Shoulder

Question 1

Resting position of the GH joint

Answer 1

40° to 55° abduction, 30° horizontal adduction

Question 2

Close Packed Position of GH joint

Answer 2

Full abduction, lateral rotation

Question 2

common missing ligament

Answer 2

middle GH Ligament

Question 2

What type of pain is diffusing or throbbing

Answer 2

vascular

Question 2

What is the provocation motion for each:
Anterior Impingement:
Posterior Impingement:

Answer 2

Anterior Impingement: IR
Posterior Impingement: AbER

Question 2

What type of pain is sharp, lightning

Answer 2

nerve

Question 2

What type of acromion morphology is most impinged?

Answer 2

Type 3 Hooked
*easy to fracture

Question 2

Closed packed position of AC joint

Answer 2

90° abduction

Question 2

Resting position of AC joint?

Answer 2

Arm resting by side in normal

Question 2

What is the most common type of Acromion morphology?

Answer 2

Type 2 (Curved)

Question 2

Resting and Closed Packed position of SC joint

Answer 2

Resting joint: arm resting by side in normal physiological position
Close packed position: Full elevation and protraction

Question 2

What type of pain is deep aching pain

Answer 2

bone

Question 2

Pain that is deep, boring toothache like pain that worsen in the night

Answer 2

A tear in a muscle, Rotator Cuff

Question 2

What type of pain is deep, boring, toothache like pain

Answer 2

Thoracic Outlet Syndrome

Question 2

Paratenonitis vs Tendinitis

Answer 2

Paratenonitis - inflammation of the paratenon (covering of the tendon); fascia ng tendon
Tendinitis - inflammation of the whole tendon, pathology related to tendon (inflamed, torned, etc)

Question 2

Type of SLAP lession that is small tear on sup labrum
detached biceps tendon from supraglenoid
instability on labrum-biceps complex

Answer 2

TYPE II

Question 3

TUBS vs AMBRI

Answer 3

TUBS: Traumatic onset Unidirectional anterior with a Bankart Lesion responding to Surgery
Trauma, Unidirectional, Bankart, Surgery

AMBRI: Atraumatic cause, Multidirectional with bilateral shoulder findings with rehabilitation as appropriate treatment and rarely inferior capsular shift surgery

Question 3

What type of pain is dull, cramping

Answer 3

Muscle

Question 3

T or F
if right handed, right shoulder is higher

Answer 3

FALSE
if right handed, right shoulder is lower

Question 3

What age groups are prone to each of these conditions?
Rotator Cuff Degeneration:
Rotator Cuff Tear:

Answer 3

Rotator Cuff Degeneration: 40 - 60 y/o
Rotator Cuff Tear: Any Age

Question 3

What is the Provocative motion for:
Anterior Instability & Bankart:
Posterior Instability & Slap Lesion:

Answer 3

Anterior Instability & Bankart: AbER
Posterior Instability & Slap Lesion: AdIR

Question 3

Weakness of TRAPZ, CN 11 (ACCESSORY NERVE) Will result to what type of scapular winging?

Answer 3

TRAPZ, CN 11 (ACCESSORY NERVE) - Lateral Winging

Question 3

If the injury/lesion is between the 3-7 o’clock position, it is?

Answer 3

If the injury/lesion is between the 3-7 o’clock position, it is Bankart

Question 3

1 25 yo male was referred to you for evaluation and treatment. Patient complains of shoulder weakness and difficulty performing activities of daily living. Upon assessment, you noticed that the scapula depresses with the inf angle rotating laterally during shoulder abduction. this movement of the scapula becomes more prominent upon applying resistance at 90 degrees of shoulder abduction. Identify the possible cause of this deformity.

Answer 3

Spinal accessory nerve injury

Question 3

, a depression above the humeral head and below the acromion process

Answer 3

SULCUS SIGN

Question 3

If the injury/lesion is between 10-2 o'clock, it is a?

Answer 3

SLAP LESION

Question 3

Weakness of SERRATUS ANTERIOR, LONG THORACIC NERVE will result to what type of scapular winggng?

Answer 3

SERRATUS ANTERIOR, LONG THORACIC NERVE - Medial Winging (tignan parati ang inferior angle)

Question 3

Bankart lesion Type III vs Type IV

Answer 3

III: bucket handle tear on sup labrum; labral biceps attachment IV: bucket handle tear on sup labrum with tear on biceps tendon

Question 4

Can occur due to an excessive protracted scapula during arm motion

Answer 4

SCAPULAR DYSKINESIA

Question 5

In Kibler's classification for scapular dyskinesia, What pattern is being described? What is the affected muscle? lift away, classic winging

Answer 5

2 Weak Serratus Anterior

Question 5

In Kibler's classification for scapular dyskinesia, What is the affected muscle? elevate

Answer 5

3 tight levator scapulae and upper trapezius

Question 5

In Kibler's classification for scapular dyskinesia, What is the affected muscle? rotate laterally, rotate winging

Answer 5

4 Weak Upper trapezius

Question 5

In Kibler's classification for scapular dyskinesia, What is the affected muscle? inferomedial border prominent at rest and the inferior angle tilts dorsally with movement, while acromion tilts anteriorly over the top of thorax

Answer 5

1 tight pectoralis minor

Question 6

SCAPULAR WINGING Primary vs Secondary

Answer 6

SCAPULAR WINGING Primary Muscle Weakness Secondary pathology in glenohumeral joint

Question 6

SCAPULAR WINGING Dynamic VS Static Winging at Rest

Answer 6

Dynamic Winging with movement (due to muscle weakness, nerve injury) Static Winging at Rest (due to structural deformity - scapula, ribs, spine)

Question 6

Malposition of Scapula, prominence of Inferior medial border of scapula, Coracoid pain and malposition, and scapular dysKinesia

Answer 6

“SICK” Scapula

Question 7

1 25 yo male was referred to you for evaluation and treatment. Patient complains of shoulder weakness and difficulty performing activities of daily living. Upon assessment, you noticed that the scapula depresses with the inf angle rotating laterally during shoulder abduction. this movement of the scapula becomes more prominent upon applying resistance at 90 degrees of shoulder abduction. Identify the possible cause of this deformity.

Answer 7

Spinal accessory nerve injury

Question 7

If the injury/lesion is between the 3-7 o'clock position, it is?

Answer 7

Bankart

Question 8

If the injury/lesion is between 10-2 o'clock, it is?

Answer 8

SLAP LESION

Question 9

in the painful arc how many degrees are, Glenohumeral painful arc: Acromioclavicular painful arc

Answer 9

Glenohumeral painful arc: (45-65) - 120 Acromioclavicular painful arc : 170 - 180

Question 10

What phase in the SCAPULOHUMERAL RHYTHM is 60° abduction, 90° lateral rotation 30° rotation 30°-50° posterior rotation, up to 15°

Answer 10

Phase 3

Question 10

Ssx of Possible Peripheral Nerve Involvement Pain on flexing fully extended arm Inability to flex fully extended arm Winging starts at 90° forward flexion

Answer 10

Long thoracic nerve

Question 10

What phase in the SCAPULOHUMERAL RHYTHM is Humerus; 30° abduction Scapula; Minimal movement (setting phase) CLavicle: 0°-5° elevation

Answer 10

Phase 1

Question 10

Ssx of Possible Peripheral Nerve Involvement Increased pain on forward shoulder flexion Shoulder weakness (partial loss of humeral control) Pain increases with scapular abduction Pain increases with cervical rotation to opposite side

Answer 10

Suprascapular nerve

Question 10

What phase in the SCAPULOHUMERAL RHYTHM is Humerus: 40° abduction Scapula: 20° rotation, minimal protraction or elevation, and possibly posteriorly tilt Clavicle: 15° elevation and posterior rotation at sternoclavicular joint

Answer 10

Phase 2

Question 11

Ssx of Possible Peripheral Nerve Involvement Inability to abduct arm with neutral rotation

Answer 11

Axillary (circumflex)

Question 11

Ssxof Possible Peripheral Nerve Involvement Weak elbow flexion with forearm supinated

Answer 11

Musculocutaneous nerve

Question 11

If the scapula is fx what nerve could be affected?

Answer 11

If nafracture ang scapula pwedeng madale ang SUPRASCAPULAR NERVE dahil umiikot ito dito

Question 12

Ssx of Possible Peripheral Nerve Involvement Inability to abduct arm beyond 90° Pain in shoulder on abduction

Answer 12

Spinal accessory nerve