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MSK basics > shoulder 3 - tests and injuries > Flashcards

shoulder 3 - tests and injuries Flashcards

1
Q

what are the two presenation of a hypermobile shoulder

A

TUBS and AMBRI

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2
Q

what is the TIBS hypermobile shoulder presentation

A

traumatic

unidirectional

bankart lesion

surgical repair

EX: I did this activity and my shoulder fell apart

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3
Q

TUBS - unidiretional

A

anterior

posterior - more traumatic

inferior

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4
Q

TIBS- bankart lesion

A

A tear that happens in the lower rim of the labrum.

The rim of the glenoid being torn off as the humeral head slides forward with friction, boney – tear off a portion of the bone as well

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5
Q

what leads to a anterior instability

A

post directed force with arm in ER and abd

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6
Q

what leas to a post instability

A

post directed force with the arm flexed and internally rot

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7
Q

what leads to an inf instability

A

inf force with the arm in abd

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8
Q

what is the AMBRI presentation

A

Atraumatic

multidirectional

bilateral

rehab

inferior capsule shift

beightons scale

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9
Q

what is the general presentation of someone with shoulder instability

A

instability and apprehension

weakness with overhead activities

loss of power and coordination

may have some clicking snapping and popping

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10
Q

what is the test for multidirectional instability

A

sulcus sign

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11
Q

what are the test for anterior instability

A

anterior apprehension

anterior drawer

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12
Q

what a is a general test for shoulder instability

A

load and shift test

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13
Q

what are the test for posterior instability

A

posterior drawer test

postierior apprehension, jerk, kim

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14
Q

what is the intervention for instability

A

strengthing of the RC and scapular

side lying ER

prone I, Y, T

other exercises to target specific musculature

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15
Q

what is the positive load and shift

A

clicking, popping, pain provocation

Evaluating the glide of the humeral head in the glenoid

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16
Q

what is a apprehension test

A

: apprehension that is reduced/ eliminated with relocation maneuver

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17
Q

what is a positive anterior drawer test

A

humeral head slides past coracoid

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18
Q

what is a positive posterior drawer test

A

the thumb is felt to slide past the coracoid.

a little pain but the pt may be apprehensive

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19
Q

what is a positive for the posterior apphrehension test

A

Looking for apprehension and pain

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20
Q

what is a positive test for the Jerk test and kim test

A

sudden onset of sharp posterior shoulder pain indicates a positive test result, with or
without a clunk

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21
Q

what is a positive sulcus sign test

A

too much inf translocation

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22
Q

o-deg sulcus sign is test

A

the superior capsule

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23
Q

90-deg sulcus sign is testing what

A

the inferior capsule

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24
Q

what is the MOI of a SLAP lesion

A

fall on a outstretched arm

traction on the long head of the biceps associated with overhead throwing activities

internal impingement

peel back of the labrum due to towist of the biceps tendon during abd and ER

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25
what are the symptoms of a slap lesion
pain and mechanical catching and grinding - LHB clicking instability
26
what are the test for a slap lesion
O'brein's anterior slide test crank test biceps load one and two
27
what is the procedure for O'breins test
arm flexed to 90, 10-deg of abd downward force is applied to the arm in full supination and pronation
28
what is a positive O'briens test
pain with the hand is in supination (IR) that reduced when the arm is in pronation (ER)
29
O'brein's pain felt inside of the shoulder
labral lesion
30
O'brein's pain felt up top of the shoulder
AC joint lesion
31
what is a postive anteiror slide test
pain of click in the front of the shoulder
32
what is the procedure for cranks test
pt sitting or supine arm abd 160 passivly IR and ER the arm while applying an axial load
33
what is a positve cranks test
click or pop
34
what is the procedure for the biceps load test
- Arm position: 900 of abduction, extreme ER, supinated - Try to pull the pt elbow into flexion
35
what is a positive biceps load test
is pain with contraction of biceps
36
what is the difference between biceps load 1 and 2
- Arm position: 1200 of abduction
37
what is a the best diagnostic test for the slap lesion
biceps load 1 and 2
38
what are speed and yergason test for
Labral tears and Evaluation of Biceps Tendon Long Head
39
what is the procedure for speeds test
stand (liked) or sitting - arm is flexed to 90°, elbow extended, and the forearm fully supinated. - Examiner applies a downward force
40
what is a positive speeds test
is reproduction of pain in the proximal shoulder during internal rotation
41
what is a positive yergusons test
reproduction of pain in the proximal shoulder specifically the bicepetal groove
41
what is the procedure for yerguson test
- The elbow is flexed to 90° - PT force into pronation and elbow extension (down) while palpating the long head of the biceps at the bicepetal groove.
42
what is the other name for a hypomobile shoulder
adhesive capsulitis
43
what is the general presentation of adhesive capsulitis
painful loss of shoulder motion of unknown orgin - rest, night, age > 40 insidious inability to sleep through the night ROM limitation
44
what is the main feature of adhesive capsulitis
pain is the predominant initial feature followed by progressive loss of motion
45
what ROM limitation do we see with adhesive capsulitis
ER - 30-deg, usally greater then 50% elevation - less then 120 IR less limited
46
look at the pre freezing chart and stuff
please
47
what is the intervention of choice for adhesive capsulitis
mobs - indicated if ROM is limited
48
how do we know when to progress from the resting poistion for mobs of the shoulder
start in the resting position and progress into the restricted ranges of motion based on the pain presentation of the patient and their tolerance
49
what is the procedure for GH distraction
70-deg of abd in the capsular plain
50
how do we improve flexion
Glenohumeral Posterior Inferior Glide
51
how do we improve abd
inferior glide
52
how do we improve ER
anterior glide
53
how do we improve IR
posterior glide
54
what is the resting and restricted position for - Glenohumeral Inferior Glide
resting - arm at you side restricted - end range ABD
55
what is the resting and restricted position for - Anterior Glide
resting - side lying arm at pt side restricted - pt prone with arm on PT's leg at end range ER
56
what is the resting and restricted position for - Posterior Glide
resting - pt prone arm at side restricted - pt prone with arm at end range IR against PT leg
57
what is the resting and restricted position for - Glenohumeral Posterior Inferior Glide
resting restricted - pt supine, arm at end range flexion
58
what are some stretching exercise that the pt can do at home or in clinic
cane movement
59
what are the spectrum of RC injuries
sprain tendionopathy artial tear full tear
60
the patient is strong and painful
contractile tissue - tendon or muscle
61
the patient is strong and painless
no issues
62
the patient is weak and painful
acute or serious pathology
63
the patient is weak and painless
nerve lesion or complete rupture or the muscle/tendon
64
what kind of athletes are RC injuries seen
throwing athletes
65
acute RC tears presentation
tarumatic event - FOOSH acute pain and weakness AROM more limited then PROM pain and weakness with resisted test
66
attritional RC tears
age > 50 lateral shoulder and arm pain visable atrophy pain at night weakness PROM good AROM limited abd weakness
67
what is the cluster for a full thickness tear
drop arm sign painful arc infraspinatus lag sign
68
what are special test for RC tear
supraspinatus - full can, empty can infraspinatus - lag sign teres major - lag sign subscapularis - belly push and lift off
69
for the full RC tear cluster what number is needed
3/3 or 2/3 there is an increase in the liklihood ratio
70
weak shoulder what is a another name for it
SAPS
71
Primary SAPS - what is it
structural narrowing of the acromion space changes to the underside of the acromion maybe - soft tissue swelling
72
secondary SAPs - what is it
functional narrowing of the SAP due to abnormal arthro normal anatomy at rest with an impigment that occurs with movement
73
what can funtional SAPs be due to
loss of dynamic stablizer - RC and long head of the biceps posterior capsule tightness glenohumeral instability altered scapular upward rotation
74
what is the common complaints with SAPs
lateral or anterior shoulder pain with overhead activities pain with reaching across hard time sleeping
75
what are the test for SAPs
hawkins kennedy neer painful arc relocation test empty can test ER test
76
what is the procedure for neer's test
the pt is sitting or standing place the pt arm in the scapular plane with the palm facing away from the body PT behind the pt and applies an inferior force at the shoulder - stablizing the scapula bring the arm into flexion
77
what is a positive neer's test
reproduction of pain
78
what is the procedure for hawkins kennedy
pt standing or sitting Passively place pt arm into 90° of shoulder flexion and 90° of elbow flexion Forcefully moves the arm into internal rotation Passive
79
what is a positive hawkins kennedy
reproduction of pain with IR
80
what is hk looking at
eval of impingment
81
Posterior relocation is looking at what
Internal impingement
82
what is the procedure for the posterior relocation test
Pt supine, towel under shoulder, arm 90-90 Put the pt into ER until we have apprehension Then apply posterior force to the humeral head – there should be less apprehension Slowly lift hand away to see if they are apprehensive again
83
what is a positive posterior relocation test
posterior pain that is reduced/ eliminated with relocation maneuver
84
how do we treat SAPs
we want to work on the shoulder depressor (infra, teres minor, and subscap), these keep the acromion out from under itself

MSK basics (20 decks)

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