Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
29 Cards in this Set
- Front
- Back
|
what are the S and S of a rotator cuff tear
|
1) severe pain following a specific event
2) positive drop arm test if significant tear 3) decrease shoulder AROM (noncapsular pattern) due to weakness and/or pain 4) painful arcu (b/t 60-120) during active should elevation (flex/abd) 5) pain and weakness with resisted shoulder abd at 10 and 90 and ER at 90 6) (+) supraspinatus test 7) (+) impingement tests |
|
|
what is a S and S that is indicative of a large tear
|
50% strengthe deficit with resisted ABD at 10
|
|
|
when will drop arm test be positive for RC tear
|
only if it is a significant tear.... a small tear should still be able to hold
|
|
|
why would a supraspinatus test be (+) of a rotator cuff tear
|
b/c inflammation in tehe area
|
|
|
what is the most distinguishing factor of a rotator cuff TEAR
|
weakness in ER and ABD
|
|
|
when is it easy to tell the difference between tendinitis and a tear in RC
|
easy to tell if the tear is significant.... if not then it is hard to tell
|
|
|
how can you tell the difference between severe tendinitis and a small tear in RC
|
tendinitis will get better with treatment because the inflammation will decrease; the tear will not get better (or it will happen at an abnormally slow rate)
|
|
|
what are the diagnostic procedures for the rotator cuff tear (and which is the tx of choice)
|
arthrogram, MRI, Arhtoscopy
MRI = treatment of choice |
|
|
explain an arthrogram of the RC and what is useful for
|
1) injection of radiopaque material in GHJ
2) radiographs look to see if material has "leaked" into subacromial space *can only detect full thickness tears |
|
|
_____ test can only detect full thickeness tears where as _______ can diagnose partial and full thickenes tears
|
arthrogram can only diagnose full thickness tears; MRI can diagnose partial and full thickeness tears
|
|
|
what is the only test that can 100% accurately diagnose a RC tear
|
arthroscopy
|
|
|
when is an arthroscopy performed
|
NVER with the sole purpose of making dx; it is done at the time of surgery to repari a RC as the first step in order to confirm the dx
|
|
|
what is considered a "small" rotator cuff tear and how is it repaired
|
<1 cm
repaired with deltoid splitting |
|
|
what is considered a "medium" rotator cuff tear and how is it repaired
|
1-3 cm
repaired with deltoid splitting |
|
|
what is considered a "large" rotator cuff tear and how is it repaired
|
3-5 cm
reparied with deltoid splitting |
|
|
what is considered a "massive" rotator cuff tear and how is it repaired
|
> 5 cm
repaired with deltoid desinsertion |
|
|
relate the "sized" categories of RC tear to the "type" categories of RC tear
|
type 1= small (<1 cm)
type 2= medium (1-3cm) and large (3-5 cm) type 3= massive (>5cm) |
|
|
why is it important to note when a RC tear is reparied with deltoid splitting
|
because we worry about the repaire of the ant. deltoid to the acroimion in rehab (note with a larger tear we get more retraction of the tendon!)
|
|
|
when must a tear be repaired
|
whenever it is symptomatic
|
|
|
what are the components of a surgical repaire for the rotator cuff tear
|
1) usually involves deltoid splitting
2) most cases a tendon to bone repaire is done 3) all include arthroscopic debridement of structures as well as an acromioplasty |
|
|
what is meant by a tendon to bone repair for RC tear surgeries
|
proximal end of the tendon is reattached to the greater tuberosity
|
|
|
what is the acromioplasy procedure in the RC tear surgery
|
anterioinferior section of acromion and inferior portion of coracoacromial ligament are partially removed
|
|
|
bigger tears require ....
|
deinsertion of anterior deltoid and a longer rehab
|
|
|
more and more repairs are now being done _____ meaning what for rehab
|
more are being done arthroscopically meaning no deltoid splitting!
|
|
|
the exact timing of rehab post RC tear repairwill vary based on
|
the srugeon who performed the surgery
|
|
|
what are the considerations for rehabilitation post RCR
|
1) NO two patients are the same
2) size of tear 3) surgical procedure 4) quality of tissue/repair 5) physicians preferences |
|
|
what is the protocol for a RCR
|
1) sling 1-5 weeks
2) first 3-9 weeks: PROM (more aggressive program may include AAROM during that time) 3) at 3-9 weeks: start AROM 4) Initiate light RROM at 6-12 weeks 5) Full PROM should be achieved within 6-9 weeks 6) full AROM should be achieved within 9-16 weeks 7) return to activities in about 4-9 months |
|
|
what is the purpose of the abduction pillow
|
keeps the tendon under a relaxed state because we dont want to bring the elbow close to the body
|
|
|
when would you expect to see a patient with an abduction pillow
|
1) a very conservative surgeon
2) very large repair |
