Shoulder 1

Question 1

What is the capsular pattern of the shoulder?

Answer 1

ER lost first

ABD

IR

Question 2

Describe the GH capsule

Normal fluid volume?

How is fluid volume effected by different conditions

Answer 2

Capsule is loose, ligaments are discrete capsular thickening

Normal fluid volume: 10-15ml

adhesive capsulitis: 5-10ml

Capsular laxity: 15-30ml

Question 3

When is the superior GH ligament taut?

Answer 3

When arm is by side in 0 degree abduction

Question 4

What ligament is the main static stabilizer of the abducted shoulder

Answer 4

Inferior complex of GH

Question 5

Describe the posterior GH capsule

Answer 5

Thin and useless

Most stability comes from the muscles

Question 6

What does it mean if you have pain when relaxing later on after doing a fatiguing activity for your shoulder

Answer 6

Instability

Note: scapular squeezes are good exercise for instability

Question 7

The AC joint is ONLY controlled by:

Answer 7

passive structures

No active structures

Question 8

If a patient says “I separated my shoulder” what joint are they likely talking about

Answer 8

AC joint

specifically the coracoclavicular ligament

Question 9

The sternoclavicular joint is only controlled by ______ structures

Answer 9

Passive structures

No active structure

Question 10

The scapulo-thoracic joint is only controlled by ____ structures

Answer 10

Active

Question 11

What is reverse scapulo humeral rhythms

Answer 11

Often seen in adhesive capsulitis and RTC

Pt moves twice as much in scapula as GH joint

Question 12

What is the open packed position of the GH joint

Answer 12

55 abd

30 horizontal add

Question 13

Decrease grip strength can be a sign of….

Answer 13

Neurological problems

In addition to numbness, tingling, heaviness

Question 14

What age groups are most effected by humeral epiphysis and osteogenic sarcoma

Answer 14

Children and adolescents

Question 15

Rotator cuff degeneration typically occurs in _______

Answer 15

40-60 years old

Question 16

Secondary impingement due to instability (caused by weakness) typically occurs in…

Answer 16

Teens-20s especially in overhead athletes

Question 17

Calcium deposits in shoulder are most common in what ages

Answer 17

20-40

Question 18

Adhesive capsulitis is common between what ages

Answer 18

45-60

Also associated with DM and ischemic heart disease

Question 19

Symptom behavior: pain relieved w arm held in dependent position(gravity NOT pulling on arm)

Answer 19

Thoracic outlet syndrome

Question 20

Symptom behavior: pain relieved by circumduction of shoulder w accompanying click or clunk

Answer 20

Internal derangement or GH instability

Question 21

Symptom behavior: Pain relieved w elbow supported

Answer 21

AC joint separation

RC tears

Question 22

What is the most common pathology in the shoulder, 70% of patients

Answer 22

Impingement/rotator cuff pathology

Question 23

Rotator cuff tear size classification:

Small:

Medium:

Large:

Massive:

Answer 23

Small: less than 1cm
Medium: 1-3 cm
Large: 3-5cm
Massive: 5+cm

Question 24

What demographics are associated with adhesive capsulitis

Answer 24

45-60 y/o

Female

Trauma

DM and thyroid disease

Question 25

T or F: 20-30% of people will subsequently develop adhesive capsulitis in opposite shoulder

Answer 25

T

Question 26

What are the 4 stages of adhesive capsulitis

Answer 26

Stage 1: pt ignores symptoms. Under 3 months Stage 2: freezing for 3-9 months Stage 3: frozen 9-14 months Stage 4: thawing 14+ months

Question 27

How does adhesive capsulitis present

Answer 27

Progressing pain w/o mechanism of injury Progressive loss of ROM in 2+ planes

Question 28

What does PT do for stage 1 adhesive capsulitis

Answer 28

Not much.. pain control maybe? If they are even seen by PT

Question 29

What would PT do for stage 2 adhesive capsulitis

Answer 29

Pain control and manual therapy

Question 30

What would PT do for stage 3 adhesive capsulitis

Answer 30

Pain has resolved, focus on restoring normal motion

Question 31

PT goals for stage 4 adhesive capsulitis

Answer 31

Continue to restore normal motion and strength

Question 32

Glenohumeral instability differential diagnosis (key positive findings)

Answer 32

40+ Hx of dislocation/sublux Apprehension Laxity

Question 33

If a patient has no history of dislocation and no apprehension it is unlikely that they have

Answer 33

Glenohumeral instability

Question 34

T or F: Gleno-humeral joint instability is a noncontractile problem

Answer 34

T

Question 35

Non contractile problem that presents with pain w/ overhead activities and at end ROM Feeling of looseness, slipping of shoulder

Answer 35

GH instability

Question 36

Most GH dislocations are…

Answer 36

Anterior 90% of all dislocations

Question 37

What is the MOI of anterior GH dislocation

Answer 37

Abd ER ext

Question 38

A hill sach’s lesion is more likely to happen with

Answer 38

Repetitive instability

Question 39

What is the MOI of a SLAP lesion

Answer 39

Trauma, fall, catch a heavy object, repetitive microtrauma

Question 40

What kind of joint instability can mimic a RTC tear

Answer 40

SLAP lesion

Question 41

Traumatic OA for the shoulder is common in

Answer 41

45+

Question 42

What is the MOI of AC joint dysfunction

Answer 42

Trauma or Chronic secondary to OA, or RA

Question 43

What is the most common fx in children

Answer 43

Clavicle fractures

Question 44

What part of the humerus is most commonly fractured

Answer 44

Proximal humerus fractures Common in children and elderly