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MSK Fall P2 > 6] SHoulder > Flashcards

6] SHoulder Flashcards

(91 cards)

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1
Q

AP axis SC joint

A

Elevation/depression

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2
Q

SI axis SC joint

A

Protraction and retraction

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3
Q

Longitudinal axis SC joint

A

Posterior and anterior rotation

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4
Q

Saddle joint

A

sternoclavicular joint

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5
Q

Articulates with sternum, clavicle and 1st rib

A

SC joint

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6
Q

Plane joint

A

AC joint

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7
Q

Articulates with acromion and distal clavicle

A

AC joint

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8
Q

Improves GH stability
Shock absorption
Increases total shoulder ROM

A

Scapulothoracic ROM

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9
Q

Scapulohumeral rhythm

A

1/3 ST motion and 2/3 GH motion but new research says elevation requires both GH and ST motion

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10
Q

Scapula is oriented ?

A

30 deg anterior to frontal plane

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11
Q

Humerus orientation- angle of inclination

A

130 - 150

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12
Q

Humerus orientation - angle of Torsion

A

30 deg retroversion

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13
Q

Ball and socket joint

A

GH joint

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14
Q 
Articular bony anatomy
Glenoid labrum
Capsule and ligaments
- intra-articular pressure
Adhesion-cohesion
A

Static factors that provide mechanical stability

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15
Q

Limits inferior translation

A

SGHL and CHL

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16
Q

Primary restraint to anterior translation in 45-75 deg ABDuction. Also limits ER in mid ABDuction.

A

Middle GH lig

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17
Q

Anterior band
Posterior band
Axillary pouch

A

3 parts of inferior GH lig

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18
Q

Controls inferior translation of humeral head in glenoid

A

inferior GH lig

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19
Q
  • pressure within the joint is negative creating a vacuum in the joint
  • venting of capsule increases translation
A

Negative intra-articular pressure

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20
Q

Characteristics of adhesion-cohesion

A

High tensile strength (difficult to pull apart)

Low shear strength (slide easily)

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21
Q

Shoulder depressors

A

Pec major

Lats

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22
Q

Move and stabilize scapula

A

Serratus anterior

Traps

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23
Q

Rotator cuff muscles and tendons function as

A

Dynamic ligaments

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24
Q

Resultant force is towards joint compression

A

Supraspinatus

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25
Humeral head depressors ad apply compressive force. Reduce anterior strain on ligaments.
Posterior rotator cuff and subscapularis
26
Coupled force for stability
Rotator cuff and deltoid
27
Loss of space
Primary impingement
28
Excess movement
Secondary impingement
29
``` Acromial morphology Degenerative spurs - AC joint Posterior GH capsule tightness Subacromial swelling RTC weak ```
Primary impingement
30
Tissues in subacromial space
Bursa Supraspinatus Long head of biceps tendon
31
GH instability Scapular weakness/dyskinesia biceps/SLAP lesion GIRD
Secondary impingement
32
Inflammation of subacromial bursa and RC tendons
Stage 1 Neer
33
Fibrosis and tendinitis
Neer stage 2
34
Tendo ruptures, possibly bony changes
Neer stage 3
35
Less than 25 years old | Reversible
Neer stage 1
36
25 - 40 years old | Still reversible- requires rest, anti-inflammatory modalities and meds, TE
Neer stage 2
37
More than 40 years old | Complicated, may require surgery
Neer stage 3
38
Rotator cuff tears
Older patients
39
Rotator cuff tendinopathy
Overuse
40
Rotator cuff weakness
Athletes
41
Most common rotator cuff tear
Supraspinatus
42
Critical zone of RCT
1 cm proximal to insertion
43
Partial vs full thickness for RCT
Partial is more common. | Full is articular- bursal surface.
44
Sizes to classify RCT
Small is less than 1 cm Medium is less than 3 cm Large is less than 5 cm Massive is more than 5 cm
45
``` History- insidious, possible incident Pain- C5 myotome Frequency - depends on irritability Night pain Difficulty lifting arm ```
RCT symptoms
46
RCT treatment stretch
Tight posterior capsule - sleeper stretch
47
Strengthening for RCT
RTC Shoulder girdle Ab and thoracic muscles
48
Which exercises activate RC muscles?
``` IR ER Full can Horizontal ABD with ER Concentric and eccentric exercises ```
49
Hyperactivity and early activitation of scapular muscle dysfunction
Upper trap
50
Insufficient activity and late activation of scapular dysfunction
Lower trap
51
Strength deficit of scapular dysfunction
Serratus anterior
52
3 tests for GH laxity
Load and shift Sulcus sign Posterior sublux test (jerk test?)
53
What are the 3 acronyms for shoulder dislocations?
TUBS AIOS AMBRI
54
What does TUBS stand for?
Traumatic Unidirectional Bankart Surgery
55
What does AIOS stand for?
Acquired Instability Overstress Surgery
56
What does AMBRI stand for?
``` Atraumatic Multidirectional Bilateral Rehabilitation Inferior ```
57
Dislocation happens at ?
GH joint
58
Separation happens at ?
AC joint
59
What is a bankart lesion ?
Separation of anterior labrum from glenoid
60
What is a hill Sachs lesion?
Compression Fx of posterolateral humeral head
61
Most common nerve injured
Axillary nerve
62
Muscles for full can
Supra Subscapularis Serratus Upper and lower trap
63
Muscles for prone horizontal ABD (100-135 deg ABD)
Supra | All traps
64
Push up plus muscles
Subscapularis | Serratus
65
Dynamic hug muscle
Serratus
66
Sidelying ER 0 deg abd muscles
Infra | Teres minor
67
Standing ER 45 deg in scapular plane
Infra | Teres minor
68
What does SLAP stand for
Superior labrum lesion from anterior to posterior
69
Causes of ? - acute trauma - excessive load on biceps tendon during deceleration and follow through phase of throwing
SLAP lesion
70
SLAP lesion MOI?
Changes in direction biceps tendon
71
SLAP lesion etiology
FOOSH Forceful eccentric biceps contraction Degeneration
72
Symptoms of ? - clicking, catching, locking - pain - instability - frequently associated with other shoulder pathology
SLAP lesion
73
Superior lateral fraying
Type I SLAP
74
Unstable attachment
Type 2 SLAP
75
Bucket handle tear
Type 3 SLAP
76
SLAP type 4
3 plus extension into biceps tendon
77
What does GIRD stand for?
GH internal rotation deficit
78
- Jobe + Neer post - Hawkins
Internal (posterior) impingement
79
+ : jobe, Neer ant, Hawkins
External subacromial impingement
80
Relocation + | Release + pain
Secondary impingement
81
Relocation -
Primary impingement
82
+ full can
RC pathology
83
+ SAT and SRT
Scapular dyskinesia
84
+ laxity tests + apprehension Relocation + apprehension
Instability
85
Speeds + O’Brien’s + Biceps load II +
Biceps/SLAP
86
Decreased IR ROM
GIRD
87
GIRD is associated with?
Scapular dyskinesia and decreased subacromial space
88
Proximal humerus fractures classifications 1 - 4
1 part = the articular segment 2 part = greater tuberosity 3 part = lesser tuberosity 4 part = humeral shaft
89
PT management for one part Fx
Conservative with sling for 1-3 weeks
90
PT management for 3/4 part Fx
ORIF; initiate AROM in pain free range 7-10 days post op
91
“Stinger”
Brachial plexus injury

MSK Fall P2 (10 decks)

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