Rossi Exam 2 Cards

Front 1

What are the critical motions necessary to maintain the scapula flush to the thorax?

Back 1

IR/ER
ANT/ POST tipping

Front 2

IR/ER and ANT/POST tipping is by way of which joint?

Back 2

AC

Front 3

What makes up the roof of the suprahumeral area and what makes it up?

Back 3

Coracoacromial arch; made up of the acromion, coracoacromial ligament, and coracoid process.

Front 4

T/F? SC joint has a fairly strong joint capsule

Back 4

True

Front 5

The anterior portion of the SC ligament limits....

Back 5

Retraction

Front 6

The posterior portion of the SC ligament limits?

Back 6

protraction

Front 7

The anterior and posterior portions of the Costaclavicular ligament limit?

Back 7

excessive elevation

Front 8

Along with resisting excessive elevation the posterior part of the Costoclavicular ligament resists?

Back 8

medially directed forces

Front 9

The interclavicular ligament limits?

Back 9

Depression and inferior gliding; also aids in protection of brachial plexus structures

Front 10

SC motions include?

Back 10

Elev/Dep
Prot/Retr
Posterior rotation of clavicle

Front 11

RP of the SC joint?

Back 11

Arm at the side

Front 12

CPP of the SC joint?

Back 12

Full Elevation

Front 13

Capsular pattern for SC joint?

Back 13

horizontal ADD and full Elevation

Front 14

The SC joint is innervated by?

Back 14

Ant. Supraclavicular Nerve and subclavius

Front 15

T/F The superior part of the clavicle does not contact the manubrium

Back 15

True

Front 16

The superior part of the SC disk is attached to ?

Back 16

superior clavicle

Front 17

There is more contact of the SC disk with the

Back 17

superior clavicle

Front 18

In what SC motion is the upper part of the disk stationary on manubrium while the clavicle moves?

Back 18

Elevation/Depression

Front 19

During _______ motion, the disk and clavicle move together on manubirum?

Back 19

Protraction/retraction

Front 20

The AC joint is responsible for what motions?

Back 20

IR/ER
UR/DR
ANT/POST tipping

Front 21

Maintains relationship b/w clavicle and scapula in early phases of elevation of UE

Back 21

AC joint

Front 22

Allows scapula additional motion on thorax

Back 22

AC joint

Front 23

RP of AC joint

Back 23

Arm at the Side

Front 24

CPP of AC joint

Back 24

90 degrees of Abd

Front 25

Capsular pattern of AC joint?

Back 25

horizontal ADD and full Elevation

Front 26

The AC joint is innervated by?

Back 26

Suprascapular nerve and Lateral pectoral

Front 27

If the angle between the acromion and clavicle is increased, what would happen?

Back 27

Shear forces leading to degeneration and increased chance for OA.

Front 28

If the angle b/w the acromion and clavicle is decreased what would be likely?

Back 28

Dislocation

Front 29

The Coracoclavicular ligament contains a medial part called and a lateral part called?

Back 29

Conoid and Trapezoid

Front 30

The Coracoclavicular ligament is responsible for providing most of AC stability; it resists....

Back 30

Superiorly directed forced, UR of scapula, and Medial forces.

Front 31

The trapezoid is primary player in

Back 31

resisting medial forces (watch FOOSH)

Front 32

Ligament responsible for flipping of clavicle at end of elevation

Back 32

Conoid

Front 33

Subluxation of AC joint is usually due to a weak...

Back 33

Capsule and AC ligaments; CC lig usually not effected

Front 34

AC Ligament is for Horizontal stabilization, while Coracoclavicular ligament is for...

Back 34

both vertical and Horizontal Stability (Mainly vertical)

Front 35

Position of Scapula on thorax?

Back 35

30 deg IR and 20 deg anteriorly tipped

Front 36

IR is limited by contact of

Back 36

lesser tubercle into glenoid

Front 37

ER is limited by contact

Back 37

greater tubercle on acromion

Front 38

Abd is limited by...

Back 38

contact with coracoacromial arch

Front 39

RP of GH joint?

Back 39

40-55 deg of ABD
30 deg of horizontal ADD

Front 40

CPP of GH joint?

Back 40

Full ABD with ER (due to capsular tightness)

Front 41

Capsular pattern of GH joint?

Back 41

LR>Abd>MR

Front 42

The Humeral head faces?

Back 42

medially, superiorly, and posteriorly

Front 43

Angle b/w long axis of humeral head and neck? Normal values are b/w 130-150 degrees.

Back 43

Angle of inclination

Front 44

Angle of inclination greater than 150 indicates

Back 44

increased likelihood for superior dislocation or subluxation leading to impingement

Front 45

If angle of torsion is shifted more posterior, what would happen to IR/ER?

Back 45

IR limited and ER increased

Front 46

The glenoid labrum is taught/ lose where?

Back 46

Loose superiorly and firm inferiorly

Front 47

The labrum is innervated by?

Back 47

The posterior cord of the brachial plexus, suprascapular, axillar, and lateral pectoral

Front 48

T/F ? The GH Capsule is taught sup. and loose inf?

Back 48

TRUE

Front 49

What component picks up the capsule slack in the GH joint to get to end range?

Back 49

ER

Front 50

Resistors to ABD?

Back 50

INF gh lig> Middle> SUP gh lig

Front 51

Strong stabilizer with arm at side along with RIC

Back 51

Superior GH lig

Front 52

Major player in anterior stabilization of gh joint? (0-45 deg of ABD)

Back 52

Middle GH lig

Front 53

limits anterior and inferior translation at GH joint at 0 degrees.

Back 53

Superior GH lig

Front 54

Limits inferior translation > 90 degrees of ABD ?

Back 54

INF gh Lig

Front 55

In this zone, the humeral head wants to pop our anteriorly and superiorly

Back 55

Zone of weitbrecht

Front 56

T/F? At 90 degrees of ABD all 3 gh ligaments are on slack?

Back 56

False..Sup and Middle

Front 57

Ligaments or fibers part of the RIC

Back 57

Coracohumeral, SUP GH lig, fibers of SS and Traps

Front 58

what is shelf sign

Back 58

weakened RIC, common in stroke and RC injury

Front 59

LHB is a static stab at arm at the side when RIC is unable to do so....it is intra....and

Back 59

intracapsular and extrasynovial

Front 60

Abduction is what type of force?

Back 60

Dislocating, hence the Deltoid is a "dislocator" since it is the PM of Abd. This motion is trying to dislocate h.h. superiorly

Front 61

With no load, the SS is has a resting tone (passive tension); as load increase the SS comes into assist the _____.

Back 61

RIC

Front 62

What muscle is the primary mover in shoulder flexion?

Back 62

Ant. Deltoid followed by the SS

Front 63

diminished RC function, stressing the RIC, you would get a humeral...

Back 63

drift

Front 64

Which muscle is the initiator or Abd?

Back 64

SS

Front 65

From 60-90 degrees of Abd, the ____ is the PM? After 90 it is quiet and ineffiecient.

Back 65

Deltoid

Front 66

90-150 degrees of Abd is done by?

Back 66

ST motion

Front 67

What is the difference b/w shoulder Abd and Flexion?

Back 67

In flexion, the first 60 degrees is by Ant deltoid, and coracobrachialis, there more protraction, and no LR is needed.

Front 68

GH pain can come from?

Back 68

subacromial bursitis
Calcium deposits
tendinitis of RC

Front 69

60-120 degrees of Abd painful=?

Back 69

Gh joint, suprahumeral area

Front 70

170-180 degrees of Abd painful=?

Back 70

AC joint

Front 71

Outer layer of the shoulder is made up of?

Back 71

Deltoid
Rhomboids
Pec Major
Upper Trapezius

Front 72

Middle layer of the shoulder is made up from?

Back 72

dynamic stability-RC muscles

Front 73

The inner layer of the shoulder is made up of?

Back 73

static stability- Joint capsule, GHL, RIC

Front 74

The outer layer is for ____ and _____.

Back 74

Strength and Power

Front 75

We have inherent stability of joint capsule because of?

Back 75

Wet adhesion betweem joint surfaces

Front 76

Pathoanatomy of the joint capsule

Back 76

Bankart Lesion
Congenital laxity
capsule stretch

Front 77

Pathoanatomy of Glenoid

Back 77

Bony Bankart

Front 78

Pathoanatomy of LHB

Back 78

SLAP tear

Front 79

Pathoanatomy of Labrum

Back 79

Bankart Tear
Posterior Labral Tear
SLAP

Front 80

Pathoanatomy of Humerus

Back 80

Hills Sachs

Front 81

Pathoanatomy of RC

Back 81

SS tear
subscapularis lesion

Front 82

Capsule Pathology:
If capsule is too loose it can lead to?
If capsule if too tight it can lead to?

Back 82

-instability which can lead to impingment
-lack of motion, adhesive capsulitis

Front 83

Drying up of capsule and loss of extensibility; RC impingement mimicker

Back 83

Frozen Shoulder

Front 84

Impingement means

Back 84

Compression and irritation in areas such as RC, subac. bursa, biceps tendon, think suprahumeral area

Front 85

Arthrokinematics (static stab) messed up is.....

Back 85

Instability; unable to control joint during motion

Front 86

what grades are primary impingements?

Back 86

1

Front 87

What grades are secondary impingements?

Back 87

2 and 3

Front 88

impingement with no instability occuring in pts older than 35 usually

Back 88

Grade 1

Front 89

Grade 1, intrinsic

Back 89

Primary Impingement, impingement , no instability.
due to RC degeneration, atrophy from not using it (35 +)

Front 90

Grade 1, extrinsic

Back 90

Primary Impingement, imping, not instability.
everything around suprahumeral area being too large.

Front 91

Name some defects that cause Grade 1, extrinsic ; primary impingement

Back 91

Congenital acromial defect
acromial hooked
osteophytes coming off acromion
degeneration of AC joint could lead to inflammation
changes in humeral head

Front 92

What type of impingement is Instability , NO impingement

Back 92

Grade 4

Front 93

Means the main problem is impingement

Back 93

Secondary Impingement

Front 94

Due to capsular or labral tearing (bankart lesion)- loss of static and dynamic stability and vacuum seal.
Occurs at any age with fall.

Back 94

Grade 2 , Secondary Impingement

Front 95

Hypermobility or laxity leading to instability. Caused by poor mechanics ex:baseball player

Back 95

Grade 3 , Secondary impingement

Front 96

Instability due to trauma, partial tearing of ligs and/or labrum; can occur from lax capsule

Back 96

Unidirectional

Front 97

Instability due to physiological lax of connective tissue (weak collagen with a lot of give)

Back 97

Multidirectional

Front 98

Instability ->Hypermobility->repetitive trauma->Resulting in:

Back 98

Bone spurs, tendon rupture, Capsular restriction, frozen shoulder

Front 99

2 other causes of Multidirectional Instability

Back 99

Overuse and Poor RC muscles

Front 100

In multidirectional Instability due to Overuse multidirectional instability can be caused by overhead throwing or repeated over head activities which cause the RC muscles to ...

Back 100

work harder which then begin to fatigue =poor mechanics. leading toImpingement to suprahumeral structures

Front 101

Unidirectional instability usually involve

Back 101

RC Tears (TRAUMA-Acute); in older individuals (Degeneration-Chronic)

Front 102

TUBS?

Back 102

Traumatic, Unilateral, Bankart Lesion, Surgery

Front 103

AMBRI?

Back 103

Atraumatic, Multidirectional, Bilateral, Rehab, Inferior Capsular Shift (IF REHAB FAILS)

Front 104

What is an inferior capsule shift

Back 104

AMBRI, tightening of inferior capsule and RIC

Front 105

AMBRI can cause

Back 105

Dislocation

Front 106

Fx of the Glenoid on the way back from a dislocation

Back 106

Bony Bankart Lesion

Front 107

Positive Tests with Anterior Instability

Back 107

Load and Shift
Apprehension Test
Ant. Drawer Test

Front 108

labrum torn, stability compromised, Lesion due to dislocation popping out tearing labrum and IGHL

Back 108

Bankart Lesion

Front 109

Symptoms of a bankart lesion

Back 109

catching, aching, susceptibility to dislocate, patient cannot trust shoulder (positive apprehension test)

Front 110

If you have a bony bankart, you should also be concerned with a ...

Back 110

Hill Sachs deformity

Front 111

With anterior instability you should try to strengthen..

Back 111

Anterior structures such as pecs, deltoid...

Front 112

What should you avoid with anterior instability?

Back 112

ER, horizontal ABD, Flys end range, bench press end range.

Front 113

What should you focus on with anterior instability?

Back 113

IR's, Adductors (pecs, subscap, Lat, deltoid)

Front 114

Force against forward flexed humerus or FOOSH

Back 114

Posterior instability

Front 115

potential problems with posterior instability?

Back 115

SGHL and IGHL
posterior Labrum
Post. capsule laxity

Front 116

Positive test for Posterior instability?

Back 116

Post. Rotary Sign

Front 117

What should you avoid with Posterior Instability?

Back 117

closed chain exerices, IR and Add.

Front 118

What muscles should you focus on with Posterior instability?

Back 118

Teres Major and Minor - the IR's

Front 119

Happens secondary to RC weakness, Paralysis, CVa, or multidirectional instability

Back 119

Inferior Instability

Front 120

Positive Tests for Inferior Instability

Back 120

Inferior Sulcus sign

Front 121

Potential problems seen with Inferior instability include:

Back 121

IGHL
SGHL
Posterior Labrum
Posterior capsule laxity

Front 122

What should you avoid with inferior instability?

Back 122

Arm overhead, unsupported arm (must sling), military press, shoulder shrugs

Front 123

What type of rehab needed for Inferior instability?

Back 123

Multidirectional rehab

Front 124

Potential problems with Anterior Dislocation?

Back 124

RC tear, Neurovascular injury (axillary most common injured)

Front 125

How to check for axillary damage with ant. dislocation?

Back 125

Check deltoid strength and sensation over lateral shoulder

Front 126

Commonly associated with anterior dislocations?

Back 126

Bankart lesion, Bony bankart, Hill sachs

Front 127

With posterior dislocation watch for

Back 127

reverse hillsachs lesion

Front 128

Shoulder dislocations:

occur with Abd and ER:

occur with Add, flex, IR:

Back 128

Ant. Dislocation

Post. Dislocation

Front 129

With older individuals who have a dislocation , immobilization period needs to be shorter b/c?

Back 129

b/c they can develop capsular restriction

Front 130

When is surgery required for dislocation?

Back 130

recurrent dislocations, if conservative treatment has failed and axilary nerve injury, and Athletes, dislocations with severe RC tears or secondary impingement

Front 131

Bicipital tendinitis can be caused by?

Back 131

impingement and can result in bicipital tears.

Front 132

SLAP stands for

Back 132

Superior, Labrum, Ant.Post.