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Orthopedic Diagnosis > Test 1 Shoulder > Flashcards

Test 1 Shoulder Flashcards

1
Q

6 muscles that support and move the scapula

A

1) trapezius 2) rhomboids 3) levator scapulae 4) serratus

anterior 5) Latissimus Dorsi 6) Pectoralis Minor

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2
Q

3 types of acromion morphology

A

1) flat undersurface
2) slightly convex
3) hooked, which
can predispose the
shoulder to rotator
cuff pathology

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3
Q

Coracoid process is a lever for the ___ to help stabilize the ___

A

pectoralis major

scapula

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4
Q

What attaches at the greater tuberosity of humerus?

A

Supraspinatus, infraspinatus, teres minor

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5
Q

What attaches at lesser tuberosity?

A

Subscapularis

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6
Q

Superior GH ligament limits which motions?

A

external rotation and inferior translation of humeral head with arm at the side

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7
Q

Middle GH ligament limits which motions?

A

External rotation and anterior translations of humeral head with arm in 0 degrees and 45 degrees of abduction

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8
Q

Inferior GH ligament consists of a __ and __ band and an ___ with varying functions

A

Anterior
Posterior
Axillary pouch

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9
Q

Coracohumeral ligament covers the __ ligament ___, and fills the space beween the tendons of __ and __ muscles, uniting these tendons to complete the rotator cuff in this area.

A

GH
anterior-superiorly
supraspinatus
subscapularis

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10
Q

Coracoacromial ligament function

A

Prevents separation of A-C joint surfaces

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11
Q

What forms the coracoacromial arch?

A

Anterior-inferior sapect of acromion, coracoacromial ligament, inferior surface of AC joint

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12
Q

When is the Suprahumeral/subacromial space at it’s narrowest?

A

Between 60-120 degrees of scaption

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13
Q

Muscle imbalances or capsular contractures can cause increases in superior translation in __ and narrow the suprahumeral soace, leading to ___.

A

humeral head

Subacromial impingemet syndrome

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14
Q

Impingement syndrome definition

A

pain in subacromial space when the humerus is elevated or internally rotated

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15
Q

What are the ranges of the pain arc of abduction (glenohumeral joint)?

A

from 45-60 degrees to 110-120 degrees

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16
Q

What are the ranges for the acromioclavicular painful arc?

A

170-180 degrees

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17
Q

Impingement syndrome: During ___ ___ the ___ tendon and __ become entrapped between the __ corner of the ___ and ___.

A 
humeral flexion
supraspinatus
bursa
anteroinferior
acromion
greater tuberosity
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18
Q

Where is the hypovascular zone of the supraspinatus tendon?

A

Critical zone just proximal to the supraspinatus insertion point

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19
Q

Once the supraspinatus (and infraspinatus) tendon is disrupted there will often be further impingement and irritation which can lead to __ and further ___

A

biceps tendonitis

rupture

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20
Q

Impingement Syndrome pain is often worse at ___, as the ___ becomes ___

A

night
subacromial bursa
hyperemic

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21
Q

Subacromial Bursa provides two smooth ___ layers, one of which adheres to the overlying ___ muscle and the other to the ___ beneath.

A

serosal
deltoid
rotator cuff

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22
Q

Erbs palsy is an ____ brachial plexus injury can be from forceful ___ of the shoulder during birth or trauma later in life. Patient presents with a ___ and ___ shoulder. ___ reflex is lost.

A 
Upper
depression
internally rotated
adducted 
biceps
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23
Q

Klumpke’s Palsy is a ___ brachial plexus injury from forceful pulling of the ___ during birth. This impairs ___ ___ and movements of the ___ muscles of the ___

A 
Lower (C8 & T1)
upper arm
wrist flexion
intrinsic
hand
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24
Q

Vascular supply to the rotator cuff muscles

A

Thoracoacromial A
Suprahumeral A
Subscapular A

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25
Q

The ___ artery provides the dominant arterial supply to each of the two heads of the biceps.

A

brachial

26
Q

Describe the close packed position of the GH joint

A

90 degrees of glenohumeral abduction and full external rotation, or full abduction and external rotation

27
Q

Describe the open packed position of the GH joint.

A

55 degrees of semi-abduction and 30 degrees of horizontal abduction

28
Q

The AC joint serves as the main articulation suspending the upper extremity from the trunk, and it is at this joint about which the ___ moves

A

scapula

29
Q

The ___ and ___ ligaments are the primary support for the AC joint. These ligaments provide mainly ___ stability, with control of ___ and ___ translation as well as ___ ___ rotation

A 
Conoid
Trapezoid
vertical
superior
anterior
anterior axial
30
Q

AC joint innervation

A

Suprascapular N
Lat. Pectoral N
Axllary N.

31
Q

AC joint blood supply

A

Branches of Suprascapular and Thoracoacromial Arteries

32
Q

At the SC joint in close-packed position, the joint is maximum arm ___ and ___

A

elevation

protraction

33
Q

At the __ joint in open-packed position is yet to be determined, but is likely to be when the arm is by the ___.

A

SC

side

34
Q

Name the ligaments that support the SC joint

A

Anterior Sternoclavicular
Posterior Sternoclavicular
Interclavicular
Costoclavicular

35
Q

Tzitze’s Syndrome AKA ___: Etiology is ___. Pain and swelling of one or more ___ may occur gradually or suddenly. Pain may radiate to (3). ___ and ___ can irritate the junctions.

A 
Costochondritis
unknown
costocartilages
shoulder, neck, arm
direct trauma
coughing
36
Q

What muscles are the scapular pivoters?

A

Trapezius
Serratus Anterior
Levator Scapular
Rhomboids

37
Q

What muscles are the Shoulder Protectors?

A

Rotator Cuff muscles and Biceps Brachii

38
Q

What muscles are the humeral positioners?

A

Three parts of deltoid

39
Q

Frozen Shoulder is an an inflammation of the ___ layers causing and outpouring secretion of exudate which contains ___. The microscopic layers attach from adjacent synovial layers which then multiply, thickcn, and shorten (___ process)

A

synovial
protein
adhesive

40
Q

With frozen shoulder, the patient will have no __ motion, only __ motion. Progressive limitation of motion continues until complete ___ stops the pain.

A

GH
ST
Ankylosing

41
Q

During the first 30 degrees of upward rotation of the scapula, the __ and upper and lower divisions of the ___ muscle are the principle upward rotators.

A

serratus anterior

trapezius

42
Q

3 possible causes of Shoulder Girdle Dysfunction

A
  1. Compromise of passive restraint components
  2. Compromise of neuromusular system’s production or control of motion
  3. Compromise of one or more of the neighboring joints
43
Q

Most common complaints associated with shoulder pathology

A 
Pain
Instability
Swelling
Stiffness
Deformity
44
Q

Overhead exertion with repetitive motion is common in which Diagnoses?

A

Subacromial Bursitis
Impingement Syndromes
Rotor Cuff problems

45
Q

FOOSH injuries can result in what Diagnoses?

A 
Sprain/Strains
AC separation
Clavicular fx
GH fx
Dislocations
46
Q

Most common dislocation of the GH joint

A

Anterior/Inferior

47
Q

Recurrent dislocations after initial GH joint disloction is greater than __% in pts. aged 25 years or younger. Presents with __ shoulder appearance. Recurrent dislocations can lead to __ ___.

A

95
squared
degenerative Arthritis

48
Q

Grade 2 and 3 AC separations cause a considerable amount of ___. Grade 3 separations usually cause a noticeable __ on the shoulder.

A

swelling

bump

49
Q

MOI for clavicular fractures is usually __ injuries. Pt has difficulty __ the arm past __ degrees. Horizontal ___ is painful

A

FOOSH
elevating
60
adduction

50
Q

What is one of the most common causes of numbness in the shoulder and down into the arm?

A

Cervical or upper thoracic nerve root involvement- either from segmental nerve roots or brachial plexus

51
Q

What are possible causes of insidious shoulder pain?

A 
RA
Lupus
Gallbladder
Liver Disease
Chronic Resp. and CV conditions
52
Q

Sprengel’s Deformity is a ___ abnormality characterized by a partially ___ scapula. This condition develops prior to the ___ month of skeletal development and shows a __ ratio of female predominance.

A

Congenital
undescended
3rd
2:1

53
Q

In Sprengel’s Deformity, pt. shows __ of scapula with reduction of ___ in the arm.

A

elevation

abduction

54
Q

Scapular winging mode of injury is usually caused by stretching during ___, severance of the nerve during surgery (___), or a direct trauma to the side of the neck to the base of the ___.

A

heavy lifting
mastectomy
cervical vertebrae

55
Q

Juvenile Kyphosis AKA

A

Scheuermann’s Disease

56
Q

*Scheuermann’s Disease is evident in mid and lower thoracic regions in which at least ___ contiguous involved vertebrae are wedged ___ more than ___ degrees. Shows a slight __ predominance and is most common from __-__ years of age

A 
3
anteriorly
5
males
13-17
57
Q

Scheuermann’s Disease etiology is ___ and shows a cosmetic deformity with a predesposition thoracic disk ___ and premature ___ changes.

A

unknown
heniation
degenerative

58
Q

Characteristic radiological features of Scheuermann’s include ___ wedging, irregular ___, and loss of Intervertebral disc ___.

A

Anterior
vertebral end plates
heights

59
Q

Some __-__% of scoliosis cases occur in women. Initial complaint may be fatigue in __ region after sitting and standing for long periods. This may be followed by ___ backaches in area of strain, such as ___ pain. Pain may increase as irritation of ___ increases.

A 
60-80
lumbar
muscular
lumbosacral
ligaments
60
Q

Many people with severe curvatures (scoliosis) suffer from __ and __ disease secondary to reduced ___ volume.

A

Cardiovascular
Pulmonary
Thoracic Cage

61
Q
  • Functional Scoliosis is a ___ problem. There are no extra structural parts or rib problems, but ___ result in muscular problems.
A

muscular

subluxations

62
Q

*The etiology of Structural/Congenital scoliosis is ___ and results from insult to embryo at - weeks of gestation. Can be classified as failure of ___ or ___, or a combination of both.

A

unknown
6-8
formation
segmentation

Orthopedic Diagnosis (17 decks)

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