Cuff Stuff

Question 1

What are the impingement tests?

Answer 1

Hawkins
Neer
Horizontal Add
Jobe Empty Can
Speed’s 

HNAES
SHANE
(Speed’s, Hawkin’s, Adduction, Neer, Empty)

Question 2

What are the RC tear tests?

Answer 2

Drop Arm, ER lag sign, Belly Press (Subscap)

DEB
Drop, ER, Belly

Question 3

What are the instability signs?

Answer 3

Apprehension/Relocation/Anterior Release
Load and Shift (A+P Glide)
Sulcus

ALS

Question 4

Which is the best of the SLAP tests?

Answer 4

Dynamic Shear

Question 5

What are the tests for scapular dyskinesia?

Answer 5

Dysk Test (Weighted Flexion)
Scap Repos
Scap Assist
Upper Limb Tension

Question 6

What is a formula for referred pain?

Answer 6

Convergence + Conditioning = Error in Perception

Question 7

Referred pain is _____________ of nerve compression.

Answer 7

independent

Question 8

Where does the cervical plexus NOT refer pain to? Where does the brachial plexus NOT refer pain to?

Answer 8

The arm. The head.

Question 9

What is more important as a sign of the gravity of referred pain?

Answer 9

The distance from the spine.

Question 10

What is true AP called in imaging and what is it for?

Answer 10

Grashey.
It’s done perpendicular to the scap and useful for seeing GH joint space / specifically in patients at risk for complications from arthritis. You can also see the concavity of the glenoid.

Question 11

What is the Y view used for?

Answer 11

Fix and position of hum on the glenoid.

Question 12

What is the best view for seeing acromion type?

Answer 12

Suprapinatus outlet

Question 13

What is the axillary view best for?

Answer 13

Looking at the inferior shoulder, but also Hill Sachs.

Question 14

For shoulder trauma, what views are usually chosen?

Answer 14

Axillary, Scap Y, AP (ER/IR w/ grashey rec)

Question 15

For a labral tear or instability, what is usually chosen for imaging?

Answer 15

Arthrography

Question 16

If you have less glenoid retroversion, which way will the humeral head shift?

Answer 16

Anterior

Question 17

What do pitchers typically develop excessive amounts of as bar as bony geometry of the humerus goes?

Answer 17

More retroversion, and there for the capacity to have much more ER.

Question 18

What is the “shelf mechanism”?

Answer 18

The more downward tilt, the more instability bc the glenoid flattens.

Question 19

What are some examples of extrinsic mechanisms for frozen shoulder?

Answer 19

C-spine, CVA, Parkinson’s, MI, Humeral Fox, Post Op (Mastectomy)

Question 20

What is the main difference between someone with SAP and FS?

Answer 20

Near normal ER/IR vs. a definitely loss of passive IR/ER

Question 21

How would you treat a non-structurally changed shoulder with FS vs. a structural changed shoulder?

Answer 21

Non-structural should not be vigorously stretched or strengthened.

Structural, should be TERT and should be vigorously stretched and strengthened but never beyond the pain threshold.

Question 22

Where, specifically, is the tear in a Bankart Lesion?

Answer 22

Usually in the capsulolabral complex at the insertion of the anterior band of the IGHL.

Question 23

What bony mechanism is responsible for getting a modified latarjet procedure?

Answer 23

“Inverted Pear” shape of the glenoid.

Question 24

What surgery is often done for a Hill Sachs?

Answer 24

Remplissage, or reattachment of the infraspinatus and the posterior capsule.

Question 25

What is the main difference between post rehab protocols for a small RC tear vs. a large?

Answer 25

In a small, you’re immob for 4 weeks, in a large, 8 weeks. And it’s very likely with large recovery will take 4 months.

Question 26

What is the worst thing you can do to a bankart lesion repair, and why?

Answer 26

Too much ER, too early. Because the subscap is taken out and then reattached in an open version of this, and/or in an arthroscopic version - ER will challenge the cuff most.

Question 27

What do you need for a Bankart Lesion Repair to be considered in Phase 4? And how long should you anticipate before return to sport?

Answer 27

Neg Apprehension Test

6 months

Question 28

What is the most important ROM to avoid s/p SLAP tear repair? What is another muscle group to avoid directly and for how long? What exercises are done first and why?

Answer 28

IR w/ extension
Biceps, until 2 months s/p
Open Chain (avoid compression of the joint)

Question 29

For a biceps tenodesis, how long do you have to wait before bicep loading?

Answer 29

6 weeks s/p