Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NMSKI > Shoulder cuff tendinopathy > Flashcards

Shoulder cuff tendinopathy Flashcards

1
Q

rotator cuff muscles

A

Supraspinatus (SST)
Infraspinatus (IST)
Teres Minor (TM)
Subscapularis (SSP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where do the supraspinatus and infraspinatus fuse

A

15mm proximal

To their insertions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what 2 muscles are inseparable

A

infraspinatus and teres minor

Proximal to their MT junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which muscle is most prone to injury

A

supraspinatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

subacromial space

A

Space between the under surface of the acromium and humeral head = 1cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

contents of subacromial space

A

Supraspinatus muscle
Long head of the biceps muscle
Subacromial bursa
Coracohumeral ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

largest bursa in the body

A

subacromial bursa - separates deltoid above Rotator Cuff below
very pain sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

rotator cuff tendinopathy

A

Pain and weakness in the shoulder,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

movements associated with RC tendinopathy

A 
most commonly associated with 
elevation
flexion
abduction
external rotation 
due to excessive load on rotator cuff tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

characteristic of RC tendinopathy

A

Overuse injury
Collagen matrix disorganised
Tendon weaker
↑ apoptosis (cell death)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

cause of RC tendinopathy

A

Altered loading
extrinsic factor
intrinsic mechanisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

extrinsic factors

A

as those causing compression of the RC tendons,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

examples of altered loading

A

sports and occupations with high levels of shoulder loading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

intrinsic factors

A 
age related - tensile tendon strength, collagen content reduced
vascularity - deficient vascular supply 
response of the tendons to tensile load
other factors
genetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

extrinsic factors

A 
Anatomical factors 
anatomical variants of the acromion and AC joint spurs (associated with osteoarthritis)
Thoracic spine kyphosis
Abnormal scapular and humeral kinematics
Internal impingement
Unique subset of patients 
Younger, related to sports
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

signs and symptoms of rotator cuff tendinopathy in subjective examination

A

Pain in upper arm
Pain worse with arm movements, esp overhead
Pain can increase at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

signs and symptoms of rotator cuff tendinopathy in physical examination

A

Pain with Shoulder Movements
Painful arc: 70-120°- most accurate test (Hermans et al, 2013)
Pain and weakness with resisted testing
Resisted External Rotation most accurate
Tender supraspinatus tendon insertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Shoulder Impingement Syndrome (SIS) aka

A

Subacromial Impingement

Rotator Cuff Impingement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Shoulder Impingement

A

Where a structure is compressed in the subacromial space between the acromium / coracoacromial arch / AC jt. (above) humerus (below) during movement
‘External Impingement’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

clinical tests for RC tendinopathy

A

RESISTED STRENGTH TESTING
Resisted Abduction, Medial Rotation, Lateral Rotation in neutral AND 90° abd
Empty can/Full Can
Painful Arc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

clinical tests for Shoulder Impingement Syndrome

A

Hawkins –Kennedy

Painful Arc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

clinical tests for RC tear

A

more weakness than pain
Lift- off sign
External rotation lag sign
Drop arm test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

painful arc test

A

Onset of pain as the humeral head passes under the acromial arch between 70 – 120° abduction
As the arm rotates and elevates further the impingement is reduced
May be more pronounced on lowering arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

empty can test

A

Arm in 90° flexion, midway abduction, internally rotated.
Apply resisted abduction- it should be painfree and show no weakness.
Positive if it reproduces the patient’s symptoms and /or

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

hawkins and kennedy test for shoulder impingement syndrome

A

Patient’s arm in 90° abduction over your arm with your hand on their shoulder
Medially rotate their humerus, then move anteriorly repeating medial rotation.
Positive if it reproduces the patient’s symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how useful is imaging?

A

Poor correlation between imaging and Symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

shoulder symptom modification procedure

A

A group of four mechanical techniques that are applied sequentially while the patient performs the activity or movement that most closely reproduces their symptoms with the aim of identifying one or a series of techniques that reduce symptoms by either decreasing pain / symptoms and/or increasing movement and function

28
Q

mechanical techniques in shoulder symptom modification procedure

A

Techniques to reduce the thoracic kyphosis
Scapular positioning techniques
Humeral head positioning procedures
Pain and symptom neuromodulation procedure

29
Q

treatment for acute reactive tendinopathy

A

Offload tendon by altering activity
Avoid aggravating activity/ relative rest
Use of taping to unload

30
Q

how is pain reduced in acute reactive tendinopathy phase

A

Pain medications
Manual Therapy may decrease pain
Steroid injection into Subacromial space may provide short-term relief, especially if Subacromial bursal involvement

31
Q

type of exercise for acute reactive tendinopathy

A

ROM to ensure passive ROM is maintained
Low-load isometrics of Rotator Cuff
Avoid heavy loading exercise

32
Q

exercise for chronic tendon disrepair

A

Reload the tendon using a supervised strengthening programme
Combination of isometric, concentric, eccentric
Functional positions

33
Q

how is normal thoracic/scapulohumeral movement restored for chronic tendon disrepair

A

Thoracic Mobility exercises e.g. Thoracic extension
Manual therapy if any glenohumeral joint stiffness
Stretch any tight muscles in scapulothoracic region
Strengthen scapular stabilisers (low evidence)

34
Q

symptoms of rotator cuff tear

A

Pain at rest and at night, particularly if lying on the affected shoulder
Pain when lifting and lowering the arm or with specific movements
Significant weakness when lifting or rotating the arm

35
Q

what movements would there be weakness in the rotator cuff tear

A

(flexion/abduction, internal and external rotation)

36
Q

signs of rotator cuff tear

A

Passive ROM is often normal
Significant loss of Active ROM esp flexion/abd/external rotation ( greater loss if full tear)
Significant loss of strength (flexion/abduction/ER)

37
Q

what do signs of rotator cuff tear depend on

A

Depending on if partial /full tear

38
Q

drop arm tests

A

Patient sitting or standing.
The arm is passively raised to above 90 abduction
The patient then actively lowers the arm to 90 abduction in internal rotation

39
Q

what is a positive rotator cuff tear for drop arm test and what does it mean

A

If the arm approaches 90 and ‘drops’, the test is positive for a full thickness tear of the rotator tear.

40
Q

external rotation lag test

A

Patient’s arm passively brought into approx 20º elevation in the scapular plane and approx 5º short of full External Rotation.
Remove your hand from their wrist, keeping other hand at elbow.
Ask them to maintain the external rotation position

41
Q

what is a positive rotator cuff tear for external rotation lag test and what does it mean

A

Test is positive if the patient is unable to maintain ER position.

42
Q

what would indicate a tear in supraspinatus or infraspinatus in external rotation lag test

A

Lag of 5-10º may indicate tear of either SST or IST or both or nerve lesion

43
Q

subscapularis tear lift off test

A

Patient sitting so that dorsum of hand rests against mid lumbar spine
Lift the distal end of patient’s forearm away from the spine so that arm is in full IR
Ask patient to maintain position

44
Q

what is a positive subscapularis tear for lift test and what does it mean

A

Positive lift off test indicates tear of SSB

Confirmed with MRI

45
Q

what does long head of bicep attach to

A

attaches to the Supraglenoid tubercle and Superior Labrum. Can be implicated in SLAP lesion

46
Q

long head of bicep pathologies

A

Bicipital Tenosynovitis / Tendinopathy
Rupture of long Head of Biceps
Subluxation of Biceps Tendon

47
Q

why is long head bicep vulnerable to bicipital tendinopathy?

A

LHB takes part in all shoulder movements and is vulnerable in the groove, hence is prone to overuse symptoms

48
Q

most usual site for bicipital tendinopathy

A

Most usual site is within the bicipital groove within synovial sheath

49
Q

aetiology of bicipital tendinopathy

A 
Overuse /Unaccustomed use
Overhead motion
Overhead serve in tennis
Catch / pull through in swimming
Follow through in golf swing
50
Q

symptoms of bicipital tendinopathy

A

History of overuse /increased loading (e.g. biceps weight training)
Anterior shoulder pain which may radiate down anterior aspect upper arm.
Aggravated by lifting
Aggravated by elbow and shoulder flexion
+Hawkins and Kennedy test esp in greater horiz adduction
+/- Positive SLAP lesion tears

51
Q

signs of bicipital tendinopathy

A

Point tenderness to palpation of biceps in bicipital groove
Pain on resisted biceps contraction: elbow flexion/ supination
Pain on stretch of biceps
Positive Speed’s Test /Yergason’s Test

52
Q

clinical tests for bicipital tendinopathy

A

yergasons test

speeds test

53
Q

Yergason’s test

A

Patient tries to supinate against resistance from therapist

54
Q

speeds tests

A

Patients flexes shoulder to 90º against resistance while maintaining the elbow in extension and the forearm in supination

55
Q

conservative management of bicipital tendinopathy

A

Relative Rest
Education on load management
Strengthening – isometric/eccentric/concentric
ROM exercise/joint mobs if ROM is restricted
Pain Meds e.g. Steroid Injection

56
Q

rupture of Long head of Bicep

A

Complete/Partial Tear

57
Q

most common patient group of rupture of long head bicep

A

Most common in middle-age/older people and is usually due to years of wear and tear on the shoulder

May occur in younger athletes occurs during weightlifting or from actions that cause a sudden load on the arm, such as hard fall with the arm outstretched

58
Q

signs of long head of bicep rupture

A

Partial tear-pain and some weakness in supination
Complete tear-less pain, more weakness
Approx loss of 20% supination strength
Obvious deformity
‘Golf ball’ appearance in the upper arm.

59
Q

symptoms of long head bicep rupture

A

Anterior shoulder pain
Sudden onset of pain assoc with event/activity
Audible ‘pop’
Pain worse with overhead activity or lifting (in supination)

60
Q

management of long head bicep rupture

A

Surgical Repair if young and play sports
Otherwise generally conservative
Deal with symptom management
Strengthening with focus on functional requirements

61
Q

long head bicep rupture may have ___% deficit

A

10-21

62
Q

subluxation of bicep tendon

A

Normally held in place in groove by transverse ligament

Subluxation associated with shallow groove

63
Q

what may cause of subluxation of bicep tendon

A

forced shoulder extension

abduction

64
Q

signs and symptoms of subluxation of bicep tendon

A

Painful clicking especially on abd/ ER/ elbow flexion
Palpable click on medial and lateral rotation
Positive Speed’s test

65
Q

management of subluxation of bicep tendon

A

Surgical repair
Post –Op Physiotherapy to restore glenohumeral
and scapulothoracic ROM and strength

66
Q

common exercises used in shoulder pathology

A 
Range of Motion (assisted active, active) 
Strengthening
Rotator Cuff and Biceps 
Scapular  
Proprioception

NMSKI (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions