease.

A

fibrosis of the cuff, permanent and irreversible changes, 25-40 years

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9
Q

Where is pain typically present with subacromial/subdeltoid bursitis:

A

pain near end of ROM

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10
Q

Adhesion or shortening of GH capsule may lead to

A

adhesive capsulitis “frozen shoulder”

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11
Q

What are the two causes of adhesive capsulitis?

A

trauma or idiopathic

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12
Q

How long does it take for idiopathic adhesive causalitis to resolve?

A

12-18 months

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13
Q

Describe Freezing Idiopathic Adhesive Capsulitis

A

First 4-6 months
very painful
losing ROM

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14
Q

Describe Frozen Idiopathic Adhesive Capsulitis

A

Second 4-6 months
pain decreases
very stiff

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15
Q

Describe Thawing Idiopathic Adhesive Capsulitis

A

Third 4-6 months
less pain
increasing motion

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16
Q

How is adhesive capsulitis managed?

A

priority: pain control

maintain ROM as much as possible (consider phase)

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17
Q

Describe GH dislocation presentation

A

o 95% Anterior: cannot touch opposite shoulder

o 5% Posterior: cannot ER arm

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18
Q

What is bankart lesion arthrogram?

A

Glenoid labral tear assiated with GH dislocation

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19
Q

What is SLAP lesion?

A

a forceful tearing of the labrum near the insertion of the biceps tendon that usually occurs with dislocation of shoulder

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20
Q

Hill-Sachs Lesion

A

Posterolateral indentation fx of humeral head associated with anterior GH dislocation

21
Q

What is the incidence of hill sachs lesion with recurrent dislocations?

A

80% incidence in recurrent dislocations

22
Q

What is the conservative treatment for shoulder dislocations?

A

Reduction
Immobilization in slip (up to 3 wks)
Progressive mobilization
shoulder strengthening (RC especially)

23
Q

What does the Bankart surgery repair?

A

Repair by suturing the leabrum and capsule

24
Q

Do you get full ROM back with a Bankart Arthroscopic surgery?

A

YEs

25
Q

What is a capsular shift surgery?

A

Tightening of the anterior capsule

26
Q

What is a method used for a capsular shift?

A

Electrothermally assisted capsular shift

27
Q

Do you get full ROM back with a capsular shift surgery?

A

May loose a little ROM

28
Q

What is done with a bristow Arthrotomy?

A

For recurrent dislocations, the coracoid is moved to the anterior glenoid

29
Q

What is a grade 1 AC sprain?

A

Tender at AC, sprain of AC ligaments, NO deformity

30
Q

What is a Grade 2 AC sprain?

A

Increased displacement of clavicle. Tear of both superior and inferior AC

31
Q

What is a grade 3 AC sprain?

A

Complete disruption, marked deformity, complete tear of AC ligaments and CC ligaments (trapezoid and conoid

32
Q

What is a piano key sign?

A

Push down on the distal clavicle and it springs back up like a piano key

33
Q

What is a conservative management of an AC sprain/dislocation
?

A

Immobilize in a kenny-howard sling for 3-6 weeks

34
Q

What is a surgical management of an AC sprain/dislocation?

A

ORIF with a rockwood screw only if severe

35
Q

What movement precautions should you take post AC dislocation?

A

Horizontal Adduction

Abduction above 90 degrees

36
Q

<p>

| What are SC joint sprains/dislocations usually secondary to?</p>

A

<p>

| Trauma (MVA), direct blow to sternum, or FOOSH(or A)</p>

37
Q

What situation would a SC joint dislocation be a medical emergency?

A

If it translates posteriorly due to the proximity of the trachea and subclavian artery/nerve

38
Q

What are two of the most common fxs of the proximal humerus?

A

Nondisplaced greater tuberosity fx

Clavicular Fx

39
Q

What are proximal humeral fxs and clavicular fxs usually caused by?

A

FOOSH’s

40
Q

What is the female:male ratio for proximal humeral fxs?

A

2:1 female to male ratio

41
Q

How does Neer classify Shoulder fractures?

A 
4 part system based on the relationship of the following bone parts and the amt of displacement:
Articular fragment of the head
lesser tuberosity 
Greater Tuberosity
Shaft
42
Q

What would a two part fx consist of?

A

Displacement between any two of the 4 parts of Neers shoulder fx classification (i.e. greater tuberosity and shaft)

43
Q

What is the conservative management of a proximal humeral fracture?

A

sling for 10-21 days IF non-displaced. THEN gradual mobility

44
Q

When do use a sling for a proximal humoral fx post-op?

A

If displaced by >1 cm, or if in 45 deg. angulation, you will be in a sling several weeks post op

45
Q

What is lipohemarthrosis?

A

the mixture of fat and blood in a joint cavity following trauma

46
Q

WHat are some considerations post humeral fracture?

A

potential for post-immobilization adhesive capsulitis
Stability of fx
Potential for CRPS (formerly shoulder-hand syndrome)

47
Q

How long are you in a sling post clavicular fx?

A

2-3 week

48
Q

How and when are clavicular fxs surgically repaired?

A

Only for severe fxs, they use a plate and screw fixation

49
Q

How does erb’s palsy present?

A

shoulder adducted/IR
forearm pronated
wrist flexed
absent biceps reflex

Musculoskeletal Pathophysiology (14 decks)

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