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Flashcards in Shoulder Deck (29):
1

What is the role of the fibrocartilaginous labrum in shoulder stability?

increases articulating surface area
enhances stability

2

What are the four muscles of the rotator cuff?

supraspinatus
infraspinatus
teres minor
subscapularis

3

What motions does supraspinatus aid in

depresses and centers the humeral head in the glenoid as the deltoid abducts the arm

4

What motions do infraspinatus and teres minor aid in

external rotation

5

What motion does subscapularis aid in?

internal rotation

6

Describe subacromial impingement

Previous injury to the AC joint, degenerative changes secondary to overuse and/or aging can result in spurring at the undersurface of the AC joint and/or calcification of the coracroamial ligament, decreasing the space beneath the coracoacromial arch, leading to subacromial impingement.

7

What tendon is most commonly involved in rotator cuff injuries?

supraspinatus

8

What group are at greatest risk of acute rotator cuff injury?

over 40 years, activity induced

9

Describe chronic rotator cuff injuries

subacromial impingement
tendinosis
tears
more common with aging, degeneration, overuse, external or internal comrpession

10

Describe the pain associated with rotator cuff pathology

- anterolateral shoulder pain, particularly with reaching overhead or behind the back.
- radiates to the deltoid region, may also radiate to the neck or down the arm to the elbow
- pain worse at night in tears

11

Describe the pain associated with rotator cuff pathology

- anterolateral shoulder pain, particularly with reaching overhead or behind the back.
- radiates to the deltoid region, may also radiate to the neck or down the arm to the elbow
- pain worse at night in tears

12

Patients older than 50 years are likely to have true bony impingement from _______ and thus have pain even at rest, as well as shoulder weakness

subacromial spurring

13

_____ is the gold standard for imaging rotator cuff pathology

MRI

14

Subacromial impingement is an _____ condition wherein there is decreased space between the undersurface of the acromion and supraspinatus leading to pain and dysfunction

extrinsic

15

Rotator cuff _____ is a degenerative process of the tendon including varying degrees of inflammation and degeneration.

tendinosis

16

Rotator cuff tendinosis is commonly associated with ______ __________

subacromial impingement

17

Describe treatment for rotator cuff tears

- smaller tears with minimal functional defects (ex older patients) treated with injections and PT
- surgery for large acute tears, tears of any size in young active patients

18

Surgical intervention for rotator cuff tears must address all associated pathology including:

removal of spurs from acromian/ AC joint
treatment of biceps tendon pathology
treatment of labral or chondral damage

19

Most anterior shoulder dislocations produce a _____ lesion

Bankart- tearing of anterior inferior labrum and capsule

20

Anterior shoulder dislocations can also impact on the posterior superior humeral head and produce a _______ lesion

Hill Sachs- indentation of the humeral head

21

Anterior shoulder dislocations can also impact on the posterior superior humeral head and produce a _______ lesion

Hill Sachs- indentation of the humeral head

22

Shoulder dislocations often involve neuropraxia from traction on the _______ nerve

axillary

23

What sorts of trauma are associated with posterior shoulder dislocations?

electrocution, gran mal seizure

24

Describe the presentation of a patient with an acute anterior shoulder dislocation

arm held in externally rotated, abducted position
shoulder has anterior fullness and loss of normal deltoid contour

25

Describe treatment for shoulder dislocations

- reduce ASAP
- period of immobilization
- PT
- surgery for young athletes with Bankart lesions to reduce risk of repeat dislocation

26

Describe treatment for shoulder dislocations

- reduce ASAP
- period of immobilization
- PT
- surgery for young athletes with Bankart lesions to reduce risk of repeat dislocation

27

AC sprains/ shoulder separations usually occur by what kind of injury?

direct fall on the acromian

28

AC sprains/ shoulder separations usually occur by what kind of injury?

direct fall on the acromian

29

Describe treatment for shoulder separations

- conservative- sling and ice if mild
- surgical repair if severe