updates, figures and table 2 Flashcards

1
Q

What muscles are impacted with Total shoulder arthoplasty

A
  • deltoid retracted
  • suscapularis released by tendon inscision or less or tubercle release
  • pec major - upper part is released
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2
Q

How can the surgeon know if they have optimal soft tissue balance follow totals shoulder

A
  • humeral head will sublux no more than about 50% of its diameter
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3
Q

How does the pathophysiology leading to a shoulder arthroplasty impact the ROM outcomes

A

Flex/ER

  1. OA- 140/40
  2. RA - 103/45
  3. Acute fx - 100/30
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4
Q

What considerations must you take into account with TSA following shoulder fracture?

A
  1. fractures with 3 or 4 parts typically have lower range of motion return, but better symptom
  2. thorough examination of pre- and post- surgery for nerve injury (particularly axillary)
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5
Q

How much ER ROM will the patient get after a TSA

A

they will never gain more than was mechanically allowed during surgery

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6
Q

When is a reverse total shoulder indicated?

A
  1. massive or irreparabel rotator cuff damage
  2. Proximal humeral fracture in a deficient rotator cuff
  3. revsion of previous total arthroplasty
  4. situations where conventional surgical approach may result in inferior outcomes
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7
Q

What muscle must work well for good functional outcomes followign a reverse total shoulder

A

deltoid

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8
Q

How much depth does the laburm add to the glenoid?

A

increased depth by 50%

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9
Q

desribe the relation of the superior GH to the biceps tendon

A

they all attach to the labrum

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10
Q

what is the IGHLC

A

inferior glenohumeral ligament complex

  1. anterior band
  2. posterior band
  3. interposed axillary pouch
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11
Q

what is the primary restraint to posterior glide of the GH joint?

A
  1. capsule
  2. posterior band of the IGHLC
  3. muscles
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12
Q

what is the rotator interval

A
  1. triangular region between the border of the supraspinatus and subscapularis
  2. superior glenomueral ligament
  3. coracohumeral ligament
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13
Q

describe superior migration of the humeral head

A
  • 60 deg center humeral head rose 2 mm of center of glenoid
  • decreased to 1 mm at 90 and 120
  • decreased to 0.5mm at 150
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14
Q

Follow subacromial decompression when is a reasonable time frame for full ROM and return to sport

A
  1. full ROM 10-12

2. reuturn to sport 12-14

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15
Q

What is arthroscopic rempilssage

A

arthorscopic procedure to fill in Hill Sach lesions

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16
Q

What shoulder x-ray view is best for identification of posterior dislocations

A
  1. axillary view, but…
    - y-scapular view for posterior
    - AP is pretty good for anterior if there is over lap with the glenoid and humeral head
17
Q

what is the A/P for couple

A

IS and SC and are active in mid range

18
Q

what is a shoulder flip sign

A

medial border flips off the thoracic wall

19
Q

what ROM place the peak amount of compression on the RTC

A

85-136

20
Q

what nerve is most often injuries with anterior dissociation and what muscle will it effect

A

axillary, deltoid and teres minor

21
Q

what is the puttie platt procedure

A

subscap and capsular shortening

22
Q

how many types are SLAP tears are described

A

4

  1. degenerative changes
  2. avulsion of superior labrum
  3. bucket handle tear of labrum
  4. same as 2 and 3 with inclusion of the biceps tendon
23
Q

Labral tear tests typical use what muscle to test the integrity of the labrum

A

use the biceps

  • obrien IR with pronation
  • resisted ER and supination postion