Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ortho Exam 2 > Total Shoulder Replacement > Flashcards

Total Shoulder Replacement Flashcards

1
Q

indications

A

severe OA

inflammatory arthritis

RA

post-traumatic arthritis

RC tear

shoulder fx or severe trauma

AVN

no relief from PT, injections, medication, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

RC tear –> indications

A

a combo of severe arthritic and a massive non-reparable RC tendon tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

primary goal of TSH

A

pain relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

secondary goals of TSH

A

improve motion, strength and fxn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

dx tests

A

plain radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what do plain radiographs show

A

bone spurs

damaged joint surfaces

narrowed joint surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how long does the procedure take

A

2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

a TSH is an

A

open repair

pt is given general anesthesia and a nerve block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

procedure

A

separate deltoid and pec muscles

incise subscap

remove humeral head

debride glenoid

place prosthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

TSR is

A

most common

conventional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is a TSR

A

highly polished metal humeral head attached to a stem w/ a plastic glenoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

components of TSR

A

come in various sizes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if the bone is of good quality –> TSR

A

may use press fit humeral component

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

if bone is soft –> TSR

A

may need to cement the humeral component

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the glenoid component –> TSR

A

cemented

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

types of prostheses

A

conventional

hemi-arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

conventional prosthesis

A

pts w/ bone on bone arthritis and intact RC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

hemi-arhtoplasty

A

can replace only the humeral component if glenoid is in good condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

phase 1

A

0-3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

precautions –> phase 1

A

no AROM

when supine, use towel roll under elbow

no supporting of body weight on hand or lifting anything

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

when supine, use towel roll under elbow –> precautions phase 1

A

avoid hyperextension, anterior capsule stretch and subscap stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

PROM goals –> phase 1

A

90 degrees F/E

45 degrees ER in scaption

90 degrees ABD w/o rotation

70 degrees IR in scaption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

AAROM –> phase 1

A

allowed w/ caution

24
Q

post-op day 1

A

PROM

avoid stress on anterior capsule and subscap

25
Q

PROM –> post op day 1

A

to tolerance (but not past 90)

ER in scaption to about 30 degrees

IR to chest

26
Q

post up day 2-20

A

AAROM flexion, ABD, ER in scaption

submax pain free isometrics w/ shoulder in neutral

AAROM elbow

pulleys

27
Q

when could we do pulleys –> post up 2-20

A

if flexion and ABD PROM > 90

28
Q

post op days 10-21

A

progress PROM, AAROM in pain free ranges

strengthen elbow, forearm, wrist and hand

29
Q

sling –> post op days 10-21

A

abduction w/ pillow for comfort

while sleeping

30
Q

when do we d/c pillow –> post op 10-21

A

gradually by week 3-4

31
Q

PROM goals –> weeks 3-6

A

140 flexion

120 ABD

60 or more ER

70 IR in scaption

32
Q

active motion –> weeks 3-6

A

FE to 100 w/ good mechanics

33
Q

what do we re-establish –> weeks 3-6

A

dynamic shoulder stability

34
Q

use the sling –> weeks 3-6

A

as needed

35
Q

precautions –> weeks 3-6

A

lifting no heavier than a coffee cup

no supporting of BW w/ hands or arms

no sudden movements

36
Q

what should we focus on in week 3

A

scapula strengthening

continue w/ PROM, AAROM, isometrics

37
Q

scap strengthening –> week 3

A

begin horizontal ADD

initiate rhythmic stabilization

38
Q

what should we do in week 4

A

begin AROM

progress scapula strengthening

39
Q

begin AROM –> week 4

A

FE, IR, ER and ABD in supine

in pain free ROM

40
Q

progress scap strengthening –> week 4

A

begin isometrics of RC periscapular exercises

41
Q

phase 3

A

weeks 6-12

moderate strengthening

42
Q

goals of weeks 6-12

A

gradual restoration of shoulder strength, power and endurance

43
Q

what do we want to increase –> weeks 6-12

A

NM control

44
Q

there is a –>weeks 6-12

A

gradual return to fxnal activities w/ UE

45
Q

precautions –> weeks 6-12

A

no lifting >5 lbs

no sudden lifting or pushing activities

no sudden jerking motions

46
Q

what should we increase in week 6

A

anti-gravity FE, ABD

AROM IR & ER in scaption

PROM w/ light stretching

47
Q

what should be initiated –> week 6

A

assisted IR behind the back

48
Q

what should we begin –> week 6

A

light fxnal activities

49
Q

what should we begin –> week 8

A

progressive strengthening of FE in supine

1-3#

50
Q

what should we begin –> weeks 10-12

A

resisted flexion, ABD, ER w/ elastic band

51
Q

what should we progress –> weeks 10-12

A

strengthening of IR/ER

52
Q

strengthening of IR/ER –> weeks 10-12

A

progress IR from behind back from AAROM –> AROM

still avoid stress on anterior capsule

53
Q

phase 4

A

weeks 12-16

advanced strengthening

54
Q

goals of phase 4

A

full, pain free AROM

enhance fxnal use of UE

improve muscle strength, power, endurance

advance to more advanced fxnal activities

55
Q

precautions of phase 4

A

avoid exercises that stresses anterior capsule

ie: no combo of ER and ABD above 80 degrees of ABD

56
Q

weeks 12+ –> rehab

A

pt is now on HEP to progress strengthening

can return to moderately challenging fxnal activities

57
Q

4-6 months –> rehab

A

return to recreational hobbies

Ortho Exam 2 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions