EXAM 3 - RC

Question 1

what does the supra help with

Answer 1

the deltoid with abd
it produced a superior compressive force and stablize it directly against the fossa

Question 2

what depresses the humeral head

Answer 2

subscap

infra

teres minor

Question 3

why muscle provide dynamic stability to the shoulder

Answer 3

infra, teres minor, subscapularis

Question 4

transvere force couple

Answer 4

subscap

and

infra and teres minor

Question 5

function of the transverse force couple

Answer 5

they pull the humeral head into the glenoid

Question 6

frontal plane force couple

Answer 6

deltoid

and

depressors - inf RC (infra, teres minor, subsacp)

Question 7

what is the function of the frontal force couple

Answer 7

prevent the humeral head from sliding up

Question 8

what is codmans critical zone

Answer 8

this is an area of freq. tears at the insertion of the rotator cuff tendons onto the greater tubercle of the humeral head

Question 9

small tears are critical zone vascular

Answer 9

showed an increase in vascularity

Question 10

larger tears in the critical zone vascular

Answer 10

failure fo the healing process and decrease vascularity

Question 11

what is an extrinsic mech of a RC

Answer 11

orginates external from the tendon - compression or shear

subacromial impingement
internal impingement

Question 12

what is a intrinsic mech of a RC

Answer 12

orginates within the tendon - degenerative process, associated with aging

tendon - vascularity, bio, mechnical properties, morphlogies, genetics

Question 13

age and RC

Answer 13

25% of people in their 50s have RC tears

Question 14

rapture what pop

Answer 14

o Ruptures can occur in active young healthy pop

Question 15

Attritional tears demographics

Answer 15

o Age > 50
o Lateral shoulder/arm pain
o Visible atrophy
o Pain at night
o Weakness

Question 16

Examination - Attritional tears

Answer 16

 PROM maintained, AROM limited
 Abductor weakness
 Altered scapular humeral rhythmn

Question 17

Acute tears demographics

Answer 17

o Ruptures can occur in active young healthy pop
o Traumatic event - FOOSH
o Development of cute pain and weakness depends on the location and size of the tear

Question 18

Acute tears exam

Answer 18

 AROM more limited the PROM
 Pain and weakness with resisted tests

Question 19

RC tear imaging options

Answer 19

xray
MRI
ultrasound
arthoscopy
arthrogram

Question 20

what is a arthrogram

Answer 20

a type of imaging test used to look at a joint, such as the shoulder, knee, or hip.

Question 21

what are they looking for in standard x-rays

Answer 21

superior migration of the humeral head

If the RC is not attached there is nothing depressing the humeral head

Question 22

what are the options with RC tears

Answer 22

non-op management

deccompressor without repair

repair

Question 23

where is the most common site for full thickness RC tears

Answer 23

post ant RC

Question 24

what muscle part of the RC is most torn

Answer 24

supraspinatus followed by infra

Question 25

what kind of tear has the best prognosis

Answer 25

crescent shaped - AP

Question 26

what kind of tear is worse U shaped or L shaped

Answer 26

L/reverse - prognosis is fair

Question 27

what are the three presentation of RC tear that we were given

Answer 27

full/partial thickness

collins classfication - depends on type of tendon and location

cofield clasification

Question 28

is PT good for medium to small full thickness tear

Answer 28

strong evidence support PT and surgical intervention

Question 29

how can you have a small or medium full thickness tear

Answer 29

only one of the tendons can tear

not everything in the RC

Question 30

• Corticosteroid injections

Answer 30

moderate evidence of single injection for short term improvement, More than once can be pretty hard on the shoulder

Question 31

what are the three surgery options

Answer 31

arthroscopy
open
mini open

Question 32

what happens if we have a larger incision site

Answer 32

incision site – longer recovery time
- That is why surgeons try to go arthroscopic first

Question 33

risk factors for RC

Answer 33

o Smoking
o Repeated steroid injections
o Systemic disease: RA, gout, neuromuscular disorders