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Musculoskeletal Physiotherapy 2 > Week 4 > Flashcards

Week 4 Flashcards

1
Q

4 joints at the shoulder

A

glenohumeral
sternoclavicular
acromioclavicular
scapulothroacic

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2
Q

What stabilises the AC joint

A

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

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3
Q

What makes shoulders difficult to diagnose

A 
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
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4
Q

3 types of impingement

A

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

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5
Q

What stabilises the GH joint

A 
joint capsule and capsular ligaments
coracohumeral ligament
glenoid labrum
rotator cuff muscles
LH of biceps brachii
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6
Q

Scapulothroacic Movements

A 
elevation
depression
adduction
adduction 
upward rotation
downward rotation
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7
Q

Overall ratio of GH:ST movement

A

2:1

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8
Q

Abduction of the arm

A

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

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9
Q

Role of supraspinatus

A

superior role of HOH
compression into fossa
restricts superior translation

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10
Q

Infraspinatus, Teres minor, subscap role

A

depression force on HOH

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11
Q

Infraspinatus and teres minor role

A

external rotation of humerus

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12
Q

list elevators of the scapulothorcic joint

A

upper traps
levator scap
rhomboids

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13
Q

list depressors of the scapulothoracic joint

A

lower traps
lat dorsi
pec minor
subclavius

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14
Q

list protractors of the scapulothoracic joint

A

serratus anterior

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15
Q

List retractors of the scapulothoracic joint

A

mid traps
rhomboids
lower traps

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16
Q

List upward rotators of the scapulothoracic joint

A

serratus anterior

upper and lower traps

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17
Q

Downward rotators of the scapulothoracic joint

A

rhomboids

pec minor

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18
Q

6 categories of shoulder pain

A 
rotator cuff
labral injury
instability 
stiffness
ac joint pathology
referred pain
-Cx
-Tx
-visceral
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19
Q

Common disorder of the shoulder

A 
rotator cuff strain and tendinopathy
GH dislocation
GH instability 
glenoid labrum tear
AC joint sprain 
Muscle tear - pec minor
Referred pain
20
Q

Viscera referred pain

A

cardiac dysfunction
diaphragm dysfunction, lung disease
disease of the oesophagus

21
Q

referred pain is commonly felt in

A

Cx spine
Tx spine
associated musculature

22
Q

Shoulder dysfunction can result in

A 
traps pain and fatigue
pain rediates into
-neck
-post scap
upper arm
forearm
wrist and hand
23
Q

painful arc for shoulder dysfunction

A

70-120 degrees

24
Q

What causes a labral lesion

A

excess traction on labrum through LHB

-FOOSA

25
Q

Different classifications of labral lesions

A

SLAP- stable vs unstable, 4 grades

Non-SLAP - degenerative, flap, vertical labral tears, bankart

26
Q

What is Bankart lesion

A

unstable lesion of the anterior inferior labrum, repetitive dislocations

27
Q

What is a Hill-Sachs lesion

A

damage to posterior humeral head

28
Q

Clinical presentation of SLAP lesion

A

TOP anterior shoulder

pain on resisted biceps contraction

29
Q

Signs and symptoms of anterior shoulder instability

A

recurrent dislocation or subluxation
shoulder pain
dead arm
potential catching

30
Q

3 theories of Adhesive capsulitis (frozen shoulder)

A

inflammatory
fibrosing
algoneurodustropic condition

31
Q

Presentation for Adhesive capsulitis (frozen shoulder)

A 
40-60 yo 
>M
diabetic
evaluate ER PROM in neutral 
may last 18 months
32
Q

3 phases of adhesive capsulitis

A

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”

33
Q

MOI for ac joint dislocation

A

direct fall onto shoulder with arm in adduction

34
Q

AC joint dislocation presentation

A

pain directly over AC joint

all extremes of movement aggravate pain

35
Q

Grades for AC joint dislocation

A

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

36
Q

Hawkins Kennedy Test

A

Subacromial Impingement

37
Q

Neer’s Test

A

Subacromial Impingement

38
Q

External Lag Sign

A

Dysfunction or weakness of the external rotators

39
Q

Speed’s Test

A

Long Head Biceps

40
Q

Gerber’s Test

A
  • Lift Off Test

- subscapularis (RC)

41
Q

Job’s Test

A
  • Empty can /Full can

- supraspinatus (RC)

42
Q

Sulcus Tes

A

Labrum/Instability

43
Q

Drawer Test (load and shift test)

A

Labrum/Instability

44
Q

O’Brien Test

A

Labrum

45
Q

3 Tests for Thoracic Outlet

A
  • Roos (EAST) Test
  • Adsons Test
  • Allens Test

Musculoskeletal Physiotherapy 2 (10 decks)

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