PCE > Shoulder > Flashcards

Shoulder Flashcards

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1
Q

Resting packed position of shoulder

A

Flexion, abduction, slight internal rotation

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2
Q

Capsular pattern of shoulder

A

External rotation > abduction > internal rotation

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3
Q

Restriction in shoulder motion due to inflammation and fibrosis of shoulder capsule usually due to disuse following injury or repetitive microtrauma what is this called

A

Frozen shoulder (adhesive capsulitis)

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4
Q

Sex and onset of frozen shoulder

A

Females / 40-60 years

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5
Q

What are risk factors of secondary frozen shoulder

A
  • systemic disease (diabetes, etc)
  • extrinsic factors (cardiopulmonary disease, fractures, parkinson, etc)
  • intrinsic factors (rotator cuff pathology, ac arthritis, biceps tendinopathy, etc)
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6
Q

Signs and symptoms of frozen shoulder

A
  • limitation of ROM external rotation > abduction / flexion > internal rotation
  • severe pain
  • reverse scapulohumeral rhythm
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7
Q

Intervention for frozen shoulder

A

-Pendulum exercises
-Acute cases of Pain relief: grades 1 & 2 mobilization
-Chronic cases to increase ROM: grades 3-4 mobilization

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8
Q

In scapulohumeral rhythm there’s a 2:1 ratio between glenohumeral and scapulothoracic movement (ex: if arm abducted 90, 60 is done by glenohumeral movement and 30 by scapulothoracic. True or False

A

True

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9
Q

Gradual onset of pain at rest and sharp pain during motion, pain at night interrupting sleep, lasting 2-9 months. What’s this phase called in frozen shoulder

A

1st phase: acute freezing painful phase

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10
Q

Pain starts to subsides, progressive loss of GH motion in capsular pattern, pain apparent during extreme movement, lasts 4-12 months what is this phase called in frozen shoulder

A

2nd phase: adhesive frozen stiffening phase

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11
Q

Progressive improvement in functional ROM phase lasting 5-24 months what is this phase of frozen shoulder

A

3rd phase: resolution thawing phase

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12
Q

A condition characterized by excessive or repetitive contact between posterior aspect of greater tuberosity of numeral head and posterior superior border of glenoid when arm is moving. What is this called

A

Subacromial impingement syndrome

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13
Q

Subacromial impingement syndrome encompasses a range of pathologies including:

A

Rotator cuff tendinosis
Subacromial bursitis
Calcific tendonitis

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14
Q

What’s the most limited motion of subacromial impingement syndrome

A

Internal rotation

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15
Q

What’s the painful arc of abduction found in subacromial impingement syndrome

A

60-120 degrees

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16
Q

Subacromial space consists of

A

Rotator cuff tendons
Long head of biceps tendon
Coracoacromial ligament
(Surrounded by Subacromial bursa)

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17
Q

What are the types of frozen shoulder

A

Primary idiopathic (unknown) & Secondary (risk factors)

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18
Q

What are types of Subacromial impingement

A

Primary & secondary

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19
Q

What is primary impingement of subacromion

A

Related to structural changes either congenital or acquired such as hooked acromion, osteophyte formation, bony malposition after fracture, increase in volume of Subacromial soft tissue

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20
Q

What is secondary impingement of subacromion

A

Abnormal muscle imbalance resulting in functional disturbance in centering the humeral head, weakness in rotator cuff muscles, lower trap, serratus anterior, tightness of pectoralis minor, gross kyphotic posture

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21
Q

Signs and symptoms of subacromial impingement syndrome

A
  • Shoulder abduction painful arc
  • tenderness over supraspinatus tendon, subacromial bursa, long head of biceps
  • reversed scapulohumeral rhythm
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22
Q

Special tests of subacromial impingement syndrome

A
  • Hawkins Kennedy test
  • neer’s impingement test
  • speeds test
  • yergasons test
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23
Q

Muscle tendinosis of the shoulder what is it

A

Degeneration of tendon tissue, common in biceps & rotator cuff muscles

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24
Q

What’s a special test for muscle tendonosis in biceps region

A

Speeds test & yergasons test

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25
What’s a special test for muscle tendonosis in supraspinatus region
Drop arm test & empty can test
26
What’s a special test for muscle tendonosis in subscapularis region
Belly press test & lift off sign
27
Upper limb tension test of which nerve: shoulder depression, abduction 110, elbow extended, wrist and fingers extended, forearm supinated
Median nerve anterior interosseous branch
28
Upper limb tension test of which nerve: shoulder depression, abduction 10 forearm supinated, elbow wrist and fingers extended
Median nerve musculocutaneous / axillary branch
29
Upper limb tension test of which nerve: shoulder depression, abduct 10, forearm pronated, elbow extended, wrist and fingers flexed, ulnar deviation
Radial nerve
30
Upper limb tension test of which nerve: shoulder depression, abduct 10-90 elbow flexed, forearem pronated, wrist and fingers extended, radial deviation
Ulnar nerve
31
What are infraspinatus special tests
Infraspinatus test & lateral rotation lag sign
32
Teres minor special test ?
Hornblowers sign
33
What is a recommended intervention for muscle tendinosis?
Eccentric Exercises
34
What is the most limited motion in frozen shoulder patients
ER
35
What is the most limited motion in shoulder impingement syndrome patients
IR
36
The most common type of of shoulder dislocation is anterior dislocation, it happens with shoulder ________ & _______
Abduction & ER
37
What’s a sign of shoulder dislocation that can be seen on a patient
Sulcus Sign
38
what lesion is commonly seen in anterior dislocation
Bankart Lesion
39
Axillary nerve supplies which muscles
Deltoid and Teres minor
40
What tests can we use to diagnose shoulder dislocation
Shoulder apprehension test & jerk test
41
What ROM is mainly affected by SLAP tears
Overhead activities & IR
42
Special test used for SLAP tear
OBRIEN test
43
A tear that happens in the lower rim of the labrum commonly occurs with repeated anterior shoulder subluxation
Bankart Tear
44
What ROM is limited for Bankart tear patients
IR & overhead activities
45
Special test for Bankart tear
Clunk Test
46
What’s an acromioclavicular joint injury
Common in physically active people, clavicle separates from acromion can be caused by falling directly on shoulder or a direct blow in sports
47
What deformity is commonly seen in acromioclavicular injury
Step deformity (grade 3 sprain)
48
What ROM is mostly limited in acromioclavicular injuries
Horizontal adduction, shoulder elevation, IR
49
Acromioclavicular painful arc
170 to 180 degrees (abduction)
50
Glenohumeral painful arc
60-120 degrees (abduction)
51
Special test for acromioclavicular joint injury
Cross body adduction test
52
What are the sites of compression in TOS
- scalenus anterior syndrome - costoclavicular syndrome - hyper abduction syndrome
53
The compression of Scalenus anterior syndrome of TOS is located where
Inter scalene triangle
54
The compression of costoclavicular syndrome of TOS is located where
Costoclavicular space
55
The compression of hyperabduction syndrome of TOS is located where
Axillary Interval
56
Special tests for TOS
Adson maneuver Halstead maneuver Military Brace Wright Test Allen test Roos Test Shoulder girdle passive elevation test
57
If you perform a special test to diagnose TOS what’s a feature that would make the test positive
Marked decrease or disappearance of radial pulse
58
Which TOS special tests specifically test for scalenus anterior syndrome
Adson & Halstead maneuver
59
Which TOS special tests specifically tests costoclavicular syndrome
Military brace & wright tests
60
Which TOS special tests specifically tests hyperabduction syndrome
Allen & Roos test
61
Scapular dyskinesia maybe be due to a lesion of which nerves
Long thoracic nerve C7 Spinal accessory nerve C5 (rhomboids)
62
What is the effect of a trapezius or spinal accessory nerve lesion
Inability to shrug shoulders
63
What is the effect of a serratus anterior or long thoracic nerve lesion
Difficulty elevating arm above 120 degrees
64
What is the effect of strain on the rhomboids
Difficult pushing elbow against resistance (with hand on hip)
65
What is the effect of muscle imbalances or contracture of the shoulder
Winging of scapula (adduction and lateral rotation)
66
What is the special test we use to diagnose scapular dyskinesia
Push up test
67
Patte test is used to assess what
Teres minor
68
Clunk test is used to asses
Labral tears
69
Neer impingement is used to asses
Supraspinatus and biceps tendon
70
What direction glide is used to increase shoulder ER
Anterior glide
71
What direction glide is used to increase shoulder IR
Posterior glide
72
What direction glide is used to increase shoulder abduction
Inferior glide
73
What direction glide is used to increase shoulder flexion
Posterior or inferior glide
74
What direction glide is used to increase shoulder extension
Anterior glide
75
Supraspinatus muscle action
- abducts - ER - stabilizes the head of humerus
76
Deltoid muscles function
Middle: abduction Anterior: flex & IR Posterior: extend & ER
77
Pectoralis major function
Upper Fibers: flexion, IR, horizontal adduction Lower fibers: depress shoulder girdle, obliquely adduct humerus towards opposite iliac crest Muscle as a whole: adducts, IR, may assist in elevating the thorax in inspiration
78
79
Pectoralis minor function
- tilts scapula anteriorly - assists in forced inspiration
80
What happens when there is weakness & shortness of Pectoralis minor
Weakness: strength of arm extension is diminished, increase respiratory difficulty Shortness: restricts flexion of arm, produce impingement in structures lying between coracoid process and rib cage
81
Infraspinatus muscle function
ER + stabilizes humeral head
82
Teres minor muscle function
ER + stabilizes humeral head
83
The chief muscles acting in medial rotation test of the shoulder are
Latissmis dorsi, Pectoralis major, subscapularis, and teres major
84
Teres major muscles function
IR, adduction, extension
85
Subscapularis muscle function
IR, stabilize head of humerus
86
Latissmus Dorsi Muscle function
- IR - adduction - extension - depression - lateral flexion of trunk - assists in tilting pelvis anteriorly & laterally - hyperextension and flexing of the spine - accessory muscle of respiration
87
Rhomboids muscle function
adduct, elevate, rotate scapula
88
Levator scapulae muscle function
Elevate & rotate scapula Laterally flex neck and rotate towards same side maybe assist in extension of neck as well
89
Trapezius muscle function
Middle fibers: adduction of scapula Upper: rotate & elevate scapula, extend, laterally flex, rotate head the cervical spine (turning head to opposite side), extends neck Lower: rotate & depress scapula + accessory muscle of respiration
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