The Shoulder (midterm) Flashcards
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
Answer: C – suprasinatus tear (Best answer)
A – impingement of subacromial space
B – impingement
D – supraspinatus tendon and/or muscle involvement
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
Answer: B, A, C
A – IR
B – ER
C – Abducts
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
Answer: C, joint pain – may cause guarding, but won’t cause “hiking” or “dumping”
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
Answer: A – highest point, C – Lowest point/furthest from vertebrae, E – closest to vertebrae
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
Answer: A – arm in slight abduction (full can)
B+C – not testing IR/ER strength on scapula
D – Not an RTC muscle
OT management for the shoulder is similar to which other area of the upper extremity?
A. Hand
B. Wrist
C. Elbow
Answer: B – 1. rest, 2. activity modification, 3. avoid aggravation
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
Answer:
D – active, MMT = 3
C – Gravity eliinated, active assistive, MMT= 2+ (maybe)
B – GE, AA, MMT = 2+ (maybe)
A – passive, MMT = 2
T/F: Progressive resistive exercises is an essential aspect of OT management in shoulder rehab.
FALSE – Even if it sayss on the Rx, not all patients need it.You need to have a CLEAR RATIONALE for using it.
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
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)
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
Answer: D – also Neer’s or Speeds
Empty can - supraspinatus muscle/tendon
For which shoulder condition are apprehension tests used?
A. Frozen shoulder
B. Shoulder instability
C. Rotator cuff tear
D. Scapular dyskinesis
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
T/F: Rhythmic stabilization exercises are not appropriate for shoulder instability
FALSE
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
Answer: A
B - #3
C - As needed
D - #2
In frozen shoulder…
A. No PROM/AROM
B. Some PROM/AROM
C. PROM > AROM
D. PROM = AROM
Answer: B – limited and very painful
A – severe contracture
C – indicates nerve issues
D – normal
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
Answer: B – LLPS
A – encourages guarding
C – as needed
D – can be in education, but not the most important
