Pta 201 Shoulder Quiz

Front 1

Name two assessment techniques that PTs use to confirm muscle strains.

Back 1

They resist the motion and stretch the suspected injured muscle. If theses reproduce symptoms then it confirms a muscle strain.

Front 2

A PT is assessing a patient with a strained anterior deltoid. When the PT tests the strength of the muscle he finds the following results: strong but painful. What is the correct intrpretation of these findings?

Back 2

Minor lesion of the musculotendinous unit

Front 3

What is the recommended treatment of grade I and II AC separations.

Back 3

Strengthening to the RC especially IR and ER

Front 4

What grades of AC separation usually require surgical intervention?

Back 4

Four, five and six

Front 5

Name the two causes of impingement syndromes (IS).

Back 5

Repetitive motion and anatomical

Front 6

Define impingement of the shoulder

Back 6

Lack of humeral depression during elevation causes the subacromial structures to be compressed against the acromion process. This compression, over time, will eventually lead to an impingement syndrome as described by Neer.

Front 7

What are the 2 categories of extrinsic factors with contribute to IS?

Back 7

Primary and secondary

Front 8

Differentiate primary from secondary impingement.

Back 8

Primary refers a those conditions that reduce the subacromial space.Secondary pertains to the mechanical compression of the subacromial tissues.

Front 9

True or False: An abnormally shaped acromion process (type III) is an example of a primary cause of IS.

Back 9

TRUE

Front 10

Name the two clinical signs associated with impingement syndrome.

Back 10

Painful arc and reproduction of pain with the combined movements of elevation (abduction or flexion) and IR

Front 11

What structures are commonly involved with an impingement syndrome?

Back 11

Subacromial bursa and RC (specifically the supraspinatus)

Front 12

What special tests are used to confirm the diagnosis of impingement syndrome?

Back 12

Neer's, Hawkins and Empty can tests

Front 13

What is the treatment philosophy associated with impingement syndromes?

Back 13

Resort normal arthrokinematics by increasing the strength of the humeral depressors (infraspinatus and Teres minor), scapular stabilization and stretch the inferior capsule.

Front 14

True or False: an unresolved impingement syndrome can progress to a RC tear.

Back 14

TRUE

Front 15

When prescribing strengthening exercises to a patient with IS what special precautions should be taken?

Back 15

Avoid performing the exercises in positions which exacerbate or reproduce the impingement.

Front 16

What motion is commonly restricted with IS?

Back 16

IR of the shoulder

Front 17

What joint mobilization techniques is emphasized with IS?

Back 17

Inferior (Shankman page 415) and posterior glides

Front 18

True or False: Initial treatments of IS should focus on reducing pain.

Back 18

False, they should be geared at reducing the inflammation.

Front 19

What surgery is used to treat IS that have not improved with conservative treatments?

Back 19

SAD

Front 20

Chronic RC tears are usually attributed to what factor?

Back 20

Poor vascularity

Front 21

Name the 3 clinical signs associated with RC tears.

Back 21

Painful arc, decreased strength and ROM and loss of functional use of the shoulder.

Front 22

What test is used to confirm a RC tear?

Back 22

Drop Arm

Front 23

Name the 4 goals associated with the conservative treatment of RC tears.

Back 23

Control inflammation, Activity modification, maintain normal shoulder kinematics and Ant/Post capsule stretching.

Front 24

Name the 3 phases of rehab associated with RC surgery.

Back 24

Maximum, moderate and minimal protection phase

Front 25

Name four factors that influence the progression of rehab after RC repair.

Back 25

Size and location of the tear, associated pathologies, age of the patient, and type of repair. ( For entire list see Colby)

Front 26

In the maximum protection phase (MaxPP) of rehab for a RC, what kinds of exercises are allowed?

Back 26

PROM

Front 27

What are the goals of treatment in the MaxPP of S/P RC repair?

Back 27

Protect the repair, reduce pain and inflammation and prevent the adverse effects of immobilization

Front 28

How long does the MaxPP usually last for a S/P RC repair?

Back 28

6-8 weeks for large tears and 3-4 weeks for small and medium tears

Front 29

What is the criteria used to determine when a patient with a RC repair can progress to the ModPP?

Back 29

Healed incision, minimal pain with assisted shoulder movements, and progressive improvement in ROM

Front 30

What are the goals associated with the ModPP of a RC repair?

Back 30

Develop strength, endurance, and neuromuscular control while continuing to regain ROM

Front 31

What is the criteria used to determine when a patient with a RC repair can progress to the MinPP?

Back 31

Full, pain-free passive ROM , progressive improvement in shoulder strength and endurance and a stable GH joint

Front 32

What direction of shoulder dislocation is the most commonly seen?

Back 32

Anterior

Front 33

Name the special tests that detect injury to the GH ligaments?

Back 33

Sulcus sign, Load and Shift, Fulcrum, Apprehension and Drawer

Front 34

What are the two categories used to classify shoulder dislocations?

Back 34

TUBS and AMBRI

Front 35

True or False: The treatment of choice for patients who suffer from Multidirectional Instability is surgery.

Back 35

False, conservative rehab is recommended

Front 36

What co comment movements of the shoulder are associated with anterior dislocation?

Back 36

ER and Abd

Front 37

In the MaxPP of an anterior dislocation rehab program, either post-surgery or when treated conservatively, what movements are contraindicated

Back 37

Abd, ER and extension

Front 38

A key goal in the conservative treatment of Ant Dislocations is to increase muscular dynamic stabilization. What muscles should rehab focus on?

Back 38

IR and adductors to support the anterior capsule, the ER to stabilize the humeral head against anterior translating forces and to restore deltoid-RC force couple

Front 39

What surgeries are used to correct unresolved Ant Dislocations of the shoulder?

Back 39

Bankart, Capsular Shift and Thermal Capsulorrhaphy.

Front 40

What muscles are targeted for strengthening when treating Post Dislocations of the shoulder?

Back 40

Adductors and ER

Front 41

What motions should be avoided in the acute phase of Post Dislocations?

Back 41

Abduction and IR

Front 42

What is the primary reason for performing a shoulder atrhoplasty?

Back 42

Pain Relief

Front 43

Correcting a faulty posture is an important goal of rehab to shoulder problems. Describe the pathomechanics associated with a forward head and thoracic kyphosis?

Back 43

Forward tilt and downward rotation of the scapula with abd and IR of the humerus.

Front 44

What are the three phases of adhesive capsulitis (Ad Cap)?

Back 44

Freezing, frozen and thawing

Front 45

What grade of sustained translatory joint mobilization techniques are indicated for Ad Cap?

Back 45

Grade III

Front 46

True or False: the goal of treating an Ad Cap is plastic deformation of the tissues.

Back 46

TRUE

Front 47

Placing a low load (stretch) for a prolonged period of time on shortened tissues incorporates what concept?

Back 47

Creep

Front 48

What modality would be appropriate to use in the frozen phase of an Ad Cap to improve soft tissue extensibility.

Back 48

US

Front 49

What test is used to detect labrum tears?

Back 49

Crank or clunk test

Front 50

What motions should be avoided in the early phases of rehab to a torn labrum?

Back 50

Abd concurrent with ER

Front 51

What guidelines should be followed regarding motion in the sagittal plane after the treatment of a surgically repaired torn labrum.

Back 51

Limit passive or AROM to 60 degrees for the first 2 weeks and to 90 degrees at 3-4 wks postoperatively.

Front 52

What guidelines should be followed regarding motion in the transverse plane after the treatment of a surgically repaired torn labrum.

Back 52

Only PROM and IR should be limited to 45 degrees and ER to 15 degrees w/in the first 2 weeks.

Front 53

Why are Codman's (Pendulum) exercises commonly prescribed in the maximum and moderate protection phase of most shoulder rehab programs?

Back 53

They simulate grade II oscillation techniques which inhibit pain and maintain joint mobility.

Front 54

Name three advantages of having a patient perform shoulder exercises in the plane of scapula also refered to as scaption.

Back 54

More functional activies occur in this plane compared to the other planes, no ER or IR is required to prevent impingement from the greater tubercle and there is less tension in the joint capsule

Hint 54

Colby page 487

Front 55

What symptoms are associated with the Freezing phase of idiopathic frozen shoulder?

Back 55

Intense pain, limitations of motion by 2 to 3 weeks after onset.

Front 56

What symptoms are associated with the Frozen phase of idiopathic frozen shoulder?

Back 56

Pain only with motion, limited GH motions with substitute motions of the scapula, and atrophy of the deltoid, RC, biceps and triceps.

Front 57

What symptoms are associated with the Thawing phase of idiopathic frozen shoulder?

Back 57

No pain and no synovitis but significant capsular restrictions