Shoulder Pain

Question 1

Shoulder pain is the _____ most common musculoskeletal complaint

Answer 1

3rd most common

Question 2

The shoulder is the site where tendons pass between what

Answer 2

Bones (acromion process and humerus)

Question 3

What is the vindicate pneumonic and what is it used for

Answer 3

Vascular 
Inflammatory
Neoplastic 
Degenerative/deficiency 
Idiopathic/intoxication 
Congenital
Autoimmune/Allergic
Traumatic
Endocrine 

Used to narrow down a differential dx.

Question 4

Who do clavicle fx most often occur in?

Answer 4

Kids (greenstick fx.)

Question 5

The proximal humerus is fractured most commonly in who

Answer 5

The elderly

Question 6

A scapular fx. Is most commonly associated with what

Answer 6

Blunt trauma

Question 7

What are the three type of Glenohumeral Dislocation

Answer 7

1. Anterior - most common
2. Posterior
3. Inferior - least common

Question 8

What do AC Joint injuries commonly result from

Answer 8

Direct trauma to the superior or lateral aspect of the shoulder (acromion) with the arm adducted

Ex. A direct blow to the shoulder or falling onto the shoulder

Question 9

What is a common sign for AC separation

Answer 9

Shoulder step off

Question 10

Define a Type I AC Tear

Answer 10

Clavicle is displaced posteriorly over the acromion

The L. Is stretched

Question 11

Define a Type II AC joint Tear

Answer 11

A partial rupture of the AC L.

Question 12

Define a Type III AC Joint Tear

Answer 12

A complete rupture of the AC and CC (coracoarcomial) L.’s

Question 13

What muscle is most commonly injured in a rotator cuff injury

Answer 13

Supraspinatus M.

Question 14

What are the muscle of the rotator cuff

Answer 14

Supraspinatus
Infraspinatus
Teres Minor
Subscapularis

SITS

Question 15

What is the most sensitive and specific rotator cuff specialty test

Answer 15

Painful arc test

Question 16

Define impingement syndrome of the Rotator Cuff

Answer 16

Symptoms resulting from compression of the rotator cuff tendons and the subacromial bursa between the greater tubercle of the humeral head and the lateral edge of the acromion process

Question 17

Define Tendinopathy of the Rotator Cuff

Answer 17

Chronic injury to the supraspinatus M. And/or infraspinatus M. Tendons

Develops as a consequence of repetitive activity

Question 18

Define Septic Arthritis. What are some common risk factors? Which joint is usually involved? What is a good conformational diagnostic

Answer 18

Inflammation and accumulation of infected fluid within the joint. Usually occurs in the knee. Risk factors include the elderly, RA, skin infections, recent surgery, IV Drug use.

Aspirate synovial fluid to check

Question 19

What x-ray to use to get the best image of the shoulder

Answer 19

A Y view

Question 20

Biceps DTR checks what nerve root?

Brachioradialis DTR?

Triceps DTR?

Answer 20

C5

C6

C7

Question 21

What does the apprehension test look for

Answer 21

(+) = pt. Apprehensive of repeat dislocation

Genohumeral instability

Question 22

What does the sulcus sign look for

Answer 22

(+) = indentation appears in the area beneath the acromion

Indicates glenohumeral instability

Question 23

What does Yergason’s test look for

Answer 23

(+) = pain and/or tendon subluxation out of the groove

Indicates unstable bicipital

Question 24

What does Speed’s Test look for

Answer 24

(+) = pain in bicipital groove

Indicates bicipital tendonitis of long-head biceps brachii M.

Question 25

What does empty can test look for

Answer 25

(+) = pain or weakness

Indicates rotator cuff pathology (specifically supraspinatus M.)

Question 26

What does drop-arm test look for

Answer 26

(+) = arm will drop or gently tap will cause arm to drop

Indicates full thickness tear of supraspinatus M.

Question 27

What does the painful arc test indicate

Answer 27

(+) = pain within 60 - 120 degree of shoulder abduction

Indicates subacromial impingement and/or rotator cuff injury

Question 28

What does Neer Impingement indicate

Answer 28

(+) = pain

Indicates subacromial bursa or RCI

Question 29

What does Hawkins Test indicate

Answer 29

(+) = pain

Indicates RCI

Question 30

What does the lift arm test indicate

Answer 30

(+) = weakness

Indicates subscapularis weakness