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561 > Upper extremity injuries > Flashcards

Upper extremity injuries Flashcards

1
Q

What is shoulder impingement

A

compression of structures found in the subacromial space

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2
Q

What is the cause of impingement

A

repetitive or sustained elevation above 90 degrees

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3
Q

What is a positive impingement test

A

Hawkins test

shoulder and elbow are flexed to 90 degrees followed by forced IR

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4
Q

What is stage 1 of impingement

A

Tendons and bursa are inflamed
symptoms can be resolved
focus is on activity modification
Treatment: Meds, stretching, progressive strengthening, taping, posture, thoracic spine mobility exercises

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5
Q

What is stage 2 of impingement

A

Bursa and tendons become thick and fibrotic

treatment is conservative (Same as stage 1) (Recovery is longer)

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6
Q

What is stage 3 in impingement

A

bone spurs and partial or full thickness tears in muscles

surgery to remove bone spurs or repair muscle tear

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7
Q

What are causes of rotator cuff tears

A

trauma, progression of impingement syndrome, degenerative changes of tendon

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8
Q

What are symptoms of rotator cuff tear

A

Overhead and rotational movt’s are difficult and painful

compensate by hiking shoulder

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9
Q

Treatment for rotator cuff tear

A

recommended 3 months of conservative therapy before surgery

activity mod, strengthening of scapular and rotator cuff

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10
Q

What are tests for rotator cuff tears

A 
Neer impingement sign
hawkins test
empty can test 
drop arm test
biceps speed test
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11
Q

When does early tendon healing take place

A

1st 4-6 weeks

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12
Q

What happens in the early phase following rotator cuff surgery

A 
Wear shoulder immobilizer 
PROM and AAROM
Ice
use Codmans pendulum 
uninvolved arm supplies power
one handed techniques
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13
Q

What happens after 4-6 weeks of healing

A 
no immobilizer 
AROM
shoulder ext and ir
avoid compensatory movt's 
strengthening through isometric exercise
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14
Q

what happens in 8-12 weeks following surgery

A

isotonic exercises using theraband and free weights

encourage adl’s above shoulder level

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15
Q

What can OT’s teach for rotator cuff tears

A

dressing and bathing one-handed

how to transfer in/out of shower

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16
Q

What is adhesive capsulitis characterized by

A

stiffness and pain in the shoulder joint

17
Q

What is adhesive capsulitis caused by

A 
differential diagnosis
post menopausal 
stress
post mastectomy
stroke
arm fractures
18
Q

What is stage 1 of adhesive capsulitis

what happens in this stage

A

Painful stage
pain w/ movt, limited shoulder range
treatment; nsaids, steroid injection, postural correction, active exercise, isometric strengthening w/in pain limits, modalities

19
Q

Who do you see adhesive capsulitis in more

A

women after age 40

20
Q

What is stage 2 of adhesive capsulitis

what happens in this stage

A

Frozen stage
more stiffness than pain
treatment: jt mobilization (compression/distraction), stretches, steroids, joints mobs under anesthesia, modalities

21
Q

What is stage 3 of adhesive capsulitis

what happens in this stage

A

Thawing stage

Joint presents w/ increased ROM and decreased pain

22
Q

What is treatment of adhesive capsulitis

A

Passive exercise: use dowel stick (to help lift and assist affected side)
Active stretch exercise: finger walk up wall, side hand up wall of shower
Active ROM: no resistance then progress to resistive exercises
Resistive exercise: weights, theraband

23
Q

How to stretch the anterior capsule

A

place arms against ope door or corner and sep back and lean forward

24
Q

How to stretch posterior capsule

A

grasp impaired arm under the elbow and pull upper arm across chest under the chin

25
Q

How to stretch the inferior capsule

A

grasp elbow and draw arm behind head

26
Q

how to stretch the superior capsule

A

while sitting, grasp chair w/ hand of affected arm and lean over to the opposite side

27
Q

What is Arthroplasty used for

A 
severe shoulder fractures
OA
RA
RC tear gone untreated
Avascular necrosis
28
Q

What are some different kinds of arthroplasty

A

replace ball
replace joint surfaces w/ ball attached to stem and plastic socket
cement humeral and glenoid components

29
Q

What is the ball

A

head of humorous

30
Q

what is the stem

A

humerus shaft

31
Q

what is the plastic socket

A

glenoid fossa

32
Q

What are the guidelines for 2-3 days after sx

A

pendulum exercise
passive should elevation
exercise wand to do ER

33
Q

What are the guidelines 1-2 after sx

A

passive IR, ext, horizontal ad

34
Q

What are guidelines for 4-6 weeks after sx

A

isometric strengthening of RC muscles

35
Q

What are guidelines for 6 weeks after sx

A

active resistive exercises
ab and rotation
free weights and theraband
no weightbearing on arm for at least 6 mo

36
Q

What to ask for assessment

A 
Symptoms
Pain-usually pain upon movt, feeling of instability, sleep disturbance
Hand dominance
activities that activate symptoms
can they lie on affected shoulder
when did symptoms begin
note posture 
DASH

561 (11 decks)

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