UE part 1 X3

Question 1

Rotator cuff general presentation

Answer 1

-pain over ant and lateral aspects of the shoulder
> radiates into the deltoid
-ROM decreased
> in ability to abduct arm about shoulder
-may catch
+ drop arm, empty can, neers hawkins possible

Question 2

Tendonosis

Answer 2

Chronic degeneration of the muscles with age

Question 3

Tendonitis

Answer 3

inflamation ass with repetative trauma ass with everday movement

Question 4

what is-Rotator Cuff Tears Chronic

Answer 4

Degeneration, impigment, and overload

• overhead occupation
• variation of shoulder structure leading to narrowing under outer edge
• typ start as partial tear of suprspin and may progress to full tear

Question 5

Roator Cuff acute tear

Answer 5

acute radiographs with neg finding

• assosiated with sig amount of force usually <30yrs
• often seen with labral pathology

Question 6

RC tendonitis/impingment

Answer 6

Risk: repeated overhead act

• pain comes on gradually
• complain deep ache on lat shoulder
• Point tenderness
• ROM pain>90degress
• neers and hawkins test*

Question 7

Chronic rotator cuff tear pres.

Answer 7

accumulation of imp and degen
- comon men >40yrs 
- pain worse with overhead act and at night and messes with sleep
- worsening pain +gradual weakness 
- subacromial tenderness 
*drop arm, empty can* 
restriccted ADLS >90 degrees

Question 8

Physical exam for RC tear

Answer 8

Muscle weakness**

• weakness to abduction and xternal rotation
• loss of smoothness over overhead reaching
• weakness does not improve with analgesics

Question 9

RC diagnosis

Answer 9

Overall to distinguid between tendinopathy and tear

• inject lidocane then do neers
• rediographs: elevation of the humeral head over 1 cm
• MRI study of choice when full thickness tear is suspected or pt has failed conservative x
• MR arthrogram preferred to evaluate labral path

Question 10

Shoulder impingment syndrome Present

Answer 10

Similar to rotaror cuff tendonitis
- subacromia tenderness
- normal gelnohymeral joint rainge of motion Pain>90
strength is preserved**
Test** pain repro by pain with neers and hawkins and painful arc

Question 11

Should imingment imaging

Answer 11

Radiography- usually normal
MSK U/S
MRI- good for chronic symptoms to rule out tear

Question 12

Impingment Tx

Answer 12

Ice, NSAIDs, Activity mod

• no sling PT REFERAL
• f/u in 3 weeks
• can do corticosteroid inject if pain persists

Question 13

Labral teat MOI and present

Answer 13

MOI: acute or repetative overuse
Pres:
acute: pain
CHronic: clicking

Question 14

Bankart lesion vs SLAP labral tear

Answer 14

Bankart: inferior tear of rim associated with dilocation
SLAP: superior labrum ant post

Question 15

Labral Tear Physical Exam

Answer 15

Biceps tendon pain
GH joint rest IR/ER
scapula motion dysfunction 
* specialized: glide test, speeds , obriens 
Imaging
MRA>MRI  and arthroscopy 
Tx: NSAIDS or acetaminophin, PT

Question 16

Adhesive capsulitis Etiology and presentation

Answer 16

Chronic choulder pain with gradual GLABAL limitation in ROM

• stiffen GH join and may develop adhesions
• unknown cause but can be secondary to trauma

Question 17

Adhesive Capsulitis

Answer 17

ROM test confirmed reduced ROM in 2 or more plane
- severe pain and mechanical restriction
-Abduction and ER!!
Appley Scratch Test
Injection test: to discern dx from other subacromical condition

Question 18

Adhesive Capsulitis Imaging

Answer 18

Xray - not super helpful but common

MRI maay be helpful

Question 19

Adhesive capsulitis Tx

Answer 19

-tx any underlying process, strethch lining of the joint , try and restore ROM, consult PT
<10% require syrgical intervention

Question 20

AC injury MOI

Answer 20

injured falling onto the tip of the shoulder

Question 21

AC sprain

Answer 21

Insp: AC joint swelling/ deformity
Palp/ROM: AC joint tenderness, pain with downard traction
cross over test>pain

Question 22

Grade ! AC

Answer 22

AC joint intact, capsular destention
-pain
- not a lot of laxity
normal Xray

Question 23

Grade II

Answer 23

Partial Tear of AC
so the CA and CC joints are intact
X-ray- widenin and offset

Question 24

Grade III

Answer 24

AC jonint and CC ligament are torn
large separtation on X-rad
* youll usually see this deformity in person

Question 25

AC sprain dx/tx

Answer 25

Xray
Tx:
-shoulder immobilizer for 3-4 wks for comfort +resprtiction overhead
- Ice rest NSAIDS and possibly injection in 2-4 wks
- Surgical considerations after grade III possibly

Question 26

Clavicule Fracture pres

Answer 26

• most often occur in the middle 1/3)
• visual deformity seen
  -tenderness with palpation over the bone
  -decreased ROM
  Imaging: single AP X-ray

Question 27

Clavicular fracture tx

Answer 27

Conservative tx for non dispaced and for most peds
- slig/swathe
-analgesics, muscle reaxlers
-sleep upright for comfort
Displaced mid clav fxs all proximal and distal 1/3fxs
possibly surgery

Question 28

Subacromical Bursitis

Answer 28

Repetative movement injury or may represent a systemic disease
Pres: pain with ROM and rest and possible decreased ROM
localized tenderness
ass: with tendonitis or impingment

Question 29

SA bursitis tx

Answer 29

Dx: clinical and possible fluid aspiration if rule out infection
Tx: Ice and NSAIDS and restiction of overuse
*often corticosteroid inj and aspiration

Question 30

Biceps Tendsonitis

Answer 30

Pain ant shoulder with abduction and ER 
- main poin of tenderness along groove
- popping sensations 
- weaness due to pain 
*yergasons and speeds*
Popeye deformity seen with rupture

Question 31

Biceps tednonitis Dx and Tx

Answer 31

Dx: maining clinical but can also use U/S
Tx: want to reduce inflam and increase strengthen and prevent rupture
NSAIDs, rest, PT, can do steroid injections