Rotator Cuff Tendinopathy Flashcards Preview

724: Medical Lectures > Rotator Cuff Tendinopathy > Flashcards

Flashcards in Rotator Cuff Tendinopathy Deck (31)
1

__-__% of the general population suffers from shoulder pain

16-34

2

Is inflammation present in RC tendinopathy?

Minimal role early on

3

What patieint populations are at risk for RC tendinopathy?

manual laborers and those whose work involves a great deal of repetitive motion

4

True or False

In the general population as well, rotator cuff disease is the most common cause of shoulder pain

True

5

What tendon is the most frequently injured?

supraspinatus

6

Other than job activities what are 4 other risk factors for RC tendinopathy?

- anatomic variants
- older age
- high BMI
- instability or hypermobility of the glenohumeral joint (not due to muscle weakness)

7

What does the supraspinatus do?

abduction and external rotation

8

What does the infraspinatus do?

abduction and external rotation

9

What does the teres minor do?

abduction and external rotation (especially when the arm is abducted to 90 degrees)

10

What does the subscapularis do?

internal rotation, also assists in abduction and adduction

11

True or False

There is a definitive pathophysiology and mechanism of injury for rotator cuff tendinopathy

False

12

What are the 2 theories of the pathophysiology and MOI for rotator cuff tendinopathy?

- Biomechanical factors
- Vascular factors

13

What does an alternative approach to describing the mechanism of injury involve?

- intrinsic factors, directly related to the tendon
- extrinsic factors, related to surrounding structures

14

What are 7 differential diagnoses to RC tendinopathy?

- cervical radiculopathy
- acromioclavicular osteoarthritis
- subacromial bursitis
- bicipital tendinopathy
- rotator cuff tear
- glenoid labrum tear
- adhesive capsulitis

15

Describe the clinical presentation of a patient with RC pathology

- Shoulder pain with overhead activity
- Pain at night (especially when lying on the affected shoulder)
- Weakness
- Decline in performance

16

Where do patients describe pain at?

lateral deltoid

17

What does the physical examination reveal?

- muscle atrophy of the affected muscle
- tenderness upon palpation
- referred neck pain
- painful ROM above 90 degrees of abduction, or pain with internal rotation

18

Pain that occurs between __-__ degrees of active abduction marks a positive arc test

60-120

19

What tests examines the supraspinatus?

"empty can" (Jobe's strength) test

20

What tests examines the infraspinatus?

resisted ER strength test

21

What tests examines the subscapularis?

Push off (Gerber's) test

22

What are the 2 special tests to assess shoulder impingement?

- Neer
- Hawkins-Kennedy

23

What is considered the gold standard for the initial evaluation of tendon disorders?

musculoskeletal ultrasound

24

Is musculoskeletal ultrasound highly specific or sensitive?

sensitive

25

When should orthopedic referral be obtained?

if nonoperative therapy fails to provide relief within six to nine months or a diagnosis of rotator cuff tear is made

26

What are the 3 basic surgical interventions?

- debridement
- acromioplasty with debridement
- rotator cuff repair

27

What does acute therapy involve?

- Cryotherapy
- Rest
- NSAIDS
- Electrical stimulation, phonophoresis and iontophoresis
- Therapeutic Ultrasound
- Laser

28

What does subacute therapy involve?

- Glucocorticoids
- Topical Glyceryl trinitrate
- Experimental therapy

29

What do topical glyceryl trinitrates do?

They cause local vasodilation, increasing blood flow to the damaged tendon

30

What are the 3 complications associated with RC tendinopathy?

- Significant loss of shoulder ROM
- Adhesive capsulitis
- Tendon tears

31

The likelihood of these complications increases with what?

age