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EPHE 344 - Final Exam > The Shoulder Complex > Flashcards

The Shoulder Complex Flashcards

1
Q

The shoulder is made up of ___ joints and a ___-joint

A

three; pseudo

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2
Q

The shoulder girdle is composed of the ____, ___ & _____

A

scapula, clavicle & manubrium

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3
Q

What is the shoulder girdle heavily dependant on?

A

muscles and ligaments

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4
Q

what is the primary function of the shoulder girdle?

A

functionally positioning the hand

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5
Q

___ pain is the third most common consulted complaint

A

shoulder

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6
Q

Where does pain referred to the shoulder stem from?

A

Heart and spleen = left shoulder

liver and gallbladder = right shoulder

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7
Q

The GH joint is what type of joint?

A

a ball and socket joint

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8
Q

Where do shoulder separations usually happen?

A

Acromioclavicular (AC) joint

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9
Q

What is the only connection of the entire extremity to the upper skeleton?

A

sternoclavicular

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10
Q

what three tendons suck in the shoulder and hold it in place? are they lateral or medial? what tendon is opposite of them?

A

supraspinatus, infraspinatus, teres minor’ lateral; subscapularis (medial)

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11
Q

What bursa cushions rotator cuff muscles from acromion and compresses during overhead arm action?

A

subacromial bursa

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12
Q

The ___ ___ innervates the arm and comes off from the neck in __ branches

A

brachial plexus; 5

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13
Q

For every __ degrees your shoulder rises, your scapula should shift __ degree

A

2;1

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14
Q

“movement of scapula relative to the humerus”

A

scapulohumeral rhythm

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15
Q

initial 30 degrees of glenohumeral ______ setting phase in scapulohumeral rhythm

A

abduction

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16
Q

2: 1 scapulohumeral rhythm
- ___ deg. total ROM
- ___ deg. GH
- ___ deg. scapulothoracic

A

180
120
60

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17
Q

what type of scapular rotation gives people kinks in the neck in the morning?

A

downward

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18
Q

6 acute shoulder injuries?

A
  1. Contusions (Deltoid)
  2. Sprains (SC, AC, GH)
  3. Strains (deltoid, biceps, triceps)
  4. Ruptures (biceps)
  5. Fractures (clavicular, humeral)
  6. GH Dislocations/ Subluxations
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19
Q

3 chronic shoulder injuries?

A
  1. rotator cuff impingement syndrome
  2. biceptual tendonitis
  3. sub-acromial bursitis
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20
Q

FOOSH?

A

fall on out stretched hand

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21
Q

Etiology:

  • FOOSH, fall on tip of shoulder or direct impact
  • Occur primarily in mid- third
  • Greenstick fracture
A

clavicular fracture

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22
Q

Signs and Symptoms:

  • Generally presents w/ supporting of arm, head tilted towards injured side with chin turned away
  • Clavicle may appear lower
  • Palpation reveals swelling, pain, deformity, point tenderness
A

clavicular fracture

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23
Q

Management for clavicular fracture?

A
  • treat for shock
  • sling and swath
  • transport to hospital
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24
Q

how long will clavicular fractures generally be braced for?

A

6-8 weeks

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25
Q

Etiology:

  • Direct blow, or FOOSH
  • Fracture locations in shaft, at surgical neck, supracondylar, or epiphyseal
  • Proximal fracture may also be associated with dislocation
A

humeral fracture

26
Q

where are common fracture sites for the humerus?

A

shaft, surgical neck, supracondylar or epiphyseal

27
Q

Pain, swelling, point tenderness, decreased ROM are signs and symptoms for?

A

humeral fracture

28
Q

____ fractures may be mistaken for contusion - check for pulse down low because if they lose this it is a problem!

A

humeral

29
Q

management for humeral fracture

A

treat for shock, splint and sling prior to transportation

30
Q

Etiology:

  • Result of direct blow, fall on point of shoulder, FOOSH
  • Graded 1-6 depending on severity
A

Acromioclavicular Sprain

31
Q

Signs & Symptoms:

  • Mild to severe pain
  • Swelling
  • Altered ROM (adduction/abduction)
  • Step deformity
A

Acromioclavicular Sprain

32
Q

management for Acromioclavicular Sprain? Grades 1-3 and 4-6?

A

-ice, stabilize and referral
-1 to 3: (nonoperative) 3-4 and 2 weeks of immobilization respectively
- 4 to 6: will require surgery
(aggressive rehab required for all grades)

33
Q

Grade 1 AC joint sprain?

A

no disruption

34
Q

Grade 2 AC joint sprain?

A

tear of AC lig. and partial displacement

35
Q

Grade 3 AC joint sprain?

A

rupture of AC and CC ligaments

36
Q

Grade 4 AC joint sprain?

A

post. separation of lateral clavicle

37
Q

Grade 5 AC joint sprain?

A

complete lig. rupture; tearing of deltoid and trap attachments

38
Q

Grade 6 AC joint sprain?

A

inferoposterior displacement

39
Q

Etiology:

Indirect force, blunt trauma (may cause displacement)

A

Sternoclavicular sprain

40
Q

Sternoclavicular sprain - pain and slight disability is grade _

A

1

41
Q

Sternoclavicular sprain - pain, subluxation with deformity, swelling and point tenderness and decreased ROM is grade _

A

2

42
Q

Sternoclavicular sprain - gross deformity (disloc.), pain, swelling, decreased ROM is grade _

A

3

43
Q

management of sternoclavicular sprain?

A

RICE, reduction if necessary, immobilized for 3-5 weeks

44
Q

sternoclavicular sprains can be ___ or ___

A

anterior or posterior

45
Q

Etiology:

Forced abduction and/or external rotation or a direct blow

A

glenohumeral sprain

46
Q

Signs and Symptoms:

  • Pain during movement especially when re-creating MOI
  • Decreased ROM & pain with palpation
A

GH sprain

47
Q

Management for GH sprain:

  • RICE for __-__ hours; sling
  • Therapeutic modalities used for?
  • Must be aware of potential development of _____ conditions
A

24-48; regaining ROM then regaining full strength; chronic

48
Q

Etiology for Acute Subluxations/Dislocations:

  • _____ dislocation (most common); forced into ____ & ____
  • ____ dislocation: forced into ____ & ____ ; falling on an extended & internally rotated GH
  • Least common is _____ (underneath armpit)
A

anterior; abduction and external rotation

posterior; adduction and internal rotation

inferior

49
Q

Signs and symptoms:

-flattened deltoid, head in axilla; arm carried in slight abd’n & ER; moderate pain and disability

A

anteroinferior sublux/dislocation

50
Q

Signs and symptoms:

  • severe pain & disability
  • arm carried in adduction & internal rotation
  • acromion & coracoid prominent
  • limited external rotation & elevation
A

posterior sublux/dislocation

51
Q

What is a SLAP lesion?

A

tissue damaged with GH dislocation (damage to the labrum) - Superior Labral tear from Anterior to Posterior

52
Q

“caused by compression of cancellous bone against anterior glenoid rim creating a divot in the humeral head (teacup ramming into saucer and actually causing a fracture)”

A

Hill Sachs lesion - tissue damage with GH dislocation

53
Q

Etiology:

  • Bursal inflammation compressing tendons; exacerbating factors
  • Contributing factors include joint laxity, postural mal-alignments & repetitive over head motions.
A

Shoulder impingement - subacromial bursitis

54
Q

Signs and Symptoms”

-Diffuse pain, pain on palpation; increased GH ER & decreased IR; positive ‘Painful Arc’ & impingement tests

A

Shoulder impingement - subacromial bursitis

55
Q

Management for Shoulder impingement - subacromial bursitis?

A
  • active rest
  • ice
  • instruct correct biomechanics
  • NSAIDs
56
Q

Etiology:
-Repetitive, overhead, ballistic activity that involves repeated stretching of biceps tendon causing irritation to the tendon and sheath; improper mechanics; impingement

A

bicipital tenosynovitis

57
Q

Signs and Symptoms:

  • Tenderness over bicipital groove, swelling, crepitus due to inflammation
  • Pain when performing overhead activities
A

bicipital tenosynovitis

58
Q

Management for ____ ____ includes:

  • Rest, ice and therapeutic modalities to treat inflammation; NSAIDs
  • Gradual program of strengthening and stretching
A

bicipital tenosynovitis

59
Q

biceps brachii rupture etiology?

A

Result of a powerful contraction typically near muscle origin

60
Q

Signs and Symptoms for ____ _____ rupture:

Patient hears a resounding snap; sudden and intense pain; deformity; weakness with elbow flexion & supination

A

biceps brachii

61
Q

management for biceps brachii rupture?

A
  • Ice for hemorrhaging, place arm in sling and refer to physician
  • Patient will require surgery
62
Q

why does a tear to the distal bicep require surgery?

A

When it is a tear in the distal bicep (inferior point) then they have to have surgery because it is the only connection to the radius/ulna

EPHE 344 - Final Exam (5 decks)

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