Shoulder Disorders: Anatomy, Pathology, And Treatment

Front 1

What does a shoulder disorder PE consist of (think broad)?

Back 1

Inspection, ROM, strength test, special test

Front 2

When performing the ROM in a PE, what always must be done?

Back 2

Compare sides

Front 3

What is a very common musculoskeletal complaint?

Back 3

Shoulder disorders

Front 4

What are extrinsic symptoms presented in shoulder disorder?

Back 4

Neural imingement (C5-C6), disphragmatic irritation, myocardial ischemia

Front 5

What is the primary stabilizer to anterior-posterior translation of the clavicle?

Back 5

AC joint

Front 6

What type of injury can occur if patients fall with a downward force, or play hockey, football, or wrestling? Who is this more commonly seen in -- males or females?

Back 6

AC joint separation

Front 7

What are common PE findings for AC joint separation?

Back 7

Deformity grade III and up, tenderness over the AC joint, and crepitation

Front 8

What diagnostic imaging is used for an AC joint separation -- especially to differentiate grade I and II?

Back 8

X-Ray

Front 9

What is the treatment for Type 1 and 2 AC joint separation?

Back 9

Treat with rest and sling 1-2 weeks, increase ROM, patient education with pain

Front 10

What is the treatment for Type III AC joint separation?

Back 10

Possibly surgery - athletes and laborers

Front 11

What is the treatment for Type, IV, V, and VI AC joint separation?

Back 11

Repair and reconstruction

Front 12

Name the fracture. Where does most commonly occur?

Back 12

Clavicle fracture and Middle 1/3 of the clavicle

Front 13

During the ROM, what would be the indicating sign of a clavicle fracture?

Back 13

unable to raise arm

Front 14

What is the diagnostic imaging for clavicle fracture? What are the views?

Back 14

X-Ray - AP and 45 degree cephalic view

Front 15

If a patient has a clavicle fracture and you are concerned about the bone quality, what imaging could be done?

Back 15

CT or MRI

Front 16

What is the treatment for a clavicle fracture?

Back 16

sling or figure 8 brace for 4-6 wks, and a series of X-rays to evaluate healing

Front 17

What type of injury is impingement syndrome associated with?

Back 17

Rotator cuff injury

Front 18

What activities promote impingement syndrome? What injury is impingement syndrome associated with?

Back 18

Overuse, overhead, pitching, and sleeping with arm over head Rotator cuff

Front 19

During flexion the supraspintous tendon and bursa become entrapped. Where do they become entrapped? What is the name of this syndrome?

Back 19

Acromion lateral edge and greater tuberosity Impingement syndrome

Front 20

What presents night pain, pain with placing on jacket, burning sensation, and crepitus?

Back 20

Impingement syndrome

Front 21

If patient presents with rotator cuff injury/ impingement, what special test are performed?

Back 21

Neer test and Hawkin's test

Front 22

What type of impingement can be discovered in the Neer test?

Back 22

Humorous and acromial impingment

Front 23

Name the test: Pain with foray flexion to 180 degrees.

Back 23

Neer test

Front 24

Name the test: Forward flex the arm to 90 degrees and elbow flexed to 90 degrees as you internally rotate the humorous.

Back 24

Hawkins test

Front 25

What would be seen on an X-Ray during impingement syndrome/ Rotaor Cuff injuries?

Back 25

Narrowing within subacromial space or subacromial spur

Front 26

What is the treatment for impingement syndrome?

Back 26

Conservative first - rest, activity modification, PT, NSAIDs Injection steroids - into subacromial space

Front 27

What rotator cuff injury is from repetitive stress on these muscles and calcium deposition in the tendons?

Back 27

Calcific Tendinitis

Front 28

What patients is calcific tendinitis more commonly seen in?

Back 28

DM patients

Front 29

What is the PE for calcific tendinitis?

Back 29

painful ROM, strength weaknees, and special test (Neer and Hawkins)

Front 30

When would you see calcium deposits lateral to the humeral head on an X-RAY?

Back 30

Calcific tendinitis

Front 31

What are diagnostic imaging test that can be ordered for a patient with Calcific Tendinitis?

Back 31

XRay and MRI - both you can see the calcium

Front 32

What is the most definitive treatment for patients with calcium tendinitis?

Back 32

Arthroscopic debridement (calcium debridement)

Front 33

What is most commonly torn tear in the rotator cuff? Second most common?

Back 33

Supraspinatus then infraspinatus

Front 34

If a patient describes having a "dead arm", night pain laying down, and pain with overhead activities, what is the most likely diagnosis?

Back 34

Rotator cuff tears

Front 35

ROM for SITS. Name them.

Back 35

Supraspinatus - abduction, flexion Infraspinatous and Teres Minor - External rotation Subscapularis - Internal Rotation

Front 36

What are special test that can be used for a rotator cuff tendon tear?

Back 36

Neer, Hawkins, Drop arm, Empty Can, Lift-off, Belly-press

Front 37

Which special test has the arm passively abducted to 90 degrees and patient is asked to maintain abduction.

Back 37

Drop arm

Front 38

If the drop arm and/or empty can test are positive, what is this positive for?

Back 38

Supraspinatous weakness

Front 39

Which special test has a bilateral 30 degrees of adduction, 90 degrees of forward flexion, and internal oration resisted force.

Back 39

Empty can

Front 40

Which special test has the hand behind the back and push posteriorly. Weakness in this test is positive for?

Back 40

Lift-of sign, subscapularis

Front 41

Which special test do you place the hands on the belly and press. Weakness in this test is positive for?

Back 41

Belly-press sig, subscapularis

Front 42

What diagnostic imaging will allow you to see a tendon tear? Which is more invasive, but more favorable?

Back 42

MRI and MR arthrogram (more favorable)

Front 43

If conservative surgery is not enough to fix the rotator cuff tear, what must be done?

Back 43

Arthroscopic or Open rotator cuff tendo repair

Front 44

Inflammation of the long head of the biceps attaching to the superior glenoid is known as?

Back 44

Tendinitis

Front 45

What is associated with subluxation of the biceps tendon?

Back 45

Biceps tendinitis

Front 46

What presents with anterior pain, rubbing the anterior aspect of the shoulder, and tenderness along the groove?

Back 46

Biceps tendinitis

Front 47

Which special test are performed for biceps tendinitis?

Back 47

Yergason and Speed

Front 48

What is the special test that you hold patients hand they resist active supination?

Back 48

Yergason

Front 49

What is the special test that patient resist forward flexion of arm with palm up?

Back 49

Speed

Front 50

What is the diagnostic image used for biceps tendinitis?

Back 50

MRI

Front 51

What is a complication with bicep tendinitis? **

Back 51

could turn into bicep rupture over time.

Front 52

What treatment for biceps tendinitis, is a deep muscle penetration of photo-like therapy?

Back 52

Laser therapy

Front 53

What is this disorder? What is "common name"?

Back 53

Biceps tendinitis or Popeyes sign

Front 54

With biceps tendinitis an arthroscopy tenotomy or tendodesis may be performed. Which one is used for younger patients? Older patients?

Back 54

Tenotomy - older Tenodesis - younger

Front 55

Adhesive capsulitis/ Frozen shoulder is associated with which disorders?

Back 55

Thyroid issues and DM

Front 56

In adhesive capsulitis/ Frozen shoulder, which ROM are affected? Which is the first to go?

Back 56

Internal rotation (1st to go), abduction, forward flexion

Front 57

How long can PT take for someone with adhesive capsulitis/ frozen shoulder?

Back 57

6-9 months

Front 58

When will surgery fail in adhesive capsulitis/Frozen shoulder**?

Back 58

If PROM(passive range of motion) is not restores early on

Front 59

What is a common diagnosis for elderly with degenerative changes in GH joint?

Back 59

Glenohumeral joint OA

Front 60

During a PE, a patient has decreased ROM due to osteophyte formation and lack of joint space. What is the most likely diagnosis.

Back 60

GH joint osteoarthritis

Front 61

What is the diagnostic image used for GH joint OA?

Back 61

XRAY - loss of joint space

Front 62

Other than conservative therapy, what is the surgical option for GH joint OA?

Back 62

Total shoulder replacement (hemiarthroplasty)

Front 63

What is another name for a shoulder dislocation?

Back 63

Glenohumeral joint instability