musc > week 2 > Flashcards

week 2 Flashcards

(60 cards)

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1
Q

3 movements the scapula has to perform to clear the acromion are

A

posterior tilt, internal rotation, upward rotation

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2
Q

To complete all functional activities how many degrees of humeral flexion does a person need?

A

0-108 degrees

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3
Q

what are The scapula moves through three (3) axes of rotation to achieve full shoulder elevation and their amount of rotation

A

Upward and downward rotation ( 60 degrees) internal and external rotation ( approx 30 degrees), anterior and posterior rotation ( 8 degrees)

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4
Q

T/F- Full shoulder mobility requires thoracic extension of 10-15°.

A

true

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5
Q

T/F The resting position of the scapula is slight downward rotation (3 °)

A

F- slightly upward position (3 degrees)

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6
Q

conditions of the ST joint

A

fractures, snapping scapula, osteochondroma, nerve palsies, scapular dyskinesis

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7
Q

conditions of AC joint

A

dislocation, clavicle #, acromion #, osteolysis, OA

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8
Q

conditions of SC joint

A

sternal #, clavicle #, dislocation

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9
Q

scapula # MOI

A

high energy tramuma
associated w other injuries
very uncommon

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10
Q

snapping scapula syndrome causes

A

audible sound during elevation (sign)

scapular dyskinesis
GHJ instability
infra-serrates bursitis
osteochondroma
bony spurs
neural paralysis
forced couple dysfunction

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11
Q

what is scapular dyskinesis

A

inability to maintain resting position , loss of ability to control - upward and external rotation & retraction

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12
Q

scapular dyskinesis results in

A

alterations of shoulder girdle mechanics and passive tissue length/ tension

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13
Q

nerves entrapment/ injuries around the shoulder diagnosed by what

A

EMG

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14
Q

long thoracic nerve palsy comes from what spinal root

A

C5,6,7

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15
Q

long thoracic nerve palsy pathology

A

paralysis, serrates anterior

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16
Q

long thoracic nerve palsy MOI

A

traction of neck
blunt trauma over anterior chest wall
viral illness

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17
Q

supra scapular nerve comes from what spinal level

A

C5,6 through supra scapular and spinglenoid notches

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18
Q

suprascapularis motor supply

A

supra and infra spinatus

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19
Q

suprascapularis MOI

A

entrapment/ compression
traction

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20
Q

axillary nerve spinal level

A

C5,6

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21
Q

axillary nerve motor supply

A

deltoid teres minor

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22
Q

axillary nerve MOI

A

anterior dislocation of GHJ
compressed in posterior scapular space

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23
Q

thoracic outlet syndrome MOI

A

stretch or compression of structures

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24
Q

thoracic outlet syndrome most common sites

A

costoclavicular space
scalene triangle
subcoracoid space

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25
thoracic outlet syndrome possible causes
elevated first rib repeated overhead sports poor posterure shortened scalenes
26
clavicle # MOI
direct contact anterior or laterally
27
AC joint sprain MOI
fallen on outstretched hand fall/ direct blow to the shoulder
28
osteolysis distal clavicle (ACjoint pathology) MOI
overuse eg weightlifters in bench press
29
OA at AC joint
often occurs with GHJ OA age over 60 occupational overuse
30
SC dislocation
occurs anteriorly mainly however posteriorly can be life threatening as it compresses respiratory tracts behind
31
what are factors contribute/ predispose RC tendon tears
* Age * Bony architecture * Cuff orientation * Risk factors
32
* Location of pain helpful to orientate sub. acromial, sub coracoid, posterosuperior
➢ Subacromial (superficial anterolateral/ superior) ➢ Sub coracoid (deep anterior) ➢ Postero-superior (deep posterior ache)
33
* Structural vs Functional sub. acromial, sub coracoid, posterosuperior
➢ Subacromial (sustained flexion/abduction > 90 degrees) ➢ Sub coracoid (flexion/IR) ➢ Postero-superior (extreme ranges of abduction and external rotation in the scapular plane)
34
RC degeneration risk factors
➢ Diabetes ➢ Age >50 ➢ Occupation overhead activities ➢ Depression ➢ Smoking ➢ Excessive alcohol consumption ➢ Obesity ➢ Nutrition ➢ Sleep hygiene ➢ Physical activity levels
35
stage 1 RC tendinopathy age MOI pathology prognosis
* Age (15-25) * MOI: traumatic, repetitive load * Pathology: Swelling/oedema * Prognosis good
36
stage 2 RC tendinopathy age MOI pathology prognosis
* Age (25 -40) * MOI: repeated episodes mechanical inflammation * Pathology: fibrosis and tendon changes * Prognosis can be good can be bad with no modifications
37
Stage 3 RC tendon degeneration
Age: >65 (? Normal) MOI: Ongoing mechanical compression Pathology: bone spurs, mid substance tears, frank tendon tears Prognosis: not good
38
Consequence Rotator Cuff Tears
➢ Loss of ability to maintain position of HOH ➢ Antero-superior migration of HOH ➢ Micro trauma to other structures * Functional limitations
39
RCRSP
➢ Subacromial bursitis ➢ Rotator cuff tendinopathy ➢ Partial thickness rotator cuff tears ➢ Full thickness rotator cuff tears (small to medium size)
40
Calcific Tendonitis
* Calcific deposit in rotator cuff tendons * Usually in supraspinatus * CS injections required
41
GHJ Osteoarthritis
Progressive degenerative changes in joint cartilage/labrum/ bony surfaces /subchondral bone
42
Clinical exam * OA in GHJ
* Stiffness end of range of movement flexion/abduction/external rotation/HBB * Early am stiffness * Progressive restriction of movement and weakness * Clicking and grating * Loss of functional ability * Previous History – Injury to GHJ – Occupation – overhead work, repetitive work – End stage – surgery (shoulder arthroplasty)
43
frozen shoulder MOI, age/gender risk factor duration
* MOI: ➢ Primary (Idiopathic, insidious onset) or secondary to injury/ risk factors ➢ May have PHx of trauma, ? instability * Age/ Gender: 35-65yrs Females > Males (3:1)?? * Risk factors: lifestyle, co-morbidities * Duration: 30 months (mean)
44
Frozen Shoulder clinical exam
➢ Increase in severe pain and progressive loss of movement. ➢ Significant night pain/ lying in that side ➢ Loss of active and passive movement ➢ Patterns of loss: external rotation >abduction > internal rotation ➢ Functional loss: HBH/HBB, lift ➢ “freezing / frozen / thawing” ➢ Pain > Stiffness? or Stiffness > Pain?
45
causes of frozen shoulder
➢ Diabetes Mellitus ➢ Thyroid (30% cases) ➢ Breast surgery ➢ Previous ipsilateral scapula/clavicle/hume ral # ➢ Metabolic disorder
46
risk factors of frozen shoulders
➢Hypermobility ➢Autoimmune disorder ➢Previous CVD ➢Metabolic disorder ➢Parkinsons ➢Hormone changes (menopause)
47
life style factors increasing risk of frozen shoulder
➢Obesity/ physical inactivity ➢+/- acute episode preceding FS development ➢QoL- depression/anxiety
48
Pathophysiology of Frozen Shoulder
* Inflammatory markers within the associated tissue. * Increased %fibroblasts and myofibroblasts, suggestive of a fibrotic process * Global fibroplasia/localized anterior capsule contracture
49
Fractures (#) of the Humerus MOI
– FOOSH – trauma – in younger population ➢ Greater tuberosity # ➢ # surgical neck humerus ➢ # shaft of humerus
50
Anterior Dislocation MOI
MOI - forced abduction and external rotation (stop sign) ➢ capsular structures ➢ +/- labral, bony, ligamentous and muscular damage ➢ 90-95% of all dislocations ➢ Prominent HOH anteriorly
51
Anterior Dislocation management
➢ < 20 years – anterior reconstruction ➢ > 20 years- conservative rehabilitation 1st
52
Posterior Dislocation MOI
direct blow or FOOSH (IR + ADD) Often missed in older population
53
Inferior / Multidirectional Instability (MDI) mechanism
general hyperelasticity
54
Inferior / Multidirectional Instability (MDI) clinical exam
– Lax in all directions but may only be symptomatic in only 1 direction – + apprehension tests – + translational tests – Uni or bilateral * Passive restraints
55
Anterior GHJ Instability MOI
➢trauma (dislocation/subluxation) ➢repetitive overuse/ incorrect technique ->microtrauma to anterior capsule ➢No Passive tissue recoil
56
Anterior GHJ Instability clinical exam
➢Increased anterior translation ➢ROM good ➢Apprehension/ relocation ➢Tender posteriorally
57
Posterior Instability MOI
➢trauma (dislocation/subluxation) ➢repetitive overuse/ incorrect technique ->microtrauma to posterior capsule ➢No Passive tissue recoil ➢associated with general hypermobility
58
Posterior Instability clinical exam
➢Apprehension in FLEX/IR/ADD ➢ROM ➢Posterior pain ➢feeling instability/lack strength with throw ➢Anterior pain (traction) ➢Anterior contour lost
59
SLAP lesion, what does slap stand for
superior labral anterior to posterior
60
SLAP lesion MOI
1. ABD/ ER position - where the long head of biceps angled posteriorly.
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