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TRI 3 - MSK 2 > Shoulder > Flashcards

Shoulder Flashcards

(58 cards)

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1
Q

Describe how the inferior glenohumeral ligament supports the shoulder

A

Support shoulder like like a hammock when the arm is abducted

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2
Q

Describe some characteristics of shoulder laxity

A 
Unilateral or bilateral
Identified with PROM A
Common
May not result in instability
No dysfunction or complaint
May be present but compensated for
May be congenital or secondary to poor movement
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3
Q

Describe some characteristics of shoulder instability

A

Mostly unilateral but not always
Likely to have MOI
Disfunction and complaint
Body has a hard time compensating for these

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4
Q

Define the term SLAP lesion

A

Superior labral injuries that are both anterior and posterior

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5
Q

Describe the MOI of SLAP lesions

A 
Traumatic or chronic
FOOSH
MVA
Sudden deceleration or traction forces
Chronic anterior and posterior instability
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6
Q

Describe the pathophysiology of SLAP lesions

A

Superior labrum is mobile and connected to biceps making it more vulnerable
Biceps tendon is in tact with slap lesions

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7
Q

Describe a type 1 SLAP lesion

A

fraying of edge of labrum

Pain with horizontal ABD and ER of shoulder

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8
Q

Describe a type 2 SLAP lesion

A

Detachment of labrum and biceps tendon anchor
Loss of stabilizing effect of the labrum and biceps
Most common type

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9
Q

Describe a type 3 SLAP lesion

A

Vertical tear in the labrum

Remaining labrum and biceps intact

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10
Q

Describe a type 4 SLAP lesion

A

Bucket handle tear in bicep tendon

Labral flap and biceps displaceable into GH joint

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11
Q

Describe a type 5 SLAP lesion

A

Bankart lesion of anterior capsule extending into the anterior superior labrum

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12
Q

Describe a type 6 SLAP lesion

A

Disruption of biceps tendon anchor with anterior or posterior superior labral flap tear

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13
Q

Describe a type 7 SLAP lesion

A

Extension of a SLAP lesion anteriorly to involve the area inferior to the middle GH ligament

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14
Q

Describe how a slap lesion presents

A

No specific symptoms
Pain with overhead activities
Catching or locking

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15
Q

What are some special tests to test for SLAP lesions

A 
O"brien active compression test
Clunk
Crank
Speed's
Jobe relocation
Biceps load
Anterior slide
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16
Q

How do you manage SLAP lesions

A

Exercises for dynamic stabilization

Surgery has good prognosis

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17
Q

What is the most common type of GH instability

A

Anterior

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18
Q

Describe some general presentation and MOI info on GH instability

A

Complains of slipping or popping out with overhead activities
May be traumatic, repetitive or genetic

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19
Q

Describe the presentation of anterior GH instability

A

Impingement like symptoms

Ill defined global shoulder pain, activity specific

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20
Q

Describe the MOI of GH anterior instability

A

ABD, ER, hori ABD

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21
Q

What do you check for in GH anterior instability

A

Posterior tightness as it may cause anterior translation

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22
Q

Describe some MOIs for GH Posterior instability

A

Rare

Seizure, electrick shock, diving into shallow pool, MVA

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23
Q

Describe the presentation of GH posterior instability

A

Severe pain, limited ER, less than 90 ABD
Vague pain with arm in flexed and adducted position
Clunk with shoulder movement from Flexion to ABD and ER
Posterior prominence of shoulders when observed from above

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24
Q

What are the 4 special tests to confirm GH posterior instability

Study These Flashcards
A

Kim
Jerk
O’Brian
Posterior impingement sign

25
Describe GH inferior instability
Very uncommon From carrying heavy things or extreme hyperabduction Sulcus sign used to asses inferior stability
26
Describe Multidirectional GH instability
Instability present in one or more direction | Usually present with scapulothoracic dyskinesia
27
Describe GH instability management
Strengthen dynamic stabilizers Follow specific instructions bases on method of repair Immobilize briefly for comfort
28
What types of exercises should be done for GH instability
ROM - emphasize posterior capsule with anterior instability Scapular stability - Scapular pinch, shoulder shrug, taping Closed chain - all movements of the scapula Open chain - PNF, diagonals upright rows, ER scapular retraction
29
What populations is shoulder replacement saved for
Elders | Those with unremitting pain
30
What Muscles should be examined preoperatively to total shoulder replacement
All muscles that attach to the scapula
31
What limb position is to be avoided after shoulder replacement
Active IR | Passive or active ER beyond 35-40
32
Describe unconstrained shoulder replacement
Most common | Inert humeral component with high density glenoid component
33
Describe constrained shoulder replacement
Parts are coupled and fixed to bone | Rarely used
34
Describe reversed ball and socket shoulder replacement
Humerus is socket, glenoid shaped to a ball | used when rotator cuff is compromised
35
Describe semi constrained shoulder replacement
Increased ROM Smaller humeral head head neck angle of 60
36
What are the risk factors for adhesive capsulitis
``` Thyroid disease Diabetes 40-65 Previous trauma Female having in one arm increases the likelihood of the other ```
37
How do you diagnose adhesive capsulitis
Shoulder pain for longer than 1 month Pain sleeping on shoulder Cannot lay on shoulder ROM restricted in all directions
38
What is ASES
OM for adhesive capsulitis 0-100 (best) MDC - 9.4 (use this) MCID 6.4
39
What is DASH
Disabilities of the arm shoulder and hand 0-100 (best) MCID - 10.2 MDC 10.5
40
What is SPADI
Shoulder pain and disability index 0-100 100 best MDC 18.1 MCID 8
41
Where is the dorsal scapular nerve impinged and what is the presentation
Middle scalene | scapular pain radiating to lateral shoulder and arm
42
Where is the supra scapular nerve impinged and what is the presentation
Suprascapular notch, underneath the transverse scapular ligament Posterior border of SCM Limited shoulder flexion and abduction pain with contralateral cervical rotation
43
Describe type 1-3 AC joint rehab
``` Recovery with conservative management Modalities sling 1-2 weeks Gentle ROM - isometric for clavicular attachments full activity in 12 weeks ```
44
Describe interventions for AC injuries grades 4-6
Surgical intervention | Pain free ROM - Normalize arthro - functional training
45
What is the most common direction for SC joint dislocations and some MOIs
anterior | MVA, sports
46
Describe the types of SA injuries
``` 1 - sprain of SC ligament 2 - Subluxation - A - anterior - B - posterior 3 - A - anterior dislocation - B posterior dislocation 4 - habitual dislocation ```
47
How long is the shoulder immobilized for after SC joint injury
3-4 days
48
Describe this test
Biceps load test | Deep pain indicates SLAP lesion
49
Describe this test
IRRST test weak ER - external impingement Weak IR - weak internal impingement
50
Describe this test
Kim test Posterior inferior labral lesion posterior shoulder pain
51
Describe this test
Jerk test Posteroinferior labral lesion Sharp shoulder pain
52
Describe this test
Compression rotation Labral tear Catching or snapping
53
Describe this test
Crank test | SLAP lesion
54
Describe the fulcrum test
Arm over head | Instabilities
55
Describe this test
O'Brian test labral tear Pain with internal rotation bit not external rotation
56
Describe this test
Speed test pain at bicipital groove Bicipital tendinopathy and SLAP tear
57
Describe this test
Jobe relocation Pain SLAP lesion
58
Describe this test
Anterior slide test Pain SLAP lesions

TRI 3 - MSK 2 (7 decks)

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