Common Shoulder Diagnoses

Question 1

open-packed position

Answer 1

joint position in which the capsule and ligaments are most lax and separation of joint surfaces are greatest

Question 2

close-packed position

Answer 2

joint position in which the capsule and ligaments are under the most tension with maximal contact between joint surfaces

Question 3

force couple

Answer 3

two resultant forces of equal magnitude in opposite directions that produce rotation of a structure

Question 4

Cervical Screen (3)

Answer 4

1. ROM Testing
2. Repeated Motion Testing
3. Cervical Radiculopathy Test Cluster

Question 5

Cervical Radiculopathy Test Cluster (4)

Answer 5

1. Spurling’s Test
2. Cervical Distraction
3. Cervical Rotation ROM
4. Upper Limb Neurodynamic Test

Question 6

Spurling’s Test

Answer 6

for cervical radiculopathy
lateral cervical flexion to end range and apply 7 kg axial compression
+ w/ pain

Question 7

Cervical Distraction Test

Answer 7

for cervical radiculopathy
patient supine head neutral
place hand under chin and base of skull and distract C - spine
+ w/ relief/decrease symptoms

Question 8

Cervical Rotation ROM

Answer 8

for cervical radiculopathy
measure with goni
+ w/

Question 9

Upper Limb Neurodynamic Test

Answer 9

for cervical radiculopathy

Question 10

Thoracic Outlet Syndrome Regions (4)

Answer 10

1. sternocostovertebral space
2. scalene triangle
3. costoclavicular space
4. pectoralis minor space

Question 11

Proximal Humerus Fx

Answer 11

most common fx of the humerus

may involve articular surface, greater tubercle, lesser tuberosity, or surgical neck

Question 12

Precautions: Proximal Humerus Fx

Answer 12

RC injuries often overlooked
high risk for adhesive capsulitis
many have concurrent axillary nerve or brachial plexus injury so screen at eval

Question 13

Adhesive Capsulitis

Answer 13

frozen shoulder

primary: idiopathic
secondary: precipitates event

Question 14

Freezing Phase

Answer 14

shoulder pain interrupting sleep
pain w/ ADLs
pain at rest
ROM close to full with pain before end range
nonspecific tenderness at ant, lat, and post aspects
over 2-9 months pain subsides and turns to typical FS pain at end range

Question 15

Frozen Phase

Answer 15

may last up to 1 year
distinct movement patterns as client attempts to substitute ST motion to compensate for lack of GH mobility
pain with stretching joint capsule at end range

Question 16

Thawing Phase

Answer 16

gradual return of motion

lasts up to 26 months

Question 17

Precautions: Adhesive Capsulitis

Answer 17

don’t push ROM during freezing phase to point that lasts beyond a few minutes–will enhance inflammatory/fibrosing processself-imposed immobilization by client

Question 18

Glenohumeral Instability - TUBS

Answer 18

"torn loose"
T raumatic etiology
U nidirectional instability
B ankhart lesion
S urgery required

Question 19

Glenohumeral Instability - AMBRII

Answer 19

"born loose"
A traumatic or microtrauma
M ulitdirectional instabilty
B ilateral symptoms
R ehab is treatment of choice
I nferior capsular shift
I nterval between supraspinatus and subscapularis closed surgically if conservative measures fail

Question 20

SLAP Lesion

Answer 20

Superior Labrum Anterior to Posterior

Question 21

Treatment: GH Instability NonOP

Answer 21

strengthen RC and subscap stabilization

Question 22

Treatment: GH Instability Op

Answer 22

in AMBRII - only after 3 month rehab failed
most common: Open Inferior Capsular Shift or Arthroscopic Capsular Plication
less common: Thermal Capsulorrhaphy

Question 23

Precautions: GH Instability

Answer 23

do not perform end range or grade IV joint mobs/stretches on client with MDI
clients w/ anterior instability need posterior capsule stretched - avoid anterior stretch
pay close attention to ROM restrictions for postop patients

Question 24

Rotator Cuff Disease

Answer 24

70% shoulder disorders related to RC disease

structures involved: muscles of RC, long head of biceps tendon, subdeltoid-subacromial bursa, and CA arch

Question 25

Extrinsic RC Lesions

Answer 25

result from repeated impingement of RC tendon against different structures of GH joint

Question 26

Intrinsic RC Lesions

Answer 26

result from age-related degeneration of RC tendon

related to vascularization of RC cuff and are on articular side of tendon

Question 27

Neer’s Three-Stage Classification of Impingement Syndrome

Answer 27

Stage I: 40 years old, bone spurs and tears of RC and long head of biceps tendon

Question 28

Precautions: Rotator Cuff Disease

Answer 28

watch for tight posterior capsule
if showing impingement signs, take care to avoid impinging shoulder during overhead motions
monitor for excessive scapular elevation
discourage clients from sleeping on involved side

Question 29

Neer system classification: one-part fractures

Answer 29

no fracture fragments displaced more than 1 cm and no more than 45 deg angulation

Question 30

Neer system classification: two-part fractures

Answer 30

exceed limits of one-part fractures and can involve the humeral head and surgical neck or the humeral head and greater tuberosity

Question 31

Neer system classification: three- and four-part fractures

Answer 31

involve the humeral head, greater tuberosity, and lesser tuberosity

Question 32

Roos Test

Answer 32

aka elevated arm stress test (EAST)

for TOS

Question 33

Sulcus Sign

Answer 33

for GH instability

Question 34

Apprehension Test

Answer 34

for GH instability

Question 35

Relocation Test

Answer 35

for GH instability

Question 36

Hawkins-Kennedy Test

Answer 36

for shoulder impingement

Question 37

Neer’s Test

Answer 37

for shoulder impingement

Question 38

Empty Can Test

Answer 38

for RC tear

specifically tests supraspinatus

Question 39

Gerber Lift-Off Test

Answer 39

for RC tear

specifically tests subscapularis

Question 40

Speed’s Test

Answer 40

for biceps tendinosis