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Flashcards in Shoulder Questions Deck (20)
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1

What is the most common shoulder injury

impingement

2

what is the continuum of symptoms related to shoulder impingement syndrome

1. bursitis / impingement
2. partial to full rotator chug tear
3. MASSIve rotator cuff tear
4. rotator cuff arthropathy

3

Clinical of AC joint sprain

- localize pain
- worse with over head activity
- worse putting on bra

- Cross adduction test - positive
- tenderness at AC joint palpation
- Obrains is positive

4

Treatment of AC joint sprain

* Type I and II
* Conservative
* activity modification, ice, NSAIDS, ?, Sling for comfort, early ROM, shoulder girdle complex stabilization and strengthening
* Type III: Sx if doesn't respond to conservative
* Type IV-VI:
* Surgical = ORIF or distal clavicularresection with reconstruction of the CC ligament

5

Distal Clavicle Osteolysis

* Osteolysis = the pathological destruction or disappearance of bone tissue
* Pathophysiology
* Repetitive microtrauma to distal clavicle leading to osteopenia

X-ray - moth eaten appearance

6

The other name for anterior GH instability

DEAD ARM

7

Clinical Anterior GH instability

* Presentation:
* Hx of trauma
* pain
* popping
* catching
* locking
* an unstable sensation
* stiffness
* swelling
* Exam:
* Apprehension test
* relocation test
* anterior drawer test
* anterior load and shift
* sulcus sign
* generalized ligament laxity
* neuro (80-90% get axillary nerve damage)

8

Bankers

* avulses the anterior inferior glenoid labrum w/ or w/o some underlying bone from glenoid rim

9

Boney bankart

* avulses the anterior inferior glenoid labrum w/ glenoid rim fracture

10

Hill Sachs lesion

Compression fracture of the posterolateral humeral head - secondary to impact from the anterior rim of glenoid fossa

11

Posterior GH instability cause

4 E
ethanol
Epilepsy
elderly
electrocution

12

Posterior GH instability

* Arm in adducted, IR position
* Limited ER
* Pain with flexion, adduction and IR
* Posterior Apprehension Test, Posterior Drawer Test, Posterior Load and Shift Test, Sulcus Sign, general ligament laxity, neuro

13

Multidirectional instability AKA

* AMBRI
* Atraumatic
* Multidirectional
* Bilateral (frequently)
* Rehabilitation (often responds to)
* Inferior capsular shift (best alternative to noon

14

Clinical multidirectional

* Pain, instability, weakness
* paresthesia
* crepitus
* shoulder instability during sleep

15

SlAP Lesion

Superior glenoid Labral tear in the Anterior to Posterior direction

16

Impingement syndrome

* Insidious onset, anterior or lateral shoulder
* exacerbated by overhead activities and lifting objects away from body
* night pain
* stiffness, weakness, and catching might also be present

17

GIRD stands for

Glenohumeral internal rotation deficiiency

18

GIRD

* Loss of internal rotation of the GH joint compared to the contralateral side
* Seen primarily in overhead athletes

19

Frozen Shoulder mechanism

* Unclear etiology
* Contracture and thickening of the capsular tissue
* Fibroblastic proliferation seen on capsular biopsy

20

Presentation

PAIN _ STIFF_ THAWING
* PAIN - Shoulder pain –vague, worse at night and with movements
* STIFF - Reduction in both active and passive ROM
* ER is lost 1st
* ER and Abduction most significant loss
* THAWING - May have tenderness over anterior or posterior GH joint, increasing ROM