shoulder conditions

Question 1

most common fracture of the humerus is what

Answer 1

proximal humerus fx

Question 2

what causes a proximal humerus fracture?

Answer 2

falling onto shoulder
direct blow to lateral arm

Question 3

Neer Classification

Answer 3

1: no fragment displacement greater than 1cm or >45 degrees angulation
2: involves the humeral head and surgical neck or humeral head and greater tuberosity
3 or 4: involves the humeral head and greater and less tuberosity

Question 4

with the classification what is the surgical procedure and risks

Answer 4

1: non-operative/conservative
2: ORIF; mod risk of AVN
3: ORIF or hemiarthroplasty; high risk AVN
4: total shoulder arthroplasty; high risk AVN

Question 5

non-operative treatment considerations for a proximal humeral fx

Answer 5

sling worn for 1-3 weeks
client can sleep in upright position for comfort

Question 6

timeline for a proximal humerus fx

Answer 6

AROM: 4-6 weeks post op
Strengthening: 8-12 weeks post op
assess sensation over deltoid to rule out axillary nerve injury

Question 7

OT interventions for a non-operative proximal humerus fx

Answer 7

minimize pain
edema control
AROM ASAP
shoulder pendulem extercises
passive table top exercises

Question 8

thoracic outlet syndrome is the space between __ and ___ which is a pathway for ___ and ___ structures to the arm

Answer 8

clavicle and 1st rib
neural and vascular

Question 9

TOS is the compression of

Answer 9

the brachial plexus and/or the subclavian artery/vein

Question 10

symptoms of TOS

Answer 10

pain in neck, shoulder, or arm
numbness/tingling in fingers
impaired circulation in arm

Question 11

activities that may increase TOS symptoms include

Answer 11

trauma to shoulder girdle
sustained work with arm above head
carrying heavy loads
hyperabduction
poor posture

Question 12

what can poor posture look like in TOS

Answer 12

dropped shoulders

Question 13

4 possible areas of TOS

Answer 13

scalene triange
costoclavicular space
pectoralis minor space
sternocostoclavicular

Question 14

scalene triangle borders and contents

Answer 14

anterior scalene, middle scalene, 1st rib, and inferior scalene
trunks and roots of the plexus and subclavian artery

Question 15

scalene triangle compression due to

Answer 15

compression of the nerves between the anterior and middle scalenes

Question 16

cervical rib is what

Answer 16

an extra rib off of C7 which is congenital

Question 17

costoclavicular space borders and contents

Answer 17

clavicle and 1st rib
divisions of the plexus and subclavian artery and vein

Question 18

pectoralis minor space contents and MOI

Answer 18

cords of the brachial plexus and subclavian artery and vein
repetitive overhead motions

Question 19

compression in the pectoralis minor space

Answer 19

compression beneath the coracoid process and pec minor inserstion

Question 20

sternocostoclavicular space borders and contents

Answer 20

ant: sternum post: spinal column lateral: 1st rib
roots of the plexus, subclavian artery and vein, jugular vein, and neck lymphatics

Question 21

a compression in the sternocostoclavicualr space is usually caused by what

Answer 21

tumors in the lungs, thymus, parathyroid gland, or lymph nodes

Question 22

Roo’s Test

Answer 22

targets entire TOS

Question 23

Adson’s test

Answer 23

targets scalene triangle

Question 24

Eden’s Test

Answer 24

targets costoclavicular space

Question 25

Wright's Test

Answer 25

targets pectoralis minor space

Question 26

adhesive capsulitis/frozen shoulder is the progressive loss of ___ ___

Answer 26

glenohumeral ROM

Question 27

frozen shoulder is the ___ and ____ with loss of ___ recess

Answer 27

tightening and thickening; axillary

Question 28

primary classification of frozen shoulder

Answer 28

idiopathic goes through three phases

Question 29

secondary classification of frozen shoulder

Answer 29

caused my a event prior to shoulder freezing does not go through three phases

Question 30

phases of frozen shoulder

Answer 30

1. freezing 2. frozen 3. thawing

Question 31

freezing phases occurs within

Answer 31

6-9 weeks

Question 32

freezing phases characteristics

Answer 32

painful, interrupts sleep, painful with ADLs ROM near WNL and pain before end range hard to distinguish no specific tenderness strength near normal decreased use due to pain

Question 33

frozen phases occurs when

Answer 33

immedeiatly after freezing phase 4-6 months

Question 34

frozen phase characteristics

Answer 34

decrease in pain but may still be present at end range

Question 35

thawing phase occurs when

Answer 35

6 months to 2 years

Question 36

characteristics of the thawing phase

Answer 36

gradual return on ROM

Question 37

how to know which phase of FS you are in?

Answer 37

pain with resisted ROM than freezing pain only at end range then frozen/thawing

Question 38

most common type of GHJ instability?

Answer 38

anterior

Question 39

bankhart lesion

Answer 39

anterior dislocation of shoulder causing a tear in the anterior (inferior) glenoid labrum

Question 40

Hill-Sachs Lesion

Answer 40

anterior dislocation causing a posterior lateral compression fracture

Question 41

SLAP Tear

Answer 41

superior labral tear anterior to posterior due to overhead/throwing activities tear at LH of biceps tendon and labrum

Question 42

SLAP tear related to

Answer 42

asymmetrical capsular tightness

Question 43

impingment is a sign of

Answer 43

RTC disease

Question 44

what space is the impigement likely occuring in

Answer 44

subacromial space

Question 45

what are the contents of the subacromial space?

Answer 45

supraspinatus insertion, infraspinatus insertion, origin of the LH biceps, subacromial bursa

Question 46

stage 1 of the Neers for impingment is

Answer 46

edema and hemorrhaging age: 25 DD: shoulder sub lux tx: conservative cc: reversible pain with painful arc

Question 47

stage 2: fibrosis and tendonitis

Answer 47

age: 25-40 dd: frozen shoulder: tx: surgery cc: reacurrent pain with acitivty

Question 48

stage 3: bone spurs and tendon rupture

Answer 48

age: 40+ tx: surgery cc: progressive

Question 49

acromian types

Answer 49

I: straight II: curve III: hook

Question 50

painful arc at 60-120 degrees means what

Answer 50

subacromial impingement (GHJ)

Question 51

painful arc at 170-180 degrees means what?

Answer 51

ACJ disorder

Question 52

what muscle is affected by pain with resisted ER

Answer 52

infraspinatus

Question 53

what muscle is affected by painful resistance to IR

Answer 53

subscapularis

Question 54

what muscle is affected by painful resisted abduction?

Answer 54

supraspinatus

Question 55

lateral elevation lateral elevation with palm up

Answer 55

supraspinatus subscapularis

Question 56

empty jar test

Answer 56

supraspinatus 90 abduction, 30 flexion, thumbs down

Question 57

gerber lift test

Answer 57

subscapularis place hand behind back with palm out and lift off back

Question 58

hornblowers test/patte test

Answer 58

teres minor and infraspinatus

Question 59

speeds test

Answer 59

LH biceps tendon 90 degrees flexion, palms up, resist downward motion

Question 60

neers test

Answer 60

subacromial impingment -go to end range flexion and than IR

Question 61

hawkins kennedy test

Answer 61

supraspinatus flex 90 at shoulder and elbow in front of body and then full IR

Question 62

RTC drop test

Answer 62

tear of the supraspinatus or infraspinatus

Question 63

TOS exercises

Answer 63

scalene stretch, pectoral strecth, scapular sqeezes, arm wall slides, thoracic extension

Question 64

pedulum exercises do what and what are the movements

Answer 64

increase circulation by increasing speed of removal of waste products and decrease soreness movements: side to slide, forward and back and circular