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pt clin med > Shoulder Pathophysiology / 3 > Flashcards

Shoulder Pathophysiology / 3 Flashcards

0
Q

adaptively shortened connective tissue of shoulder joint

A

adhesive capsulitis

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1
Q

loss of integrity of motor unit in shoulder

A

rotator cuff tears

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2
Q

inflammation in any of the 4 rotator cuff tendons

A

rotator cuff tendinitis

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3
Q

most common location for rotator cuff tendinitis

A

supraspinatus

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4
Q

rotator cuff tendinitis is common with blank overuse

A

overhead

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5
Q

this is due to imbalances of the shoulder and can cause rotator cuff tendinitis

A

impingement syndrome

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6
Q

arthrokinematic glenohumeral instability that can lead to rotator cuff tendinitis is due to weakness of blank muscles

A

stabilizing

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7
Q

rotator cuff watershed area is where there is a blank and can lead to rotator cuff tendinitis

A

zone of weakness

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8
Q

zone of weakness of shoulder is where blank meets blank

A

subclavian, brachiocephalic

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9
Q

rotator cuff outlet reduction, active insufficiency of rotator cuff, abnormal scapulothroacic mechanics, passive capsule ligamentous insufficiency, and capsulo ligamentous laxity are all blank

A

impingement (external) etiology

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10
Q

impingement is caused by tissues thickening from blank

A

microtrauma

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11
Q

not all forward shoulders are caused by weak blank

A

trapezius

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12
Q

reduced supraspinatus outlet cause of impingement etiology is presents with a blank acromion, blank of C-A ligament, blank joint djd, enlarged blank tissues, or blank formation

A

abnormal, hypertrophy, ac, subacromial, spur

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13
Q

abnormal acromion that is flat

A

type 1

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14
Q

type 2 abnormal acromion is blank

A

smooth curve

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15
Q

abnormal acromion type 3 is blank

A

anterior hook

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16
Q

tight capsuloligamentous structure will contribute to a blank capsular constrain mechanism

A

hyper

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17
Q

in a passive capsulolig insufficiency, direction of the translation will be blank to the anatomic anatomical location of the blank strcuture

A

opposite, tight

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18
Q

passive capsuloligamentous insufficiency most commonly occurs during

A

overhead reaching

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19
Q

there is excessive blank humeral head translation during motion with a capsuloligamentous laxity

A

anterior

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20
Q

UNDER SURFACE OF posterior rotator cuff being impinged

A

internal shoulder impingement

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21
Q

posterior humeral head and glenoid are incriminated in blank impingement

A

internal

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22
Q

internal impingement when horizontal abduction is beyond the POS and scapular protraction/winging beyond normal POS

A

hyper angulation

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23
Q

internal impingement comes with an anterior blank laxity

A

capsuloligamentous

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24
Q

GH apprehension and relocation tests are for blank of internal impingement

A

capsuloligamentous laxity

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25
Q

glenohumeral is the most common area for blank tendinitis

A

calcific

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26
Q

calcific tendinitis is when calcium deposits into the substance of a blank

A

tendon

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27
Q

biceps tendon is cited to be the 2nd most common location of blank

A

shoulder tendinitis

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28
Q

bicep tendinitis is typical with athletes attempting to decelerate elbow blank and radioulnar blank during follow through

A

extension, pronation

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29
Q

overhead movements can cause blank biceps tendinitis

A

intraarticular

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30
Q

impingement, spur, subluxation can cause this type of biceps tendinitis

A

extraarticular

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31
Q

shoulder bursitis is not usually the blank cause

A

primary

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32
Q

shoulder bursitis is typically in the blank

A

subdeltoid

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33
Q

bursitis can become blank or develop adhesions

A

fibrotic

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34
Q

rotator cuff tears are the end of the blank process

A

degenerative (ct disease process)

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35
Q

full tears are classified by blank in rotator cuff

A

size

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36
Q

less than 1 cm rotatory cuff tear

A

small

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37
Q

less than 3 cm rotator cuff tear

A

medium

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38
Q

less than 5 cm rotator cuff tear

A

large

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39
Q

greater than 5 cm rotator cuff tear

A

massive

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40
Q

partial rotator cuff tears are classified by blank

A

location

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41
Q

two reasons rotator cuff tears don’t heal that well

A

tear bathed in synovial fluid, muscles retract from each other

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42
Q

most partial tears occur at blank age

43
Q

three tests for rotator cuff tears

A

drop arm sign, painful arc (60-120), infraspinatus muscle test: resisted er in neutral

44
Q

most full tears occur near blank age

45
Q

blank percent recurrence rate of gh dislocation in younger patient

46
Q

most commonly dislocated joint and rate

47
Q

percent of traumatic gh dislocations

48
Q

percent of atraumatic gh dislocations

49
Q

most gh dislocations (98%)

A

subacromial

50
Q

subacromial dislocation occurs blank to glenoid and blank to acromion

A

posterior, inferior

51
Q

very rare gh dislocation that has extreme soft tissue damage

52
Q

gh instability may result from or contribute to gh blank or blank

A

subluxation, dislocation

53
Q

gh blank is more difficult to diagnose than dislocation and how classified

A

subluxation, how far humeral head is out of glenoid

54
Q

most common type of gh instability

55
Q

glenohumeral capsule becomes inflamed, thickened, and fibrotic and adheres to itself or the humeral head

A

adhesive capsulitis

56
Q

Matsen’s GH instability classifications TUBS and AMBRI

A

TUBS: Traumatic Unilateral Bankart Surgery
AMBRI: Atraumatic Multidirectional Bilateral Rehabilitation Inferior capsule shift

57
Q

adhesive capsulitis is blank etiology

58
Q

spontaneous atraumatic onset of adhesive capsulitis

A

primary classification

59
Q

posst trauma, post immobilization, concurrent system disorder type of adhesive capsulitis

A

secondary classification

60
Q

pain is during blank phase

61
Q

stiffness is during blank phase

A

frozen phase

62
Q

return to normal phase

63
Q

frozen shoulders often last blank months per phase and blank to blank total

A

3-4, 6 months to 3 years

64
Q

separation or subluxation of ac joint from moderate trauma can be a complete tear of ac ligament

A

ac joint injury grade 2

65
Q

secondary to mild injury force and results in partial tearing of ac ligament fibers

A

ac joint injury grade 1

66
Q

severe force, rupture ac lig and capsule and cc ligaments… aka ac joint dislocation

A

ac joint injury grade 3

67
Q

clavicular fracture to middle third, most common

–MOI: “FOOSH” or lateral shoulder

68
Q

clavicular fracture to lateral clavicle between coracoclavicular ligaments & AC joint
–MOI: downward force or fall on to the “point” of the shoulder. Often associated with AC separation

69
Q

clavicular fracture to medial third, very rare seldom displaced
–MOI: direct blow from lateral shoulder

70
Q

scapular fractures are very blank

71
Q

normal moi of scapular fracture

72
Q

Common complication of “body’ fractures of scapula is blank of overlying muscles to scapula reducing mobility.

73
Q

glenoid fossa fractures are associated with glenoid blank

A

dislocations

74
Q

most common injury resulting from foosh

A

proximal humeral fractures

75
Q

blank commonly fracture humeral heads and there is a blank ratio of women to men and often is caused by blank

A

elders, 2:1, osteoporosis

76
Q

–Axillary nerve most common
–Brachial plexus: 6.1% frequency
–Avascular necrosis: 3-14% incidence in three part fractures

these are all blank complications associated with blank fractures

A

neural, humeral head

78
Q

ra is a blank disease

79
Q

Age for type I Neer’s impingement

A

Less than 25

80
Q

Characteristics of type I Neer’s impingement (4)

A
  1. Edema
  2. Hemorrhage
  3. Inflammation
  4. Typically reversible
81
Q

Treatment for type I Neer’s impingement (2)

A
  1. Avoid causitive ADLs

2. Improve biomechanics

82
Q

Age for type II Neer’s impingement

83
Q

Characteristics of type II Neer’s impingement (4)

A
  1. Bursa thickening
  2. Tendon fibrosis
  3. Pain recurrent
  4. Decreased chance of reversing
84
Q

Treatment for type II Neer’s impingement (2)

A
  1. Add anti inflammatory

2. Consider surgery

85
Q

For type II Neer’s impingement what is surgically removed (2)

A
  1. Subacromial decompression

2. Bursectomy

86
Q

Age for type III Neer’s impingement

A

Older than 40

87
Q

Characteristics of type III Neer’s impingement (3)

A
  1. HH and acromial bone spurs
  2. Tendon tears
  3. Progressive disability
88
Q

Treatment for type III Neer’s impingement (2)

A
  1. Acromioplasty

2. RC repair

89
Q

Is it more effect to go into hyperangulation when throwing or stop at the POS

A

Stop at POS

90
Q

What are the classifications of partial RC tears (3)

A
  1. Articular side
  2. Mid substance
  3. Bursal side
91
Q

What is the notch phenomenon

A

The progression of the RC tear

92
Q

Example of notch phenomenon

A

Eventually supraspinatus tear will become large enough to include infraspinatus tear due to improper mechanics of the RC muscles

93
Q

Age for type I Neer’s impingement

A

Less than 25

94
Q

Characteristics of type I Neer’s impingement (4)

A
  1. Edema
  2. Hemorrhage
  3. Inflammation
  4. Typically reversible
95
Q

Treatment for type I Neer’s impingement (2)

A
  1. Avoid causitive ADLs

2. Improve biomechanics

96
Q

Age for type II Neer’s impingement

97
Q

Characteristics of type II Neer’s impingement (4)

A
  1. Bursa thickening
  2. Tendon fibrosis
  3. Pain recurrent
  4. Decreased chance of reversing
98
Q

Treatment for type II Neer’s impingement (2)

A
  1. Add anti inflammatory

2. Consider surgery

99
Q

For type II Neer’s impingement what is surgically removed (2)

A
  1. Subacromial decompression

2. Bursectomy

100
Q

Age for type III Neer’s impingement

A

Older than 40

101
Q

Characteristics of type III Neer’s impingement (3)

A
  1. HH and acromial bone spurs
  2. Tendon tears
  3. Progressive disability
102
Q

Treatment for type III Neer’s impingement (2)

A
  1. Acromioplasty

2. RC repair

103
Q

Is it more effect to go into hyperangulation when throwing or stop at the POS

A

Stop at POS

104
Q

What are the classifications of partial RC tears (3)

A
  1. Articular side
  2. Mid substance
  3. Bursal side
105
Q

What is the notch phenomenon

A

The progression of the RC tear

106
Q

Example of notch phenomenon

A

Eventually supraspinatus tear will become large enough to include infraspinatus tear due to improper mechanics of the RC muscles

pt clin med (15 decks)

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