Quiz 2

Question 1

What are the typical Subacromial impingement sxs

Answer 1

• anterior/lateral shoulder pain
• c/o overhead activity
• gradual or sudden onset
• night pain

Question 2

Does decompression surgery for SIS work?

Answer 2

not as well as therex,MT, other surgeries

Question 3

Scapular dyskinesia

Answer 3

• may be associated with SIS
• usually reduced UR
• increased ant. tilting

Question 4

RCT neer classification type 1

Answer 4

-less than 25, reversible, swelling, tendonitis, no tear

Question 5

RCT neer classification Type 2

Answer 5

25-40, permanent scarring, tendonitis, no tears

-subacromial decompression

Question 6

RCT neer classification type 3

Answer 6

• over 40, small RC tear,

- SAD w/debridement and repair

Question 7

RCT neer classification type 4

Answer 7

• over 40, large RC tear,

- SAD with repair

Question 8

Rotator cuff tear thickness (explain)

Answer 8

• partial thickness can heal
• full thickness cannot
• full thickness can have depth that reaches bone

Question 9

Rotator cuff tear size (explain)

Answer 9

• small < 1cm

- large > 1cm

Question 10

RCT traumatic tears

Answer 10

• usually FOOSH
• supraspinatus usually involved (84%)
• conservative care is less effective
• surgery for younger pts is good for this

Question 11

Risk factors for degenerative RCT

Answer 11

• smoking
• hypercholesterolemia
• genetics
• age
• conservative care is favored

Question 12

Poor prognosis factors RCT

Answer 12

• more pain
• less motion
• older
• large/full thickness tear
• > 1 year duration

Question 13

RCT examination findings

Answer 13

• scapular dyskinesia
• limited elevation
• muscle belly atrophy

Question 14

What is the most common cause of shoulder dislocation?

Answer 14

• trauma (96%)

- 90% anterior 10% posterior

Question 15

Special tests for shoulder instability

Answer 15

• sulcus sign
• apprehension test
• jobe relocation

Question 16

Scapula motor control should focus on what?

Answer 16

• middle/lower trap

- serratus

Question 17

Therex for middle/lower trap

Answer 17

• prone Ys and Ts, horizontal abd, ext,

- rows

Question 18

Therex for serratus

Answer 18

• wall walks, push up plus

- punches, med ball throws

Question 19

Rotator Cuff interval

Answer 19

-triangular space between, subscap, supraspinatus, and coracoid process, and roof of coracohumeral ligament

Question 20

Epidemiology of Frozen shoulder

Answer 20

• ages 40-65
• 10-20% with DM or thyroid disease
• 70% female

Question 21

Primary frozen shoulder

Answer 21

-insidious onset, no other associated disease

Question 22

Secondary diabetic frozen shoulder

Answer 22

• increase severity

- poor prognosis

Question 23

Secondary frozen shoulder

Answer 23

• associated with other shoulder pathology

- poor prognosis

Question 24

What are the initial symptoms of adhesive capsulitis

Answer 24

• diffuse severe pain lasting for more than 1 month
• similar to SIS or RTC
• progresses to limited motion/capsular end feel, and severe end range pain

Question 25

Adhesive capsulitis ER ROM stages

Answer 25

mild >45° moderate 11-45° severe <10°

Question 26

Adhesive capsulitis Exam findings

Answer 26

- diffuse pain - decreased AROM and PROM w/ ER most significant - scapular compensations - capsular end feel - normal mid range strength

Question 27

Adhesive capsulitis treatment goals

Answer 27

- relieve pain - restore movement - regain function

Question 28

Freezing stage PT

Answer 28

- pain relief - pt education - exercise w/in pain limits - corticosteroid injections

Question 29

Frozen and Thawing PT

Answer 29

- increase ROM - more aggressive active and passive techniques - DO NOT TORTURE PTS

Question 30

Risk factors for chronic neck pain

Answer 30

- age >40 - LBP - Hx of neck pain - cycling - loss of strength in hands - poor QoL

Question 31

Neck pain with Radiating pain signs

Answer 31

+ spurlings, + ULTT distraction test - <60° rotation to involved side

Question 32

Neck pain w/ mobility deficits signs

Answer 32

<50 years old - acute neck pain <12 weeks - sxs isolated to neck - decreased cervical ROM

Question 33

Cervical Mobility class Interventions

Answer 33

- C and T spine mobs | - Scalene, trap, lev scap, pec maj, min flexibility

Question 34

Cervical Manipulation CDR (6)

Answer 34

- NDI <11.5 - bilateral involvement - not performing sedentary work - feeling better with motion - no worse with cervical ext - diagnosis of spondylosis w/o radiculopathy

Question 35

T spine manipulation CDR

Answer 35

- sxs < 30 days - no sxs distal to shoulder - looking up does not aggravate sxs - FABQPA score <12 - decreased upper T spine kyphosis T3-5 - cervical ext <30°

Question 36

4 tests for cervical radiculopathy

Answer 36

spurling test upper limb tension test (Median nerve) -cervical distraction -cervical rotation <60° to involved side

Question 37

Pts with cervical radic likely to respond to PT

Answer 37

- <54 years - dominant arm not affected - looking down does not aggravate sxs - multimodal Rx for >50% of visits

Question 38

Pts likely to respond to cervical traction

Answer 38

- >55 years - + shoulder abduction test - + ULTT - sxs peripheralization with C4-C7 PA motion - + cervical distraction test

Question 39

Pain control interventions

Answer 39

- Gentle AROM w/in pain tolerance - modalities - control pain

Question 40

Role of deep neck flexors

Answer 40

- support cervical lordosis - eccentric control during ext - segmental control during head and UE movement

Question 41

Role of deep neck extensors

Answer 41

- stable base for sub occipital muscles to control small movements of head - eccentric control during flexion - segmental control

Question 42

Who do thoracic compression fractures happen in?

Answer 42

white, old, small, nutrient deficient (vitamin D Calcium), women

Question 43

PT for osteoporosis

Answer 43

- WB exercise - spinal extensor strengthening - balance - LE strength

Question 44

Percutaneous vertebroplasty

Answer 44

-injection of low viscosity bone cement into vertebral body

Question 45

Balloon Kyphoplasty

Answer 45

inflation of one or two intervertebral body balloons to create void for injection cement

Question 46

Open balloon kyphoplasty

Answer 46

-usually traumatic fractures, non osteoporotic bone, with lami or fusion