Shoulder Flashcards

(47 cards)

1
Q

What is the Cluster for Subacromial pain syndrome?

A

+ Neer or Hawkins
+ painful arc
+ Painful ER

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2
Q

Interventions for Subacromial pain syndrome include?

A

Joint mobs (GH, Thoracic, Scapulothorasic)

Stretching (pecs)

Scapular stabilization/strength training

RC weakness

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3
Q

Subacromial impingement can fall into any category except?

A

radicular pain

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4
Q

What is a bankkart lesion ?

A

detachment of ant or post labrum

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5
Q

Special test cluster for ANT instability

A

apprehension/relocation
sulcus sign
load and shift

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6
Q

Frozen shoulder will present with what symptoms ?

A

Pain near insertion of deltoid, inability to sleep on affected side, painful and restricted AROM & PROM

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7
Q

Stages of adhesive capsulitis?

A

Stage one: 0-3 months pain, rom limitations
Stage two: freezing stage, 3-9 months, chronic pain with AROM & PROM
Stage 3:Frozen stage 9-15 months, minimal pain except at end range
Stage 4: Thawing stage: 15-24 months, minimal pain

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8
Q

What do you have to rule out if you suspect adhesive capsulitis (frozen shoulder) ????

A

Rotator cuff injury

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9
Q

How can you rule out adhesive capsulitis (frozen shoulder)?

A

if PROM is normal with no pain.

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10
Q

How can we rule in adhesive capsulitis vs rotator cuff pathology?

A

age 40-65, progressive worsening, gradual onset of pain, if GH IR & ER ROM decreases when abducted from 45 to 90

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11
Q

Interventions for adhesive capsulitis?

A

Passive ROM, AAROM, ESTEM, HEAT/ICE, Low to high grade mobs

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12
Q

What is the most common tendon pathology?

A

Supraspinatus tendon

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13
Q

What movements cause symptoms for supraspinatus tendinopathy??

A

Resisted FLX/ABD

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14
Q

What tendon can be injured during deceleration phase of overhead sports?

A

infraspinatus tendon

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15
Q

What causes most pain with infraspinatus tendinopathy?

A

Resisted ER

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16
Q

What may present similar to subacromial pain syndrome?

A

Supraspinatus/infraspinatus pathologys

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17
Q

How can we rule in tendon pathology as opposed to subacromial pain syndrome?

A

***PEARL: when we load tendon, pain will present (which is not common for subacromial pain syndrome)

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18
Q

How can we rule in subacromial pain syndrome as opposed to tendon pathology?

A

during passive ROM no pain or significantly less with tendon pathology

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19
Q

What are the special tests for supraspinatus?

A

Empty can test
Full can test
Champagne Toast test

20
Q

What is the special test for infraspinatus tear??

A

Resisted ER at 45 deg abduction

21
Q

What are the test for biceps tendiopathy? Extra articular

A

Speeds test
&
Yergasons test

22
Q

What are the Tests for FULL RTC Tear of supraspinatus ?

A

Drop arm test aka Drop arm sign

23
Q

What is the test for FULL RTC of infraspinatus??

A

External Rotation Lag Sign

24
Q

What are the special test for FULL RTC Tear of Subscapularis?

A

Belly Press Test
&
Internal Rotation Lag Sign

25
How should we address tendon pathology in inflammation phase to healing phase ?
Control inflammation with modalities, minimize load on tendon, cross friction soft tissue massage, eccentrics and stretching can help. UNLOAD TENDON AFTER INFLAMATION PHASE. Then heavy slow resistance scapular retraining T spine mobility
26
What is the most common type of shoulder instability?
ANT instability 90%
27
How can we improve scapular proprioception?
perturbations, closed chain, tilt board, plyometrics,
28
What is a SLAP tear?
Superior Labrum anterior & posterior (glenoid labrum tears)
29
How do SLAP tears typically happen?
Repetitive overhead activities, trauma, sudden avulsion of biceps tendon, hypermobilty or instability.
30
Common exam findings of a slap tear?
Deep pain, Hx of overuse or trauma, Clicking, popping or catching.
31
What is the best of all Slap tear tests if done correctly?
Active compression O'Briens
32
What slap lesion grades (1-4) involve the biceps tendon
2 & 4
33
How to treat SLAP tear Post-OP ???
week 1-3 treat inflammation, Start with low level isometrics Week 3-4: Progress ROM and strengthening (not aggressive) NO FORCEFUL Stretching into ABD/ER NOOOO biceps resistance in SLAP lesions
34
Causes of AC joint sprain or dislocation?
FOOSH or repetitive reaching (across chest or overhead).
35
What grades of AC joint sprain dont need surgery?
grade 1-3
36
Special Tests for AC joint ???
AC horizontal adduction test & AC resisted extension test
37
Treatment for grade 1-3 AC joint sprain?
Reduce pressure for ligaments to heal, restrict reaching, limit lifting, ICE, immobilize (sling), FULL PROM BY WEEK 2-3 (pendulums, door pulleys)
38
Who is more likely to have MDI ?
Younger people under 40, women, people with hypermobility.
39
Best test clusters for for MDI ??
Sulcus sign Load and shift Arc of pain History/complain
40
Interventions for MDI?
Strengthen (balance all muscles), RC and scapular stabilizers, dynamic stability.
41
Post op protocol for Biceps Tenodesis?
No resisted elbow or shoulder FLX 6-8 weeks, Early shoulder ROM to full, slow strengthening.
42
Post op interventions for biceps tenotomy?
No precautions but respect tissue, delay resistive activities.
43
How does the active compression test work for SLAP tears??
Step 1: patient flexes arm to 90 deg, full IR, then apply force. Step 2: same except have them fully supinate hands, and push down. If step one cause pain & step two is not painful it is + ASK TO POINT WHERE PAIN IS, if its at the AC joint it is AC joint pathology, if it is deep it is biceps labral pain.
44
Name the other Slap tear tests?
Modified dynamic sheer test Biceps load test resisted supination with ER
45
What is the long head of biceps tear tests ???
Throwers Test & Active compression test & palpation within proximal groove
46
Best Cluster for MDI tests???? Anterior Specific (3 of them)
Load and shift Sulcus Sign Apprehension test
47
Tests for Posterior Specific Labral tear ? (bank hart)
Jerk test & Kim Test