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Bootcamp Quiz Questions > Week 1: Quiz 3 > Flashcards

Week 1: Quiz 3 Flashcards

1
Q

What are the norms for ROM in the shoulder?

A

PART A: Flexion ROM: 0-180˚

PART B:Abduction ROM: 0-180˚

PART C: Extension ROM : 0-60˚

PART D:Internal Rotation ROM : 0-45˚ isolated, 70˚ composite

PART E:External Rotation ROM: 0-90˚

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2
Q

Epidemiological factors for RTC repair and rehab

Part A- what is the important indicator?

A

Size of the tear

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3
Q

Epidemiological factors for RTC repair and rehab

Part A: Top three (best predictor for outcomes)

A
  1. Size of the tear
  2. Quality of tissue
  3. FIbro-fatty inlfiltration of muscle
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4
Q

Epidemiological factors for RTC repair and rehab

Part C: what size tear has better prognosis?

A

smaller, the better

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5
Q

Epidemiological factors for RTC repair and rehab

Quality of tissue:

Part D: List two factors affecting quality

A
  1. Age
  2. Smoking
  3. Activity level
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6
Q

Epidemiological factors for RTC repair and rehab

Part E: name 2 others factors besides the top three (if he asks for a Part E)

(there are 7)

A
  1. Type of surgical approach (open vs mini-open vs arthroscopic)
  2. Status of deltoid
    • Open detaches deltoid, mini-open splits deltoid
  3. Ability to mobilize tissue
  4. Type of fixation (bony vs soft tissue)
  5. Safe ROM achieved at surgery
  6. Secondary surgical procedures (comorbidities)
  7. Degree of post-op immobilization (wedge vs. sling)
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7
Q

What are the stages of fibro-fatty infiltration?

A
  1. Stage 0: normal muscle
  2. Stage 1: muscle containing some fatty streaks
  3. Stage 2: manifest fatty infiltration but less fat than muscle
  4. Stage 3: same amount of fat as muscle
  5. Stage 4: more fat than muscle
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8
Q

Is fibro-fatty infiltration reversible or irreversible?

A

Irreversable

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9
Q

What is the staging system for fibro fatty infiltration called?

A

Goutallier staging system

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10
Q

PART A: What are the different types of RTC fixations (3 most common)?

and briefly describe each?

A
  1. Single Row Suture Anchors
    • Sutures in tendon connecting to anchors in the bone
  2. Double Row Suture Anchors
    • Anchors through the tendon and anchors in the bone; sutures to connect the double set of anchors
  3. Transosseous Sutures
    • Anchors driven diagonally from the superior facet of the greater tuberosity through to the lateral side of the humeral head
    • Sutures run through the “bone tunnel”
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11
Q

PART B: What is the gold standard for RTC fixations?

(name and brief description)

A

Double Row Suture Bridge Technique

  • Suture bridging is a criss cross of the sutures instead of straight
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12
Q

What is the ultimate goal of RTC fixations?

(include quantitative information in your answer)

A

Footprint restoration (percentage of original footprint)

  • Single Row: 47%
  • Transosseous: 71%
  • Double Row: 100%
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13
Q

Why do patients with re-tears still not feel as bad as they did before the surgery?

(2 things)

A
  1. Surgeon cleans out all the “bad stuff” in the sub-acromial space during repair
  2. Partial integrity of a tear is better than a full thickness tear
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14
Q

What are the different types of surgical approaches for RTC repairs?

(include relevant summaries)

A
  1. Open
    • Anterior deltoid is completely detached (BAD) from the anterior acromion
  2. Mini-open
    • Deltoid is split
  3. Arthroscopy
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15
Q

Difference between adhesive capsulitis and selective hypomobility

PART A: what part of the capsule does adhesive capsulitis or selective hypomobility involve?

A

Adhesive capsulitis is global; selective hypomobility is isolated

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16
Q

Difference between adhesive capsulitis and selective hypomobility

Part B: does adhesive capsulitis or selective hypomobility follow a capsular pattern?

A

Adhesive capsulitis usually follows capsular pattern; selective hypomobility does not

17
Q

Difference between adhesive capsulitis and selective hypomobility

PART C: which responds quicker to treatment?

A

Adhesive capsulitis does not respond quickly; selective hypomobility will

18
Q

Difference between adhesive capsulitis and selective hypomobility

PART D: Describe phases of adhesive capsulitis vs selective hypomobility

A

Adhesive capsulitis has three phases (freezing, frozen, thawing) and selective hypomobility does not

19
Q

Difference between adhesive capsulitis and selective hypomobility

PART E: Which is more common/ what is adhesive capsulitis commonly mistaken for?

A

True adhesive capsulitis: selective hypomobility = 1:100

20
Q

What type of injury is a rotator cuff pathology?

A

Continuum or propagation injury (gets progressively worse and worse)

21
Q

RTC Continuum

Part B: What are the reversible Stages?

A
  • Impingement
  • Inflammation
  • Tendonitis
22
Q

RTC Continuum

Part C: What are the irreversible Stages?

A

Tendonosis / fibrotic scar tissue

Bone spurs

Partial/ Full thickness tear

23
Q

What is the capsular pattern of the shoulder?

A

ER>ABD>IR

(where > means more restricted)

24
Q

Shoulder Capsular Pattern

PART B: Name one mobilization that could be used to address each movement

A

ER: anterior glide

ABD: caudal glide

IR: posterior glide

25
Q

Shoulder Capsular Pattern

PART C: Name a common pathology that may follow a capsular pattern

A

Adhesive capsulitis

26
Q

Part A: What are the 3 components of the Stress Strain Deformation Curve?

(also draw since he may make us draw the curve!–beware))

Part D: Draw it

A

Elastic Deformation

Visco-elastic deformation

Plastic (permanent) deformation

27
Q

Stress Strain Deformation Curve

PART B: what type of effect does elastic deformation have?

A

Transient (short-lasting) effect

28
Q

Stress Strain Deformation Curve

PART C: what is Davis’s Law?

A

Soft tissue (the collagen and formed crosslinks) will remodel according to the stresses imposed on it

29
Q

Stress Strain Deformation Curve

PART D: What is the component that we should try to employ when trying to increase ROM?

A

The Plastic (permenent deformation) component

30
Q

What are the three limiting factors causing motion limitation in selective hypomobility?

(include why we care and a possible example?)

A
  1. Osseous (cannot change in rehab)
    • Example: retroverted humerus in GIRD/ERG (not sure about this one)
  2. Non contractile (check with passive mobility testing)
    • Example: superior capsule tightness (also not sure about this one)
  • Contractile (muscle tendon unit in the shoulder)
    • Process of elimination bc muscle flexibility tests are not well recorded in the literature
31
Q

Part A: What is the optimal window of time to perform a RTC surgical repair?

A

3-4 months

32
Q

RTC Repair surgery

PART B: what happens if you wait too long?

A

The retracted part of the tendon will scar down and the surgeon will not be able to salvage it to re-attach to the superior facet of the greater tuberosity

33
Q

BONUS: Describe the arthrokinematics and osteokinematics of the glenohumeral joint.

A

The joint is convex on concave, therefore, the arthrokinematics move in the opposite direction of the desired osteokinematics.

34
Q

BONUS: (this is from the rest of the powerpoint that we didn’t finish today)

What is the prescriptive formula for TERT based on?

A

Intensity X Duration X Frequency

35
Q

Pts with RTC re-tears still do not feel as bad as they did before surgery:

Part B: Name 2 improvements reported by patients after surgery even with a re-tear.

A

Decreased pain

Increased functional performance

36
Q

What is the best rehab approach for RTC repairs?

A

Decelerated

37
Q

Part A: What are the three limiting factors causing motion limitation in selective hypomobility?

PART B: Which factors can be addressed in rehab?

PART C: Give an example of each

A
  • Osseous (cannot change in rehab)
    • Example: retroverted humerus in GIRD/ERG (not sure about this one)
  • Non contractile (check with passive mobility testing)
    • Example: superior capsule tightness (also not sure about this one)
  • Contractile (Process of elimination bc muscle flexibility tests are not well recorded in the literature)
    • Example: muscle tendon unit in shoulder

Bootcamp Quiz Questions (8 decks)

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