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2) Patho 2 > 7) Shoulder > Flashcards

7) Shoulder Flashcards

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1
Q

Fxn of superior GH & coracohumeral ligaments

A

Limits ER of the adducted shoulder

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2
Q

Fxn of middle glenohumeral ligament

A

Limits anterior translation of the abducted shoulder

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3
Q

Fxn of inferior glenohumeral complex

A

Gives multidirectional stability

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4
Q

Fxn of glenoid labrum

A
  • Increases depth of the glenoid

* Attachment site for GH ligaments

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5
Q

Fxn of subacromial Burma

A

Water balloon for the shoulder

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6
Q

Things that are important when taking a hx for shoulder:

A
  • Age
  • MOI (Trauma, overuse, etc)
  • Stage of healing
  • OLDCARTS
  • Night pain
  • Meds
  • Hx of spinal patho
  • Pain vs weakness vs ROM
  • Parasthesia
  • Difficulty w/motor tasks
  • Hand Dominance
  • ADL limitations
  • Catching
  • Constitutional Sx’s
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7
Q

Things to consider when doing a shoulder exam

A
  • Inspect skin for bruising
  • Look for anatomical deformity
  • Muscle atrophy
  • Scapular Winging
  • Contours & creases
  • Asymmetry
  • Palpation
  • ROM
  • MMT
  • Sensation
  • Ligament Laxity
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8
Q

Purpose of differential subAC injection

A

Helps to differentiate a tear from inhibition causing 2 weakness

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9
Q

What causes anterior traumatic GH instability & why?

A

Hyperabduction & ER–>Causes capsulolabral avulsion between 3-6 o’clock on the glenoid

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10
Q

True or False: Anterior traumatic instability often requires surgery.

A

True

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11
Q

Classic Bankart Lesion

A

Labrum & capsule get avulsed from the glenoid

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12
Q

Anterior Labroligamentous Periosteal Sleeve Avulsion (ALPSA)

A

Labrum is torn but periosteum remained intact

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13
Q

Does ALPSA have healing potential?

A

Yes

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14
Q

Bony Bankart Lesion

A

Associated w/dislocation

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15
Q

Hill-Sachs Lesion

A

Dent/chip in the humeral head

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16
Q

HAGL

A

Capsular avulsion on the inferior aspect of the glenoid

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17
Q

Multi-Directional Instability

A

Symptomatic subluxation/dislocation in 2 or more directions

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18
Q

Type 1 Multidirectional Instability

A

Multidirectional laxity & global instability

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19
Q

Type 2 Multidirectional Instability

A

Multidirectional laxity & anteroinferior instability

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20
Q

Type 3 Multidirectional Instability

A

Multidirectional laxity & posteroinferior instability

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21
Q

Type 4 Multidirectional Instability

A

Multidirectional laxity & anteroposterior instability

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22
Q

Typical profile of pt w/shoulder pathologies

A

Young adults who are often athletic & reporting generalized pain

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23
Q

Common shoulder pathologies:

A
  • Loose/torn capsule
  • Weak/overwhelmed dynamic stabilizers
  • Generalized laxity
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24
Q

Non-operative management of shoulder pathologies is effective in up to what percent of cases?

A

90%

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25
What things should non-operative management of shoulder pathologies focus on?
* Adductor ER, & IR strengthening * Progressive ROM * Periscapular Re-ed
26
When is surgical management of shoulder pathologies indicated?
When 6-12 months of rehab has failed
27
Contraindications to surgical management of shoulder pathologies
* Voluntary dislocators w/emotional problems | * Behaviorally immature teens
28
Post-op protocols
* Protect the subscap & labrum repair * Limit passive ER & active IR * Wait 6wks to progress ROM * Wait 10-12wks to progress strengthening * Ok to start periscapular program
29
ACLR
Tx of shoulder pain in throwing athletes focused on excessive anterior laxity
30
What is the benefit to an ACLR?
Don't have to protect the subscap so you can start early strengthening & periscapular program
31
After an ACLR, when can you begin to progress ROM?
After 6wks
32
180 Rule in Throwers
IR loss < ER gain
33
What is the peel-back mechanism responsible for?
Causing type 2 SLAP tears in throwers
34
Grade 0 GH Instability
No translation
35
Grade 1 GH Instability
Humeral head moves slightly up the face of the glenoid (0-1cm translation)
36
Grade 2 GH Instability
Humeral head rides up the face to, but not over the rim of the glenoid (1-2cm translation)
37
Grade 3 GH Instability
Humeral head rides up & over the glenoid rim (>2cm translation) *Usually reduces when stress is removed, but not always
38
Principles of tx for
* Avoid repetitive stress * Restore strength & flexibility * Activity modification * General conditioning
39
Rehab implications for
* Must decr pain before attaining motion * Need motion for strength * Can take wks to months
40
Rehab implications for
* Must decr pain before attaining motion * Need motion for strength * Can take wks to months
41
Benefits of scope vs open repair
* Avoids deltoid morbidity * Surgeon can better asses tear geometry * More precise * Faster rehab & earlier return to ADL's
42
Principles of tx for impingement
* Avoid repetitive stress * Restore strength & flexibility * Activity modification * General conditioning
43
Tx for adhesive capsulitis
* Tx should be conservative for 6 months * NSAID's & articular injections * Aggressive ROM * Strengthening when motion returns
44
Surgical tx for adhesive capsulitis
Surgical release w/manipulation
45
What condition is surgical release w/manipulation done for?
Adhesive capsulitis
46
Why are pain pumps not used anymore & what is used instead?
Pain pumps kill cartilage so scalene blocks are now used
47
Tx after surgical manipulation
* Aggressive ROM * Nerve Block * CPM * Motion, motion, motion!
48
Tx after surgical manipulation
* Aggressive ROM * Nerve Block * CPM * Motion, motion, motion!
49
What is a SLAP tear associated w/?
Biceps tendon rupture
50
Neer Test
Tests for subacromial impingement
51
Hawkins-Kennedy Impingement Test
Tests for subacromial impingement
52
O'Brien's Compression Test
Tests for SLAP tear
53
What does the acronym TUBS stand for?
Traumatic Unidirectional Bankart Surgery
54
What does the acronym AMBRII stand for?
``` Atraumatic Multidirectional Bilateral Rehabilitation Inferior capsular shift Interval ```
55
What pathologies are under the umbrella of RTC disease?
* RTC tendinitis/osis/opathy * Calcific tendinitis * RTC tear * Subacromial bursitis * Impingement Syndrome
56
What pathologies are under the umbrella of RTC disease?
* RTC tendinitis/osis/opathy * Calcific tendinitis * RTC tear * Subacromial bursitis * Impingement Syndrome
57
Grade 1 AC jt dislocation
Partial tear of AC ligament caused by a mild blow
58
Grade 2 AC jt dislocation
Subluxation bc of a full AC ligament tear
59
Grade 3 AC jt dislocation
AC ligament, coracoclavicular ligament, & capsule are torn
60
Grade 4 AC jt dislocation
Clavicle is posteriorly displaced & pushed through the fascia of the traps
61
Grade 5 AC jt dislocation
Severe displacement of the GH jt w/the clavicle 300% to the acromion
62
True or false: In a grade 2 AC jt separation, the coracoclavicular ligament is intact.
True
63
Grade 6 AC jt dislocation
Acromial end of the clavicle is locked inferior to the coracoid

2) Patho 2 (20 decks)

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