Shoulder Eval and Dx

Question 1

what is an important shoulder question?

Answer 1

does it go past your elbow?

Question 2

what kind of pain goes past your elbow?

Answer 2

cervical root damage

Question 3

what is the most common rotator cuff tear?

Answer 3

superspinatous

Question 4

why might you watch a pt undress himself?

Answer 4

assesses actual pain (differentiates real from fake pain)

Question 5

what is important when inspecting?

Answer 5

compare bilaterally

Question 6

what does the rotator cuff do?

Answer 6

“humeral head depressor”

Question 7

what is the most common age for rotator cuff?

Answer 7

40s, 50s, 60s

Question 8

when might you use a goniometer?

Answer 8

when you have to document for workman’s comp

Question 9

what would pain on a Neer’s sign mean?

Answer 9

impingement under acromion

Question 10

what would pain on Hawkin’s sign menan?

Answer 10

impingement on coracoacromial ligament

Question 11

what would cross body adduction pain mean?

Answer 11

pain at AC joint

Question 12

what would positive apprehension test mean?

Answer 12

sense of impending anterior dislocation

Question 13

what is the most common shoulder dislocation?

Answer 13

abduction, external rotation

Question 14

what is pain with obriens maneuver mean?

Answer 14

anterior labral tear

Question 15

what is does a positive sulcus sign mean?

Answer 15

inferior instability

Question 16

what does a positive jerk test mean?

Answer 16

excessive laxity of humeral head relative to glenoid

Question 17

what is stage 1 rotator cuff dz?

Answer 17

<25 yo
non-operative
acute, resolving inflammation

Question 18

what is stage 2 rotator cuff dz?

Answer 18

25-40 yo
progresses to fibrosis and tendonitis
requires operative intervention

Question 19

what is stage 3 rotator cuff dz?

Answer 19

> 40 yo
mechanical disruption of the rotator cuff tendon
osteophytosis along anterior acromion
surgery usually required

Question 20

what usu. causes rotator cuff dz?

Answer 20

repetitive overhead movements or trauma

Question 21

what is characteristic of rotator cuff pain?

Answer 21

does not radiate past elbow
pain with overhead movements
night time pain

Question 22

what PE findings are common with rotator cuff pain?

Answer 22

+ Neer sign
+ Hawkins sign
pain with FF
weakness

Question 23

which imaging study is the gold standard for rotator cuff?

Answer 23

MRI

Question 24

what is stage 1 txment for impingement?

Answer 24

NSAIDS
injection
PT
avoid overhead activities
\+/-MRI

Question 25

what is stage 2 txment for impingement?

Answer 25

arthroscopic subacromial decompression distal clavicle resection evaluation/ possible rotator cuff repair

Question 26

what is stage 3 txment for impingement (tear greater than 4.5 cm)?

Answer 26

possible open repair
graft (depending on age)
total shoulder arthroplasty

Question 27

what time frame should you refer?

Answer 27

if pain is greater than 6 months

Question 28

what is a speeds test?

Answer 28

test biceps tendonitis

slap hand, resist motion

Question 29

what is yergason’s test?

Answer 29

resist supination and rotation

tests biceps tendonitis

Question 30

what nerve root radiates abdominal pain into shoulder?

Answer 30

C4