NPTE - MSK > Shoulder Pathologies > Flashcards

Shoulder Pathologies Flashcards

(53 cards)

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1
Q

explain common shoulder dislocations? what causes this

A

anterior inferior glenohumeral dislocation

external rotation of an abducted arm

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2
Q

what structures are affected in anterior-inferior shoulder dislocations

A

inferior GH ligament
anterior capsule
glenoid labrum

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3
Q

explain cause of posterior dislocation

A

horizontal adduction and internal rotation of GH jt

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4
Q

hills-sachs lesion

A

compression fx of the posterior humeral head

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5
Q

SLAP

A

superior labrum anterior to posterior lesion

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6
Q

bankart lesion

A

avulsion of anterior-inferior capsule and glenoid labrum

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7
Q

isolated axillary nerve injury clinical presentation

A

tingling in lateral shoulder
weakness in abduction

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8
Q

explain pt pop and level of recurrence in those with GH instability

A

young, active individuals
(Ant/Inf) have the most risk

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9
Q

explain difference between atraumatic/traumatic GH instability

A

atraumatic - global instability and hypermobility

traumatic - typically due to one instance

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10
Q

what population is generally associated with atraumatic GH instability

A

throwing athletes

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11
Q

s/s of atraumatic instability

A

popping/clicking in the joint

(+) apprehension relocation test
— painful

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12
Q

explain surgical intervention in traumatic vs atraumatic GH instability

A

trauma = surgery is best

atraumatic = PT is best

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13
Q

explain PT interventions related to atraumatic GH instability

A

functional training/resistance training
– strength, endurance, prop, coordination, flexibility

manual therapy

AVOID 90/90 for 12 weeks post-op

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14
Q

common subjective history for atraumatic instability

A

10-35 y/o
pain/instability upon activity (anterior or posterior)

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15
Q

exam findings related to atraumatic instability
- observation
- P/AROM
- isometric test

A

normal bone / soft-tissue outlines

Full / Excessive A/PROM

normal iso test

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16
Q

special test related to atraumatic GH instability

A

(+) to:
apprehension relocation
load shift test
augmentation tests

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17
Q

RTC history/subjective

A

30-50 y/o
pain/weakness during eccentric load

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18
Q

frozen shoulder
- history/subjective

A

age 45+ (insidious)
– post trauma/surgery

loss of ER, abduction, IR

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19
Q

cervical spondylosis
– subjective/history

A

age >50

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20
Q

RTC
– A/PROM
– isometric testing

A

A: weakness ER/AB or both
– crepitus present

P: RTC = pain-free
impingement = painful

painful/weak ER/AB

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21
Q

explain dileniation of labral tears

A

superior: toward top of glenoid socket

inferior: toward bottom of socket

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22
Q

SLAP lesion

Study These Flashcards
A

tear of rim above the medial portion of the glenoid socket

– may include bicep tendon

23
Q

explain difference in SLAP and Bankart lesion

Study These Flashcards
A

bank: inferior medial rim of glenoid w/inf GH ligament

SLAP: superior medial rim of glenoid w/superior GH ligament

24
Q

shoulder labral lesion
s/s

Study These Flashcards
A

generalized pain
– worse with arm overhead or behind back

weakness and instability

pain when iso testing bicep

tenderness over front of shoulder

25
gold standard of labral tear identification
arthroscopic surgery of shoulder
26
PT goals for pts with labral tear
painless return to function functional/resistance training addressing underlying instability
27
labral repair post-op surgery protocol
no 90/90 for 3 mo (12wk) sling 3-4 wks
28
TOS
compression of neurovascular bundle consisting of: -- brachial plexus -- subclavian art/vein -- vagus/phrenic nerves -- sympathetic trunk
29
areas of compression related to TOS
superior thoracic outlet scalene triangle clavicle / 1st rib pec minor/thoracic wall
30
what surgery may be done to alleviate TOS
removal of cervical rib release of ant/middle scalenes
31
TOS diagnostic test
radiograph MRI electrodiagnostics
32
TOS special test
adson's roos
33
PT goals for pts with TOS
postural re-ed functional / resistance training jt mobility maintenance -- manual/soft tissue work 1st rib mob/manip
34
AC/SC jt lesion common MOI
fall onto adducted shoulder lateral, direct collision to GH head
35
AC/SC joint special test
paxinos (AC shear) horizontal adduction
36
MOI related to RTC lesions
compression = impingement tensile overload = tendinopathy macotrauma = RTC tear
37
explain intrinsic vs extrinsic subacromial impingement
in: factors directly affecting tendon health (age, genetics, vascular changes) ex: damage to RTC tendons due to humeral contact with coracoacromial arch -- possibly due to repetitive overhead activity
38
explain posterior internal subacromial impingement
mechanical irritation of RTC between greater tuberosity / posterior glenoid labrum
39
test related to internal subacromial impingement
(+) apprehension relocation test
40
Full-thickness Supraspinatus tear test cluster
(+) to: Jobe (empty can) Full Can ER lag
41
full thickness infraspinatus tear test cluster
ER lag sign
42
full thickness sub scap tear special test cluster
(+) on: lift off test belly press or belly press and bear hug test
43
proximal humeral fx MOI - humeral neck - greater tuberosity
neck: FOOSH in older osteoporotic women tube: middle-aged/elderly adults when falling onto shoulder
44
adhesive capsulitis
equal (A/PROM) loss of shoulder motion resultant of inflammation/fibrosis of shoulder capsule can be associated with disuse following injury/repeated microtrauma
45
explain risk factors for adhesive capsulitis
35-65 y/o female > male diabetes thyroid disease
46
pt populations of acute vs chronic rotator cuff tendinitis
acute = 20-40 y/o chronic = 30-70 y/o
47
common age of rotator cuff rupture
40+
48
RC tendinitis exam/observation findings
pain w OH motion -- resisted AB limited AB AROM chronic: AB/flex limited IR/ER PROM pain at 90 abduction
49
RC rupture exam/observation
pain w/elevation limited AB AROM -- pain w resistance PROM = full and w/o pain
50
bicipital tendinitis subjective characteristics
20-45 y/o repetitive OH activity - bicep long head will impinge between groove and anterior acromion
51
bicipital tendinitis -- exam/observational findings
pain from full SH ext to flexion ER limited in 90 abduct SH/elbow PROM extension painful when combined -- stretching bicep resisted elbow flexion pain
52
Grade 1-3 AC JT injury
1 = AC sprain 2 = AC tear, CC sprain 3 = AC/CC tear (stepdown)
53
SICK scapula - subjective - objective - special test
20-40 y/o scapular malposition with inferior-medial border prominence -- coracoid pain -- movement abnormalities scapula assistance/repositioning test
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