The Shoulder Complex

Question 1

What are the four basic mechanical characteristics of the shoulder?

Answer 1

Motion, strength, stability, and smoothness

Question 2

Referred symptoms from the shoulder are usually found in the what dermatome?

Answer 2

C5

Question 3

T or F: the scapulothoracic joint has a capsular pattern

Answer 3

False

Question 4

What is is the capsular pattern for the glenohumeral joint ? (Most restricted to least restricted)

Answer 4

ER, Abduction, IR

Question 5

What is is the capsular pattern for the acromioclavicular joint ? (Most restricted to least restricted)

Answer 5

HAD and full elevation

Question 6

What is is the capsular pattern for the sternoclavicular joint ? (Most restricted to least restricted)

Answer 6

HAD and full elevation

Question 7

What is painful arc?

Answer 7

a condition in which the tissues in the subacromial space become inflamed causing pain

Question 8

Degenerative changes to the RTC, acromion process, coracoid process, and anterior tissues from stress overload resulting in impingement are considered primary or secondary impingement?

Answer 8

Primary Impingement

Question 9

The shape of the acrominon and degeneration of the coracoacromial ligament is considered extrinsic or intrinsic?

Answer 9

Extrinsic

Question 10

What is a primary cause of secondary impingement?

Answer 10

Altered muscle dynamics in the ST joint and GH joint

Question 11

T or F: bursitis can increase with age

Answer 11

True

Question 12

list some special tests for impingement

Answer 12

Hawkins-Kennedy test, Neer Impingement test, Cross over Impingement test, Yergason Test, Empty Can

Question 13

list some special tests for bicipital tendinits

Answer 13

Speed’s test and Ludington’s Sign

Question 14

T or F: frozen shoulder is more common in men and stroke patients

Answer 14

False

More common in women and diabetics

Question 15

T or F: atraumatic dislocation is a less common cause of shoulder dislocation

Answer 15

True

Question 16

*Special tests: instability

Answer 16

*Inferior Multidirectional
-Sulcus sign
-Feagan (Feagin) test
Anterior
-Anterior Drawer test
-Surprise Test
-Load and Shift test
-Crank
Posterior
-Posterior Drawer Test
-Jobe Relocation Test
-Load and Shift test

Question 17

special tests: dislocation

Answer 17

apprehension tests (anterior and posterior)

Question 18

What ligament is responsible for preventing anterior humeral translation in the 90/90 position?

Answer 18

Inferior Glenohumeral Ligament

Question 19

Special tests: labral tear

Answer 19

O’Brien test, Crank test, Biceps Load/tension test: SLAP, Drop Arm test, Posterior Impingement test, Grind test, Clunk test

Question 20

What does the acronym TUBS represent?

Answer 20

Traumatic MOI
Unilateral Shoulder Involvement
Bankart and Hill-Sachs glenohumeral Fractures
Surgery often required for management

Question 21

What do the acronym AMBRI represent?

Answer 21

Atraumatic mechanism 
Multidirectional instability 
Bilateral Shoulder involvement
Rehabilitation as primary management 
Inferior Capsular shift surgery

Question 22

Explain the differences between a Grade I, II and III AC Joint sprain?

Answer 22

Grade I: minor strain to the fibers of the AC ligaments, joint remains stable, and ligaments intact, no palpable deformity

Grade II:rupture of the AC ligaments, distal end of the clavicle is unstable, but the Coracoclavicular ligaments are intact

Grade III:disruption of the AC and Coracoclavicular ligaments. On PE, may be less painful than a Type II. GH Abduction generally causes the most severe pain, clavicle may be prominent enough to tent the skin.

Question 23

What is the main action of the Supraspinatus?

Answer 23

Abduction

Question 24

What is the main action of the Infraspinatus and Teres Minor?

Answer 24

External Rotation

Question 25

What is the main action of the Subscapularis?

Answer 25

Internal Rotation

Question 26

How is Subacromial impingement characterized?

Answer 26

by anterior/lateral shoulder pain and weakness, esp. with overhead activities

Question 27

Tests for Neurovascular Compression

Answer 27

Adson's Manuever
Allen's Test
*Roos Test (most clinically accurate)
Military Brace Position 
Brachial Plexus Stretch test