Week 4

Question 1

4 joints at the shoulder

Answer 1

glenohumeral
sternoclavicular
acromioclavicular
scapulothroacic

Question 2

What stabilises the AC joint

Answer 2

superior and inferior AC joint capsular ligaments
coracoclavicular ligament
Articular disc
Deltoid and upper trap muscles

Question 3

What makes shoulders difficult to diagnose

Answer 3

complex joint interplay
complex co-operative muscular control
Special tests often don't have high specificity & sensitivity 
regularly painful >90degrees
mechanical vs non-mechanical pain
pain can be referred from other regions

Question 4

3 types of impingement

Answer 4

external - encroachment of subacroial space form superior strcutures
spurs may be seen on x ray

External- inadequate muscle stabilisation of scapula

Internal - overhead sports - undersurface of RC against posterosuperior of glenoid during late stage cocking

Question 5

What stabilises the GH joint

Answer 5

joint capsule and capsular ligaments
coracohumeral ligament
glenoid labrum
rotator cuff muscles
LH of biceps brachii

Question 6

Scapulothroacic Movements

Answer 6

elevation
depression
adduction
adduction 
upward rotation
downward rotation

Question 7

Overall ratio of GH:ST movement

Answer 7

2:1

Question 8

Abduction of the arm

Answer 8

Clavicle retracts & posteriorly rotates
scapula tilts and ER
GH ER
supraspinatus contracts - taut superior capsule and depression of HOH
Auxillary pouch stretches - inferior sling for HOH

Question 9

Role of supraspinatus

Answer 9

superior role of HOH
compression into fossa
restricts superior translation

Question 10

Infraspinatus, Teres minor, subscap role

Answer 10

depression force on HOH

Question 11

Infraspinatus and teres minor role

Answer 11

external rotation of humerus

Question 12

list elevators of the scapulothorcic joint

Answer 12

upper traps
levator scap
rhomboids

Question 13

list depressors of the scapulothoracic joint

Answer 13

lower traps
lat dorsi
pec minor
subclavius

Question 14

list protractors of the scapulothoracic joint

Answer 14

serratus anterior

Question 15

List retractors of the scapulothoracic joint

Answer 15

mid traps
rhomboids
lower traps

Question 16

List upward rotators of the scapulothoracic joint

Answer 16

serratus anterior

upper and lower traps

Question 17

Downward rotators of the scapulothoracic joint

Answer 17

rhomboids

pec minor

Question 18

6 categories of shoulder pain

Answer 18

rotator cuff
labral injury
instability 
stiffness
ac joint pathology
referred pain
-Cx
-Tx
-visceral

Question 19

Common disorder of the shoulder

Answer 19

rotator cuff strain and tendinopathy
GH dislocation
GH instability 
glenoid labrum tear
AC joint sprain 
Muscle tear - pec minor
Referred pain

Question 20

Viscera referred pain

Answer 20

cardiac dysfunction
diaphragm dysfunction, lung disease
disease of the oesophagus

Question 21

referred pain is commonly felt in

Answer 21

Cx spine
Tx spine
associated musculature

Question 22

Shoulder dysfunction can result in

Answer 22

traps pain and fatigue
pain rediates into
-neck
-post scap
upper arm
forearm
wrist and hand

Question 23

painful arc for shoulder dysfunction

Answer 23

70-120 degrees

Question 24

What causes a labral lesion

Answer 24

excess traction on labrum through LHB

-FOOSA

Question 25

Different classifications of labral lesions

Answer 25

SLAP- stable vs unstable, 4 grades | Non-SLAP - degenerative, flap, vertical labral tears, bankart

Question 26

What is Bankart lesion

Answer 26

unstable lesion of the anterior inferior labrum, repetitive dislocations

Question 27

What is a Hill-Sachs lesion

Answer 27

damage to posterior humeral head

Question 28

Clinical presentation of SLAP lesion

Answer 28

TOP anterior shoulder | pain on resisted biceps contraction

Question 29

Signs and symptoms of anterior shoulder instability

Answer 29

recurrent dislocation or subluxation shoulder pain dead arm potential catching

Question 30

3 theories of Adhesive capsulitis (frozen shoulder)

Answer 30

inflammatory fibrosing algoneurodustropic condition

Question 31

Presentation for Adhesive capsulitis (frozen shoulder)

Answer 31

``` 40-60 yo >M diabetic evaluate ER PROM in neutral may last 18 months ```

Question 32

3 phases of adhesive capsulitis

Answer 32

1: onset of severe pain, but movement not stiff 2: pain at EOR and night, movement more restricted 3: pain decreasing slowly increasing movement "thawing"

Question 33

MOI for ac joint dislocation

Answer 33

direct fall onto shoulder with arm in adduction

Question 34

AC joint dislocation presentation

Answer 34

pain directly over AC joint | all extremes of movement aggravate pain

Question 35

Grades for AC joint dislocation

Answer 35

Gr 1 : damage to capsule and acomioclav lig Gr 2: rupture acromioclav and damage to coracoclav lig Gr 3 : rupture acromioclav and coracoclav ligs Gr 4: post displacement of clavicle Gr5: similar to Gr III + greater ST damage Gr6 : inferior displacement to subacromial or subcoracoid space

Question 36

Hawkins Kennedy Test

Answer 36

Subacromial Impingement

Question 37

Neer's Test

Answer 37

Subacromial Impingement

Question 38

External Lag Sign

Answer 38

Dysfunction or weakness of the external rotators

Question 39

Speed's Test

Answer 39

Long Head Biceps

Question 40

Gerber's Test

Answer 40

- Lift Off Test | - subscapularis (RC)

Question 41

Job's Test

Answer 41

- Empty can /Full can | - supraspinatus (RC)

Question 42

Sulcus Tes

Answer 42

Labrum/Instability

Question 43

Drawer Test (load and shift test)

Answer 43

Labrum/Instability

Question 44

O'Brien Test

Answer 44

Labrum

Question 45

3 Tests for Thoracic Outlet

Answer 45

- Roos (EAST) Test - Adsons Test - Allens Test