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Musculoskeletal Pathophysiology > Shoulder Dysfunction > Flashcards

Flashcards in Shoulder Dysfunction Deck (49):
1

How are rotator cuff diseases classified?

Neer Classification of Rotator Cuff Disease: Stage I -III

2

Tendonopathy with repeated insult that causes decreased integrity of soft tissues resulting in partial or full tendon tear can be classified as:

stage III

3

Theories of RC injury?

avascularity
mechanical wear
micro/macro trauma

4

Explain the avascular component of RC injury

"wringing out" occurs with prolongued/repetitive overhead activities resulting in loss of blood flow

5

What is tendonosis?

intra-tendon degeneration

6

What is sprengels deformity?

failure of scapula to defend

7

What is erb's palsy?

obstetrical brachial plexus traction injury

8

Describe stage II RC disease.

fibrosis of the cuff, permanent and irreversible changes, 25-40 years

9

Where is pain typically present with subacromial/subdeltoid bursitis:

pain near end of ROM

10

Adhesion or shortening of GH capsule may lead to

adhesive capsulitis "frozen shoulder"

11

What are the two causes of adhesive capsulitis?

trauma or idiopathic

12

How long does it take for idiopathic adhesive causalitis to resolve?

12-18 months

13

Describe Freezing Idiopathic Adhesive Capsulitis

First 4-6 months
very painful
losing ROM

14

Describe Frozen Idiopathic Adhesive Capsulitis

Second 4-6 months
pain decreases
very stiff

15

Describe Thawing Idiopathic Adhesive Capsulitis

Third 4-6 months
less pain
increasing motion

16

How is adhesive capsulitis managed?

priority: pain control
maintain ROM as much as possible (consider phase)

17

Describe GH dislocation presentation

o 95% Anterior: cannot touch opposite shoulder
o 5% Posterior: cannot ER arm

18

What is bankart lesion arthrogram?

Glenoid labral tear assiated with GH dislocation

19

What is SLAP lesion?

a forceful tearing of the labrum near the insertion of the biceps tendon that usually occurs with dislocation of shoulder

20

Hill-Sachs Lesion

Posterolateral indentation fx of humeral head associated with anterior GH dislocation

21

What is the incidence of hill sachs lesion with recurrent dislocations?

80% incidence in recurrent dislocations

22

What is the conservative treatment for shoulder dislocations?

Reduction
Immobilization in slip (up to 3 wks)
Progressive mobilization
shoulder strengthening (RC especially)

23

What does the Bankart surgery repair?

Repair by suturing the leabrum and capsule

24

Do you get full ROM back with a Bankart Arthroscopic surgery?

YEs

25

What is a capsular shift surgery?

Tightening of the anterior capsule

26

What is a method used for a capsular shift?

Electrothermally assisted capsular shift

27

Do you get full ROM back with a capsular shift surgery?

May loose a little ROM

28

What is done with a bristow Arthrotomy?

For recurrent dislocations, the coracoid is moved to the anterior glenoid

29

What is a grade 1 AC sprain?

Tender at AC, sprain of AC ligaments, NO deformity

30

What is a Grade 2 AC sprain?

Increased displacement of clavicle. Tear of both superior and inferior AC

31

What is a grade 3 AC sprain?

Complete disruption, marked deformity, complete tear of AC ligaments and CC ligaments (trapezoid and conoid

32

What is a piano key sign?

Push down on the distal clavicle and it springs back up like a piano key

33

What is a conservative management of an AC sprain/dislocation
?

Immobilize in a kenny-howard sling for 3-6 weeks

34

What is a surgical management of an AC sprain/dislocation?

ORIF with a rockwood screw only if severe

35

What movement precautions should you take post AC dislocation?

Horizontal Adduction
Abduction above 90 degrees

36


What are SC joint sprains/dislocations usually secondary to?



Trauma (MVA), direct blow to sternum, or FOOSH(or A)


37

What situation would a SC joint dislocation be a medical emergency?

If it translates posteriorly due to the proximity of the trachea and subclavian artery/nerve

38

What are two of the most common fxs of the proximal humerus?

Nondisplaced greater tuberosity fx
Clavicular Fx

39

What are proximal humeral fxs and clavicular fxs usually caused by?

FOOSH's

40

What is the female:male ratio for proximal humeral fxs?

2:1 female to male ratio

41

How does Neer classify Shoulder fractures?

4 part system based on the relationship of the following bone parts and the amt of displacement:
Articular fragment of the head
lesser tuberosity
Greater Tuberosity
Shaft

42

What would a two part fx consist of?

Displacement between any two of the 4 parts of Neers shoulder fx classification (i.e. greater tuberosity and shaft)

43

What is the conservative management of a proximal humeral fracture?

sling for 10-21 days IF non-displaced. THEN gradual mobility

44

When do use a sling for a proximal humoral fx post-op?

If displaced by >1 cm, or if in 45 deg. angulation, you will be in a sling several weeks post op

45

What is lipohemarthrosis?

the mixture of fat and blood in a joint cavity following trauma

46

WHat are some considerations post humeral fracture?

potential for post-immobilization adhesive capsulitis
Stability of fx
Potential for CRPS (formerly shoulder-hand syndrome)

47

How long are you in a sling post clavicular fx?

2-3 week

48

How and when are clavicular fxs surgically repaired?

Only for severe fxs, they use a plate and screw fixation

49

How does erb's palsy present?

shoulder adducted/IR
forearm pronated
wrist flexed
absent biceps reflex