Conditions Cervical and Shoulder

Question 1

This condition involves overstretching and/or tearing of annular rings, vertebral endplate, and/or ligamentous structures.

Answer 1

Central Bulge/Herniation

Question 2

What are the common signs and symptoms of a Central bulge/herniation?

Answer 2

Loss of strength, 
Radicular pain
Paresthesia,
Inability to perform ADL
Possible compression of spinal cord

Question 3

Does a central bulge/herniation demonstrate UMN or LMN signs?

Answer 3

Upper motor neuron symptoms

Question 4

This condition often involves intervertebral foremen stenosis, posterolateral disk bulge, nerve root inflammation, or any combination of these.

Answer 4

Cervical Radiculopathy

Question 5

This condition often presents with a central canal stenosis, central disk bulge, spinal inflammation, ligamentous laxity/damage or any combo of these.

Answer 5

Cervical Myelopathy

Question 6

How do you diagnose a central bulge or cervical radic, or Cervical Myelopathy?

Answer 6

MRI

Clinical exam can be used to assist

Question 7

Myelopathy has (bilateral/unilateral) loss of strength and typically demonstrates (UMN/LMN) signs.

Answer 7

Bilateral symptoms, and upper motor signs

Question 8

Excess shear and tensile forces are exerted on cervical structures during which condition?

Answer 8

Whiplash Associated Disorder

Question 9

What are some common signs and symptoms associated with Whiplash Associated Disorder?

Answer 9

Headaches, neck pain, vertigo, spinal posture abnormalities, cranial nerve signs, dysethesias, etc…

Question 10

How do yo diagnose whiplash associated disorder

Answer 10

Plain films, CT, MRI

Clinical exam also used

Question 11

What are some diagnostic tests for hypermobile spinal segments?

Answer 11

Plain film particularly dynamic/stress views

Question 12

What movements cause an anterior-inferior shoulder dislocation and are they common?

Answer 12

95% are anterior-inferior

Forceful Abduction and ER

Question 13

What directions are needed to have a posterior shoulder dislocation?

Answer 13

Forceful horizontal adduction and IR

Question 14

Name some complications of a shoulder dislocation.

Answer 14

Hill-sacks lesions
Bankart lesions
SLAP lesions

Question 15

How can you diagnose a dislocation?

Answer 15

Diagnostic tests - Medical imaging

Diagnosis made by examination (apprehension sign)

Question 16

What does the acronym TUBS stand for and how do you treat it?

Answer 16

Traumatic etiology
Unidirectional instability
Bankart lesion is the pathology
Surgery is required

Question 17

What does the acronym AMBRI stand for and how do you treat it?

Answer 17

Atraumatic (minor trauma)
Multidirectional instability
Bilateral: (asymptomatic shoulder is also loose)
Rehab is the treatment
Inferior capsular shift (might need surgery if conservative measures fail)

Question 18

Describe a superior and inferior labral tear.

Answer 18

Superior - above middle of socket - often involves bicep

Inferior - below middle of socket - often involves Bankarts’ lesion

Question 19

What is the preferred diagnostic test for labral tears?

Answer 19

MRA

Question 20

Describe the clinical findings for a labral tear (4)

Answer 20

Shoulder pain that can’t be localized
Weakness and instability
Pain with resisted elbow flexion
Positive Biceps Load II Test

Question 21

In Thoracic Outlet Syndrome, where is the compression of the neruovascular bundle?

Answer 21

Superior thoracic outlet
Scalene triangle
Between 1st rib and clavicle
Between pec minor and chest wall

Question 22

Are AC/SC disorders usually traumatic or non traumatic?

Answer 22

Traumatic

Question 23

What are the clinical findings for AC/SC disorders?

Answer 23

Step off at AC
Pain above 120 degrees
Painful to palpation

Question 24

Describe the Subacromial continuum.

Answer 24

1. Subacromial bursitis
2. Rotator cuff tendonopathy
3. Impingement syndrome
   (can start or progress to any stage)

Question 25

Where is the irritation during posterior internal impingement syndrome?

Answer 25

Irritation between rotator cuff and greater tuberosity | or posterior glenoid/labrum

Question 26

What type of athlete or working environment has common posterior internal impingement?

Answer 26

Overhead athletes/ workers

Question 27

True/False: Biciptial Teninopathy mostly involves the short head of biceps and is often present with bankart lesion or subacromial impingement.

Answer 27

FALSE | Long head of biceps is mostly affected and is common with SLAP tear

Question 28

What is the capsular pattern for the GH joint?

Answer 28

ER -> Abduction & flexion -> IR

Question 29

Name the 3 stages of adhesive capsulitis

Answer 29

Freezing, Frozen, Thawing