The Shoulder

Question 1

Superficial Muscles of Shoulder

Answer 1

Deltoid, Pectoralis, Biceps, Traps, Lats, Serratus ant.

Question 2

Deep Muscles (Rotator Cuff)

Answer 2

Supraspinatus, Infraspinatus, Teres minor, Subscapularis

Question 3

Glenohumeral/scapulothoracic rhythm

Answer 3

5:4

Question 4

Humerus and scapula rhythm

Answer 4

2:1

After 30 degrees of abduction

Question 5

Scapulothoracic Joint movements

Answer 5

Elevation, Depression, Abduction/Protraction, Adduction/Retraction

Question 6

Arthrokinematics (AK) of the GH joint

Answer 6

Flexion, Horiz. Add., IR, Extenion, Horiz. Abd., ER, Abduction

Question 7

Flexion AK

Answer 7

Roll: Anterior
Glide: Posterior

Question 8

Horiz. add. AK

Answer 8

Roll: Anterior
Glide: Posterior

Question 9

IR AK

Answer 9

Roll: Anterior
Glide: Posterior

Question 10

Extension AK

Answer 10

Roll: Posterior
Glide: Anterior

Question 11

Horiz. abd. AK

Answer 11

Roll: Posterior
Glide: Anterior

Question 12

ER AK

Answer 12

Roll: Posterior
Glide: Anterior

Question 13

Abduction AK

Answer 13

Roll: Superior
Glide: Inferior

Question 14

Impingement Syndrome

Answer 14

A mechanical impingement of the subacromial structures, especially the rotator cuff tendons

Question 15

Symptoms - Impingement Syndrome

Answer 15

pain in the anterosuperior part of the shoulder; weakness and stiffness

Question 16

Outlet - Impingement Syndrome

Answer 16

occurs when the coracoacromial arch encroaches on the supraspinatus outlet

Question 17

Non-outlet - Impingement Syndrome

Answer 17

occurs secondary to thickening or hypertrophy of the bursa or the rotator cuff tendons

Question 18

Intrinsic Impingement Syndrome

Answer 18

1. Rotator cuff weakness
2. Overuse of the shoulder
3. Degenerative tendinopathy

Question 19

Extrinsic Impingement Syndrome

Answer 19

1. Shape of the acromion
2. Instability
3. Degeneration of the AC joint
4. Impingement by the Coracoacromial Ligament or coracoid process

Question 20

Stage 1 Impingement

Answer 20

Characterized by edema and hemorrhage of the bursa and cuff and is typically found in patients who are less than 25 y/o

Question 21

Stage 2 Impingement

Answer 21

Represents irreversible changes, such as fibrosis and tendinitis of the rotator cuff, and is typically found in patients who are 25-40 y/o

Question 22

Stage 3 Impingement

Answer 22

Mark by more chronic changes, such as partial or complete tears of the rotator cuff, and usually is seen in patients who are > 40 y/o

Question 23

MOI for Impingement

Answer 23

Age, Position of the arm during activities, Repetitive overhead, Muscle imbalances, Capsular tightness, Postural imbalance, Structural asymmetry, Impaired Scapular kinematics

Question 24

Primary Impingement

Answer 24

1. More than 40 years
2. Overuse
3. Painful arc

Question 25

Secondary Impingement

Answer 25

1. Young
2. Repetitive overhead/athletic activity
3. Painful arc

Question 26

Impingement Treatment

Answer 26

1. Postural corrections, ROM, stretching and strengthening

2. Inferior and posterior glides

Question 27

Traumatic Shoulder Instability

Answer 27

Bankart Lesion

Question 28

Atraumatic Shoulder Instaability

Answer 28

GH ligaments: IGHL/AGHL

Question 29

Traumatic - Symptoms

Answer 29

Recurrent Shoulder dislocation (chronic phase)

Apprehension test: positive

Question 30

Atraumatic - Symptoms

Answer 30

Tendinitis, sensation of instability and laxity

Apprehension test: negative

Question 31

Shoulder Instability Treatment

Answer 31

1. Scapular stabilization, exercises and rotator cuff strengthening

Question 32

SLAP Lesion

Answer 32

Injury to the Glenoid labrum

Superior labral tear form anterior to posterior

Question 33

Type 1 - SLAP

Answer 33

finding in degenerate shoulders where there is fraying and roughening of the biceps anchor area

Question 34

Type 2 - SLAP

Answer 34

the biceps anchor peels off from the supraglenoid tubercle

Question 35

Type 3 - SLAP

Answer 35

bucket handle tear of the superior labrum without involvement of the biceps anchor

Question 36

Type 4 - SLAP

Answer 36

The labral tear extends into the biceps anchor and tendon for a variable distance

Question 37

Type 5 - SLAP

Answer 37

SLAP with a Bankart lesion

Question 38

Type 6 - SLAP

Answer 38

Flap tear of anterior labrum with detachment of biceps anchor

Question 39

Type 7 - SLAP

Answer 39

SLAP tear associated w/ anteriorcapsuloligamentous tear involving the middle glenohumeral ligament (MGHL)

Question 40

MOI - SLAP

Answer 40

1. Sudden eccentric biceps contraction
   Ex. Trying to grab an object while falling from a height or a fall onto the outstretched hand
2. Repetitive overhead activity - especially baseball players

Question 41

Symptoms - SLAP

Answer 41

Pain is the most common long term complaint along with a feeling of instability or lack of control of the arm in the overhead as well as abducted externally rotated positions

Question 42

SLAP - Treatment

Answer 42

1. Scapular stabilization exercises and posterior capsular stretching

Question 43

Adhesive Capsulitis (Frozen Shoulder)

Answer 43

1. Inflamed and fibrotic condition of the capsuloligamentous tisue

Question 44

Stage 1 - Adhesive Capsulitis

Answer 44

1. 0-3 months

2. Pain w/ active and passive ROM

Question 45

Stage 2 - Freezing Stage

Answer 45

1. 3-9 months

2. Chronic pain