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Flashcards in SLAP Deck (9):
1

Qual acréscimo o labrum dá para a glenoide?

Saha has shown that adding the glenoid labrum increases the glenoid surface to 75% of the humeral head vertically and 57% in the horizontal direction.

2

Como o labrum atua nas forças compressivas aplicadas ao membro superior?

Labrum affects the distribution of contact stresses when a compressive load is applied to the shoulder at 90 degrees of abduction.

3

Quais são os mecanismos de lesão do labrum superior mais comuns?

The most common mechanisms of injury to the superior labrum (i.e., SLAP lesions) are extrinsic secondary to traction on the upper extremity and intrinsic during the throwing motion, which likewise produces traction on the biceps anchor.

4

Como ocorre a lesão de "peel-back" no labrum?

A second mechanism of injury proposed by Burkhart and Morgan is torsional peel-back of the posterior superior labrum during the cocking phase of throwing.

5

Como é dividido didaticamente o labrum? Quais lesões estão associadas à lesão do manguito e do bíceps? Quais estão associadas à instabilidade?

To aid in localizing the site of labral injury, the glenoid labrum has been divided into six areas: (1) the superior labrum, (2) the anterior labrum above the midglenoid notch, (3) the anterior labrum below the midglenoid notch, (4) the inferior labrum, (5) the posteroinferior labrum, and (6) the posterosuperior labrum. Lesions located above the equator of the glenoid (a line drawn between the 3-o’clock and 9-o’clock positions on the glenoid) often are associated with rotator cuff or biceps disease. Lesions located below the equator, most commonly split, nondetached lesions anteriorly and posteriorly, are highly suggestive of shoulder instability.

6

Como é a classificação de Snyder para lesões SLAP?

Type I lesions, which can be treated with simple débridement, are described as fraying of the superior labrum with a solid biceps tendon anchor attachment. Type II lesions involve pathological detachments of the labrum and biceps anchor from the superior part of the glenoid. These lesions most commonly progress posterior to the biceps but may progress anterior or both anterior and posterior to the biceps attachment at the supraglenoid tubercle.

7

Quando é evidenciada a instabilidade biceps-labral?

Biceps-labral instability is evidenced by labral displacement of 3 mm or more with traction on the biceps tendon, hemorrhage, or fibrous granulation tissue at the insertion with long-standing lesions and superior articular cartilage changes.

8

Como é realizado o peel-back test descrito por Burkhart?

The peel-back test as described by Burkhart is used to evaluate for posterior extension of the lesion by removing the arm from traction and placing it in 90 degrees of abduction. The labrum is observed to displace medially on the scapular neck as the shoulder is externally rotated to 90 degrees.

9

Qual a característica das faces internas e externas do labrum?

On the inner side, the labrum is continuous with the hyaline cartilage of the glenoid, and on the outer side, it is continuous with the fibrous tissue of the capsule.