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Shoulder Pathologies Flashcards

1
Q

True or False:

The ligaments and capsules can be referred to as the same thing

A

True

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2
Q

What is the primary function of the supraspinatus

A

First 10-15 abduction

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3
Q

What rotator cuff muscles cause external rotation of humerus

A

Supraspinatus, infraspinatus, and teres minor

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4
Q

What rotator cuff muscles cause internal rotation of humerus

A

Subscapularis

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5
Q

Which rotator cuff muscle is most commonly torn

A

Supraspinatus

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6
Q

What are the joints of the shoulder complex (4)

A
  1. Glenohumeral (GH)
  2. Sternoclavicular (SC)
  3. Arcomioclavicular (AC)
  4. Scapulothoracic (ST)
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7
Q

What is the scapulothoracic joint considered

A

A pseudo joint

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8
Q

What makes up the glenohumeral joint

A

Glenoid fossa of scapula and head of the humerus

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9
Q

What makes up the sternoclavicular joint

A

Manubrium of sternum and clavicle

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10
Q

What makes up the acromioclavicular joint

A

Acromion of scapula and clavicle

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11
Q

What makes up the scapulothoracic joint

A

Scapula and ribs

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12
Q

What is normal flexion of the shoulder

A

0-180

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13
Q

What is normal extension of the shoulder

A

0-60

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14
Q

What is normal abduction of the shoulder

A

0-180

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15
Q

What is normal scaption of the shoulder

A

0-180

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16
Q

What is normal external rotation of the shoulder

A

0-90

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17
Q

What is normal internal rotation of the shoulder

A

0-70

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18
Q

Where else can IR and Er rotation be done

A

45 or 0 just note where you measured from

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19
Q

What is the loose pack position of the GH joint

A

50 degrees of abduction and 30 degrees of scaption

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20
Q

What is the loose pack position used for

A

Assessing joint motion

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21
Q

What does DASH stand for

A

Disabilities of the Arm Shoulder and Hand

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22
Q

What is the difference between DASH and quick DASH

A

Quick DASH is shorter

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23
Q

What does SPADI stand for

A

Shoulder Pain and Disability Index

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24
Q

What does ASES stand for

A

American Shoulder and Elbow Surgeons

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25
Q

What does MCID stand for

A

Minimally Clinical Important Difference

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26
Q

What does the NPRS ask questions about

A

Ask patient to rate past, least, worse, and average pain

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27
Q

What scale is used for the NPRS

A

0-10

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28
Q

What is the MCID for the NPRS

A

2

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29
Q

What does the Beighton hypermobility score test

A

Hypermobility

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30
Q

How many positions are included in the Beighton hypermobility score

A

5

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31
Q

What are the 5 positions of the Beighton hypermobility score

A
  1. Extend pointer finger to 90
  2. Thumb touching forearm
  3. Hyperextension at elbow
  4. Hyperextension at knee
  5. Palms flat on floor
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32
Q

What is a normal score for the Beighton hypermobility score

A

0-3

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33
Q

What is a hypermobile score for the Beighton hypermobility score

A

4-9

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34
Q

What are the pathologies of the shoulder (10)

A
  1. Shoulder impingement
  2. Rotator cuff tendinitis
  3. Rotator cuff tear
  4. Adhesive capsulitis
  5. Labral tear
  6. Unidirectional instability
  7. Bidirectional instability
  8. AC sprain
  9. Sc sprain
  10. Clavicular fracture
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35
Q

What age most commonly has partial tear of rotator cuff

A

35

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36
Q

What age most commonly has full tear of rotator cuff

37
Q

What age most commonly has atraumatic instability

38
Q

What age most commonly has traumatic anterior instability

39
Q

What age most commonly has adhesive capsulitis

40
Q

What age most commonly has RA

41
Q

What age most commonly has DJD

42
Q

How does Neer classify impingements

A

Stages I-III

43
Q

What is a stage I Neer’s impingment (5)

A
  1. 25 y/o
  2. Repetitive overhead activity
  3. Tenderness over supraspinatus insertion
  4. Painful arc (60-120)
  5. Break test: Strong and painful ABD and ER
44
Q

What is stage II Neer’s impingement (6)

A
  1. 25-40 y/o
  2. Symptoms greater than stage I
  3. Pain with activity and night pain
  4. Crepitus or catching greater than 100 degrees
  5. Decreased PROM secondary to fibrosis
  6. Presence of capsular pattern
45
Q

What is stage III Neer’s impingement (5)

A
  1. Older than 40
  2. Hx of chronic tendinitis and prolonged pain
  3. Increased limitation in A/PROM
  4. Capsular laxity with multidirectional instability
  5. Break test: Weak and painful ABD and ER
46
Q

What are limited from most to least with impingement of the shoulder (3)

47
Q

How does Jobe and Knvite classify impingement of shoulder (5)

A
  1. Group IA
  2. Group IB
  3. Group II
  4. Group III
  5. Group IV
48
Q

What is group IA (3)

A
  1. Older than 35
    • impingement signs
  3. No instability
49
Q

What is group IB (3)

A
  1. Older than 35
    • impingement signs
    • instability
50
Q

What is group II (4)

A
  1. Younger than 35
  2. Repetitive overhead trauma
    • impingement signs
    • instability anterioir
51
Q

What is group III (3)

A
  1. Younger than 35
  2. Mulitdirectional instability
  3. Generalized laxity in all joints
52
Q

What is group IV (3)

A
  1. Younger than 35
  2. Anterior instability secondary to trauma
    • impingement signs
53
Q

How does a patient with RC tendinitis present (4)

A
  1. Mild to moderate limitation in ROM
  2. Pain during AROM
  3. Pain free PROM in direction of muscle action
  4. Break test= strong and painful
54
Q

What are 2 MOI of RC tendinitis

A
  1. Typically insidious onset

2. Microtrauma secondary repetitive overhead activity

55
Q

What are 4 configurations of tissue and load

A
  1. Abnormal load and abnormal tissue
  2. Abnormal load and normal tissue
  3. Normal load and abnormal tissue
  4. Normal load and normal tissue
56
Q

What are the 2 types of RC tear

A
  1. Full

2. Partial

57
Q

How does a full RC tear present (5)

A
  1. Significant deficits in AROM
  2. Full or near full PROM
  3. Break test= weak and painless
  4. May have complaints of instability
  5. C/o pain lying on involved side
58
Q

True of False:

Full/partial RC tears can be insidious or traumatic

59
Q

How does a partial RC tear present (5)

A
  1. Moderate deficits in AROM
  2. May complain of instability
  3. Moderate to significant functional complaints
  4. C/o pain lying on involved side
  5. Break test= weak and painful
60
Q

How does adhesive capsulitis present (5)

A
  1. Gradual onset
  2. Progressive worsening of pain and stiffness
  3. Functional c/o with sleeping, grooming, dressing, and reaching activities
  4. PROM limitation in capsular pattern ER, ABD, IR
  5. Joint play restricted in all directions
61
Q

Where does PROM produce pain in adhesive capsulitis patients

62
Q

What are factors that make you susceptible to get adhesive capsulitis (4)

A
  1. Insidious onset
  2. Age 40-65
  3. Medical hx of diabetes mellitus and thyroid disease (hypo/hyper)
  4. Females more than males
63
Q

True or False:

If you get adhesive capsulitis on on side you are more likely to get it on the other side

64
Q

What are the 2 types of labral tears

A
  1. Bankart lesion

2. SLAP

65
Q

What does a Bankhart lesion present with (4)

A
  1. Nonspecific shoulder pain/ache
  2. Symptoms of instability
  3. Catching sensation
  4. Avoid FER secondary sensation of dislocation
66
Q

What are MOI of Bankhart lesions (3)

A
  1. Trauma
  2. Repeated dislocations
  3. less than 30
67
Q

Where does a Bankhart lesion occur

A

Inferior labrum

68
Q

Where does a SLAP tear occur

A

Superior labrum anterior to posterior

69
Q

What does a SLAP tear present with (3)

A
  1. Nonspecific shoulder pain with overhead or cross body activity
  2. Reports of popping, clicking, or catching at shoulder joint
  3. Deep vague pain within the shoulder joint in association with weakness or stiffness
70
Q

What are MOI of SLAP tears (5)

A
  1. Traction injury
  2. Direct blow to shoulder area
  3. FOOSH
  4. Overhead throwing athletes
  5. Overload to biceps
71
Q

What does FOOSH stand for

A

Fall On Out Stretched Hand

72
Q

What does a patient with instability present with (4)

A
  1. Less than 40
  2. History of shoulder dislocation
  3. Excessive GH passive accessory motion in one or multiple directions
  4. Apprehension at end range
73
Q

What are the 3 motions where an instability patient will have apprehension at end range

A
  1. Flexion
  2. ABD
  3. ER
74
Q

What are the MOIs of instability (2)

A
  1. Trauma

2. Global hypermobility

75
Q

Where do anterior dislocations occur

A

90 ABD and ER

76
Q

Where do posterior dislocations occur

A

Horizontal ADD and IR

77
Q

What is the most common unilateral instability

78
Q

How do you determine multidirectional instability directions

A

Look at uninvolved side

79
Q

How does an AC joint sprain present (3)

A
  1. Pain with lying on involved shoulder
  2. Pain on superior portion of shoulder
  3. Decreased AROM
80
Q

Where is pain noted with AC joint sprain

A

Greater than 160 degrees

81
Q

What are MOI of AC joint sprain (2)

A
  1. Direct trauma to superior portion of shoulder

2. FOOSH

82
Q

SC joint sprain presents pain with what (4)

A
  1. Side lying on uninvolved side
  2. Horizontal ADD
  3. Overhead activities
  4. Heavy lifting
83
Q

What are MOI of SC joint sprain

A

Trauma-direct blow to area or top of shoulder

84
Q

How does biceps tendinitis present (4)

A
  1. Achy anterior shoulder pain exacerbated by lifting or elevated pushing or pulling
  2. Pain with overhead activity or lifting heavy objects
  3. Location of the pain is vague
  4. Symptoms may improve with rest
85
Q

What are MOI of biceps tendinitis (2)

A
  1. Repetitive motion

2. Partial traumatic biceps tendon ruptures have been described and may occur in combination with underlying tendinitis

86
Q

How does rupture of the biceps tendon occur (2)

A
  1. Sudden fall with a painful popping sensation

2. Nontraumatic due to hx of shoulder pain that occurs after a painful audible snap

87
Q

What does a ruptured biceps tendon look like

A

Ball near elbow

88
Q

What is the balled up biceps tendon called

A

Ludington’s sign

Musculo (18 decks)

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