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MSK III > Shoulder > Flashcards

Shoulder Flashcards

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
Q

How should we address tendon pathology in inflammation phase to healing phase ?

A

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
Q

What is the most common type of shoulder instability?

A

ANT instability 90%

27
Q

How can we improve scapular proprioception?

A

perturbations, closed chain, tilt board, plyometrics,

28
Q

What is a SLAP tear?

A

Superior Labrum anterior & posterior (glenoid labrum tears)

29
Q

How do SLAP tears typically happen?

A

Repetitive overhead activities, trauma, sudden avulsion of biceps tendon, hypermobilty or instability.

30
Q

Common exam findings of a slap tear?

A

Deep pain, Hx of overuse or trauma, Clicking, popping or catching.

31
Q

What is the best of all Slap tear tests if done correctly?

A

Active compression O’Briens

32
Q

What slap lesion grades (1-4) involve the biceps tendon

A

2 & 4

33
Q

How to treat SLAP tear Post-OP ???

A

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
Q

Causes of AC joint sprain or dislocation?

A

FOOSH or repetitive reaching (across chest or overhead).

35
Q

What grades of AC joint sprain dont need surgery?

A

grade 1-3

36
Q

Special Tests for AC joint ???

A

AC horizontal adduction test
&
AC resisted extension test

37
Q

Treatment for grade 1-3 AC joint sprain?

A

Reduce pressure for ligaments to heal, restrict reaching, limit lifting, ICE, immobilize (sling), FULL PROM BY WEEK 2-3 (pendulums, door pulleys)

38
Q

Who is more likely to have MDI ?

A

Younger people under 40, women, people with hypermobility.

39
Q

Best test clusters for for MDI ??

A

Sulcus sign
Load and shift
Arc of pain
History/complain

40
Q

Interventions for MDI?

A

Strengthen (balance all muscles), RC and scapular stabilizers, dynamic stability.

41
Q

Post op protocol for Biceps Tenodesis?

A

No resisted elbow or shoulder FLX 6-8 weeks, Early shoulder ROM to full, slow strengthening.

42
Q

Post op interventions for biceps tenotomy?

A

No precautions but respect tissue, delay resistive activities.

43
Q

How does the active compression test work for SLAP tears??

A

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
Q

Name the other Slap tear tests?

A

Modified dynamic sheer test
Biceps load test
resisted supination with ER

45
Q

What is the long head of biceps tear tests ???

A

Throwers Test
& Active compression test
& palpation within proximal groove

46
Q

Best Cluster for MDI tests???? Anterior Specific (3 of them)

A

Load and shift
Sulcus Sign
Apprehension test

47
Q

Tests for Posterior Specific Labral tear ? (bank hart)

A

Jerk test &
Kim Test

MSK III (4 decks)

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