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ICP > Spring ICP Exam 2 > Flashcards

Spring ICP Exam 2 Flashcards

1
Q

Influencing Factors on the Shoulder

A

Stability (Static and Dynamic)
Scapular Muscles
Force Couples
Trunk and Hip
Posture
Cervical and T-Spine

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2
Q

2 mobs to increase extension

A

PA glide and PA Spring

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3
Q

4 joints of the shoulder

A

Sternoclavicular
Acromioclavicular
Scapulothoracic
Glenohumeral

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4
Q

How does the shoulder match up in relation to mobility and stability?

A

Great mobility w/ limited stability

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5
Q

What does the humeral head articulate with?

A

Glenoid (Flat)

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6
Q

Ability of the rotator cuff and long head of biceps provide what?

A

Dynamic Stability

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7
Q

During overhead motion, The supraspinatus does what to the head of the humerus while the other rotator cuff muscles do what?

A

Compress, Depress

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8
Q

Movement of scapula relative to the humerus?

A

1:2 scapula to humeral movement

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9
Q

Initial 30 degrees of glenohumeral abduction does…..

A

Does not incorporate scapular motion

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10
Q

30 to 90 degrees

A

The scapula abducts upwardly rotates 1 degree for every 2 degrees of humeral elevation

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11
Q

Above 90 degrees

A

The scapula and humerus move in 1:1 ratio

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12
Q

SICK Shoulder

A

Scapular malposition
Inferior medial winging
Coracoid tenderness
Scapular dyskinesia

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13
Q

When is the SICK shoulder visable?

A

Elbow Flexion 90
Abduction 90
ER

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14
Q

Scapular Dyskinesis Stats

A

64% instability
100% impingement
72% in healthy population

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15
Q

Why do we care about Scapular Dysfunction?

A

Scapular motion is critical for normal motion of the UE
The critical link between trunk and UE
The site of multiple muscular attachment
Provide a mobile base for the humerus to maintain GH stability

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16
Q

Posterior displacement of medial border and/or inferior angle away from thorax

A

Scapular Dyskinesis

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17
Q

Premature or excessive elevation or protraction, non-smooth/stuttering motion, or rapid downward rotation during arm lowering

A

Dysrhythmia

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18
Q

Causes of Scapular Dyskinesis

A

Poor Posture
Soft Tissue Changes
Reduced GH mobility
Lower Scap weakness
Upper Trap hyperactivity
Acute injury

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19
Q

Limited IR when compared to ER
20 degree deficit in IR from side to side
Limited by posterior musculature and capsule tightness
Morphological changes in bone also occur

A

Glenohumeral internal rotation deficit (GIRD)

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20
Q

Scap dyskinesis rehab

A

Re-establish coordinated UE movement
Increase endurance
Scap stabilization exercises that minimize upper trap and levator scap and normalize upward rotation of scapula

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21
Q

TUBS

A

Traumatic Onset, Unidirectional anterior with a Bankart lesion responding to Surgery

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22
Q

AMBRI

A

Atraumatic cause, Multidirectional with Bilateral shoulder findings with Rehabilitation as an appropriate treatment and, rarely, Inferior capsular shift surgery

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23
Q

Permanent anterior defect of labrum

A

Bankart lesion

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24
Q

Compression of cancellous bone against anterior glenoid rim creating a divot in the humeral head

A

Hill Sachs lesion

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25
Q

3 types of repair for Bankart lesion

A

Arthroscopic - most common, not good for younger age, hyper lax, male, contact sports
Open Capsular Shift - lower recurrence, results in motion loss and can be used in contact athletes
Bony - creates a bony block to instability

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26
Q

SLAP tear

A

Not usually associated with instability
Onset in sport
Type II most common
Mechanical, posterior/deep pain, decreased force production
Surgery = 30% return to baseball at former level

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27
Q

Initial management of SLAP lesion

A

Overhead:
Non-operative route first
Decrease pain/Improve function/RTP
Guided injection + rest
3-6 months non-op management before surgery

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28
Q

Adolescents and Throwing

A

Tensile forces on medial elbow
Medial elbow p! = Little League Elbow in skeletally immature athletes

29
Q

Presents as a gradual onset of discomfort during the throwing motion with aching following activity. Can lead to avulsion. Accompanied by increased volume and intensity. May have slowed throwing velocity and diminished accuracy.

A

Apophysitis

30
Q

Apophysitis treatment

A

Rest for 4-6 weeks, start RTT program after another 6 weeks of rehab

31
Q

If Apophysitis leads to avulsion, treatment plan?

A

Treat non-op with 2-4 weeks immobilized to hinged elbow brace for another 6-8 weeks then follow with rehab

32
Q

If there are compressive forces on lateral elbow with lateral elbow pain, what do we want to rule out

A

OCD

33
Q

Often presents with more severe pain and limitations. Disruption in subchondral blood to capitellum. Radial head can be involved as progresses and loose bodies may be present

A

OCD

34
Q

How to treat stable OCD lesions of the capitellum

A

Non-op with activity restriction and close observation. Surgical management is diverse and may include open/arthroscopic debridement, loose body removal, microfracture, or drilling. Average RTS is 6 months

35
Q

Lateral Epicondylitis

A

Kinetic Chain Theory = Dual rehab for scapula and elbow
Good evidence for proximal and radioulnar joint mobs

36
Q

An intervention aimed at affecting the neural structures or surrounding tissue directly or indirectly through exercise or manual techniques. Normally divided into “sliders” and “tensioners”

A

Neural Mobilization

37
Q

Actions that elongate the nerve bed through movement at one joint while moving another to relieve tension in the nerve. Also known as “neural flossing”

A

Sliders

38
Q

Joints are moved in such a way that the nerve bed is elongated and the tension in nerves is increased

A

Tensioners

39
Q

Before doing neurodynamics

A

Ensure tissue mobility is good by working on pain, swelling, joint motion, fascial movement, and tissue extensibility/length

40
Q

Why use slider?

A

Don’t increase tension/compression, decrease pain, increase excursion of nerve

41
Q

Why use tensioner?

A

More progressive, makes viscoelastic and physiological changes to nerve tissue

42
Q

Parameters for Neurodynamics

A

Low Reps/Sets
10-15 slow reps (3-5 sec), 3-5 times per day

43
Q

Manual and Exercise technique, uses maximum facilitation of neural input to produce maximum output response. Uses dermal receptors, muscle spindles/GTOs, and visual/auditory/tactile stimulation.

A

Proprioceptive Neuromuscular Facilitation (PNF)

44
Q

The body naturally moves in functional patterns that are multi-joint and involve

A

Diagonals and spiral motions

45
Q

PNF Techniques

A

Rhythmic Stabilization
Rhythmic Initiation
Slow Reversal
Slow reversal-hold
Agonist Reversal

46
Q

Place extremity into any part of the D1 or D2 movement pattern and have the pt hold the position isometrically with perturbations

A

Rhythmic Stabilization

47
Q

Rhythmic motion of the limb or body through the desired range, starting with passive motion and progressing to active resisted movement

A

Rhythmic Initiation

48
Q

Have pt move through pattern (both flexion and extension) and using an isotonic concentric contraction

A

Slow Reversal

49
Q

Same as Slow reversal but hold isometrically at end ROM for 6-10 seconds

A

Slow reversal-hold

50
Q

Have pt move through pattern using an isotonic concentric contraction in one direction and then “reverse” the agonist role into an eccentric contraction to resist moving back to the starting position

A

Agonist Reversal

51
Q

D1 pattern

A

Buckle your seat belt

52
Q

D2 pattern

A

Drawing your sword

53
Q

UCL provides how much support

A

54%, able to resist 32 NM of strain
Youth - 28 NM
HS pitchers - 48 NM
College pitchers - 55 NM
Pro pitchers - 64 NM

54
Q

Osseous provides how much support

A

33%, lateral compression at radiocapitellar joint

55
Q

Soft tissue provides how much support

A

13%, FCU + FCR = 15%, Pronator Teres = 7%

56
Q

Risk of elbow pain increased by 6% for every _ pitches and _ % over 75 pitches

A

10 pitches, 50%

57
Q

Deficit of what increases risk of UCL injury

A

IR

58
Q

UCL Rehab Considerations

A

Type of repair/reconstruction
Position/Level of Play
Elbow position and exercise
Underlying factors
Rotator cuff and forearm conditioning
Proprioception
LE and lumbopelvic strength and stability

59
Q

Traumatic anterior shoulder dislocations have been reported in how much of Gen Pop?

A

1.7%

60
Q

Anterior dislocations make up how much of all shoulder dislocations

A

90%

61
Q

Highest rates of shoulder dislocations are found in?

A

Contact sports

62
Q

In 45% of injured athletes due to shoulder dislocation, how much time did they miss

A

Greater than 10 days

63
Q

Recurrence rates of shoulder dislocation based on age

A

52% if 1st SD was under 23 y/o
18% if 1st SD was over 30 y/o

64
Q

Common pathology related to SD

A

Hills-Sachs lesion
Glenoid bone loss
Alpsa lesion (non-acute)
Prolonged instability
HAGL (Humeral avulsion of GH ligament)

65
Q

AMBRI vs TUBS

A

“Born Loose” vs “Torn Loose”

66
Q

3 purposes of Glenoid Labrum

A

Increase surface contact area
Buttress
Attachment site for GH ligament

67
Q

Risk factors for impingement

A

Pathomechanics
Acquired instability overuse syndrome (AIOS)
IR deficit and implications
Scapular dyskinesis

68
Q

2 primary causes of Internal Impingement

A

Excessive Humeral Head translations (leads to microinstability and IR deficit)
Abnormal scapular patterns (leads to dyskinesis and retractor deficiency)

ICP (3 decks)

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