The Shoulder (midterm) Flashcards

1
Q

A patient comes to you with a suspected supraspinatus tear. Which provocative assessment would you use to evaluate this patient?

A. Hawkin’s
B. Forced forwarded extension
C. Drop arm
D. Empty can

A

Answer: C – suprasinatus tear (Best answer)

A – impingement of subacromial space
B – impingement
D – supraspinatus tendon and/or muscle involvement

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2
Q

Match the following provocative tests to the rotator cuff muscle they assess.

__ External Rotation at the side
__ Belly press test
__ Empty can

A. Subscapularis
B. Infraspinatus
C. Supraspinatus

A

Answer: B, A, C

A – IR
B – ER
C – Abducts

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3
Q

Which of the following is not a cause for scapulohumeral dysrhythmia?

A. Poor or abnormal posutre
B. Pectoralis minor tightness
C. Joint pain
D. Periscapular muscle performances

A

Answer: C, joint pain – may cause guarding, but won’t cause “hiking” or “dumping”

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4
Q

Which 3 landmarks are used to assess a dropped scapula? (Select 3)

A. Acromion
B. Spine
C. Inferior angle
D. Superior Border
E. Medial Border
F. Lateral Border

A

Answer: A – highest point, C – Lowest point/furthest from vertebrae, E – closest to vertebrae

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5
Q

The scapular retraction test helps you assess:

A. Effect of scapular kinematics on supraspinatus strength
B. Effect of scapular kinematics on infraspinatus strength
C. Effect of scapular kinematics on subscapularis strength
D. Effect of scapular kinematics on pectoralis minor strength

A

Answer: A – arm in slight abduction (full can)

B+C – not testing IR/ER strength on scapula
D – Not an RTC muscle

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6
Q

OT management for the shoulder is similar to which other area of the upper extremity?

A. Hand
B. Wrist
C. Elbow

A

Answer: B – 1. rest, 2. activity modification, 3. avoid aggravation

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7
Q

For restoring mobility in the shoulder, order the activities below from easiest to hardest (all forward elevation):

__ A. Supine extension to flexion
__ B. Seated overhead row
__ C. Standing rocking a dowel forward/back
__ D. Passing flexion by therapist

A

Answer:
D – active, MMT = 3
C – Gravity eliinated, active assistive, MMT= 2+ (maybe)
B – GE, AA, MMT = 2+ (maybe)
A – passive, MMT = 2

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8
Q

T/F: Progressive resistive exercises is an essential aspect of OT management in shoulder rehab.

A

FALSE – Even if it sayss on the Rx, not all patients need it.You need to have a CLEAR RATIONALE for using it.

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9
Q

Patient complains of pain when reaching overhead to put away dishes, latching her bra behind her back, donning and doffing shirt sleeves and pain at night. What condition do you suspect?

A. Joint contracture
B. Frozen shoulder
C. Rotator cuff tendinopathy
D. Shoulder instability

A

Answer: C – pain @ night, overhead abduction, IR, crossing

A - rom isn’t limited
B - limitations would be seen in passive movements also
D - would see apprehension (fear of dislocation)

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10
Q

Which of the following provocative tests could be used to assess rotator cuff tendinopathy?

A. Cozen’s
B. Empty can
C. Finkelstein’s
D. Hawkin’s

A

Answer: D – also Neer’s or Speeds

Empty can - supraspinatus muscle/tendon

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11
Q

For which shoulder condition are apprehension tests used?

A. Frozen shoulder
B. Shoulder instability
C. Rotator cuff tear
D. Scapular dyskinesis

A

Answer: B – if you have dislocated shoulder, you’d be apprehensive to have it pressed on

You will re-injure if you do this on RCT
None of the tests assess scapular movement

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12
Q

T/F: Rhythmic stabilization exercises are not appropriate for shoulder instability

A

FALSE

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13
Q

You are seeing a patient post-op from a bankart procedure. What is the most important aspect of OT management?

A. Protection
B. Mobility
C. Strength
D. Posture

A

Answer: A

B - #3
C - As needed
D - #2

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14
Q

In frozen shoulder…

A. No PROM/AROM
B. Some PROM/AROM
C. PROM > AROM
D. PROM = AROM

A

Answer: B – limited and very painful

A – severe contracture
C – indicates nerve issues
D – normal

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15
Q

You are seeing a patient with frozen shoulder. What is the most important aspect of OT Management?

A. Protection
B. Mobility
C. Strength
D. Posture

A

Answer: B – LLPS

A – encourages guarding
C – as needed
D – can be in education, but not the most important

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16
Q

In proximal humerus fractures, which of the following should be a part of your evaluation? (SATA)

A. Review of X-Ray
B. Assess for signs of peripheral neuropathy
C. Asses the distal arm for edema
D. Consider likeliness of a rotator cuff tear

A

Answer: all of the above
A - and report for info on type and location of fracture
B - especially axillary nerve
C - elbow, wrist, hand
D - especially > 50 yrs

17
Q

Your patient just had a total shoulder arthroplasty. Which of the following ADL’s can they do independently?

A. Reach behind them to adjust their pillow
B. Zip up the back of their skirt
C. Drink from a glass of water
D. Help themselves up from a chair

A

Answer: C – posture would be important but it’s doable (elbow in and flexing, turn head toward..)

A + B - both adduction, extension, and internal rotation
C - no weight bearing

18
Q

Which of the following should post-op arthroscopy patients not do for the first 4 weeks (PROM)?

A. Forward elevation
B. Internal rotation
C. Extension
D. External rotation

A

Answer: B

No AROM for 0-4 weeks or weight bearing
A – up to 130
C – back to 0 ok
D – Limit to 30