Shoulder Pt. 1 Flashcards
close pack of GHJ
90 abd (or full)
full ER
open pack of GHJ
55 deg abd
30 deg horz add
capsular pattern of GHJ
ER>abd>IR
that glenoid labrum is made of ____cartilage
fibro (avascular and aneural)
T/F: the GH capsule is large, loose, and redundant
T
GHJ capsule fluid volume
normal:
adhesive capsulitis:
capsular laxity:
normal: 10-15 ml
adhesive capsulitis: 5-10 ml
capsular laxity: 30 ml
what occurs if the superior GH lig is incompetent?
humeral head will sublux inferiorly
when is the superior GH lig taut?
arm by side (0 deg abd)
which lig is a secondary restraint to anterior translation?
middle GH lig
which lig aids the RC to support suspended humeral head?
superior GH lig
the middle GH lig is absent or poorly defined in ___% of people
30%
what is the main static stabilizer of an abducted shoulder?
inferior GH lig
how does the inferior GH lig change with abd and rotation?
abd - taut
rotation - fans out
what lig allows reciprocal tightening of anterior and posterior structures w/ arm motions?
inferior GH lig axillary pouch
which part of the GHJ has no distinct capsular ligaments?
posterior capsule (very thin)
majority of posterior stability at GHJ comes from _____
dynamic stabilizers
what lig provides stability to the humeral head when the arm is abducted 90 deg and IR?
posterior band of inferior GH lig
main function of RC
provide dynamic balance and control
the RC muscles are a force couple with ___
deltoid
dynamic stability of the GHJ is achieve through contraction of ___ & _____
RC muscles and biceps
with arm at side, subacromial space is ___ mm
10-11
when is the subacromial space most narrow
b/w 60-120 deg of elevation
______ tendon is most involved with overuse injuries
supraspinatus
glenoid covers ____ of the humeral head
0.25-0.33
what is the main articulation that suspends the UE from the trunk?
AC joint
T/F: the AC and SC joints are NOT controlled by active structures
T
closed pack of AC joint
90 deg abd
if pt says they separated their shoulder, they probably injured what?
coraco-clavicular lig at AC joint
what is the primary support for the AC joint?
coraco-clavicular lig
what is the only joint that connects the shoulder girdle to the axial skeleton?
SC joint
closed pack of SC joint
max elevation and protraction
open pack of ST joint
30-45 deg IR
slight upward rotation
5-20 deg anterior tipping
the ST joint is only controlled by ____ structures
active (NO passive)
(17 mm attach)
what is reverse scapulo-humeral rhythm?
scapula moves more than humerus
ex: hike shld w/ min abd
nerve supply to GHJ
C5-8
nerve supply to ACJ
C4
sympathetic nerve supply to GHJ
T2-T8
the vascular supply of the shoulder primary are branches of the ___ artery
axillary
___ & ____ tendon are relatively avascular
supraspinatus and biceps
4 buckets of shoulder dysfunction
- RC/impingement
- frozen shoulder
- GH instability
- post-op/other
key + findings for RC/impingement
impingement signs
painful arc
pain w/ isometric movement
weakness
atrophy
key (-) findings for RC/impingement
significant loss of motion
instability signs
key + findings for frozen shoulder
spontaneous progressive pain
loss of motion in multiple planes
pain at end ROM
key (-) findings for frozen shoulder
normal motion
age < 40
____% of all shoulder pain in PT is related to RC dysfunction
50-70%
____% of people with frozen shoulder will develop it in the other UE
20-30%
stage I adhesive capsulitis
<3 months
pain present
stage II adhesive capsulitis
freezing
3-9 months
pain present
stage III adhesive capsulitis
frozen
9-14 months
no pain
stage IV adhesive capsulitis
thawing
14+ months
pain present
key + findings for GH instability
age <40
hx disloc/sublux
apprehension
general laxity
what is TUBS?
Trauma Unidirectional Bankart Surgery
for instability
what is AMBRI?
Atraumatic Multidirectional Bilateral Rehabilitation Inferior (surgery)
anterior dislocations are ___% of all shoulder dislocations
> 90%
T/F: when dislocate, always tear labrum
T
where is a Bankart lesion?
anterior inferior labrum (4-6:00)
what is a Hill-Sachs lesion?
depression in the glenoid due to impact to the humeral head
MOI for Bankart
traumatic
abd, ER, extension
MOI for SLAP
trauma (usually in 90/90)
repetitive microtrauma
where is SLAP?
2-10:00
MOI for posterior GHJ instability
flex, add, IR (football, bench press)
AC sprain present in ____% of pts with shoulder pain
31%
which AC joint sprains only require conservative treatment
type 1-2
which AC joint sprain has controversial treatment options
type 3
which AC joint sprains require surgical reduction
4-6
____ SC dislocations can be life threatening
posterior
what is the most commonly fractured bone in childhood?
clavicle
what is the most common humeral fracture in children and elderly?
proximal humerus
outcome measures for the shoulder
DASH
QuickDASH
Penn Shoulder Score
SPADI
K-JOC Score (baseball)
