Sm Caq - Shoulder Instability, Arthroscopy, Slap

Front 1

nerve supply to ant capsule and GH joint?

Back 1

Axillary, Suprascapular with Musculocutaneous to the anteriosuperior portion

Front 2

nerve supply to posterior capsule and GH joint?

Back 2

Axillary and suprascapular

Front 3

Anterior blood supply to the shoulder?

Back 3

Anterior Humeral Circumflex A to subscap, anastomoses w Post Humeral Circumflex A @ biceps tendon

Front 4

Post Blood supply to shoulder?

Back 4

suprascapular a and post humeral circumflex

Front 5

Labral blood supply to shoulder?

Back 5

suprascapular, post humeral circumflex, circumflex scapular a.
(note ant sup labrum has poor blood supply and inferior labrum has robust blood supply)

Front 6

GH Congruency?

Back 6

GH becomes more congruent at higher levels of abduction so contact area increases

Front 7

IGHL action?

Back 7

tighten w Abd/ER

Front 8

SGHL action?

Back 8

tighten w Add/ER

Front 9

MGHL action?

Back 9

tighten w Add/ER

Front 10

Ratio GH to Scapulothoracic motion in abduction?

Back 10

generally 2:1 BUT:
first 30 degrees all GH
last 60 from 120-180 ratio 1:1

Front 11

Nreve complication from Anterior Portal shoulder scope?

Back 11

MusculoCutaneous Nerve - running 2cm inf and 1cm medial to coracoid

Front 12

Nerve complicatio from Posterior Inferior Portal shoulder scope?

Back 12

Axillary nerve - 5 cm below acromion

Front 13

**With increasing abduction in teh scapular plane, maintaining neitral rotation, contact area, and contact pressure per unti area between the humeral head and glenoid follows what pattern if the total load across the joint is held constant?

Back 13

Contact area increases and contact pressure decreases.

Front 14

What ligaments are primary static restraints to inferior translation of the arm when the shoulder is in 0 degrees abduction and neutral rotation?

Back 14

Superior GlenoHumeral and coracohumeral

Front 15

Best description of most common anatomic variation in glenoid labrum and MGHL in anterosuperior quadrant of shoulder?

Back 15

Labrum attached to glenoid rim and a flat/broad MGHL

Front 16

Atraumatic neuropathy of the suprascapular nerve usually occurs at what anatomic location?

Back 16

Suprascapular and spinoglenoid notches.

Front 17

Xray view to detect Bony Bankart?

Back 17

West Point Axillary

Front 18

Xray view to detect Hill-Sachs?

Back 18

Stryker notch

Front 19

GLAD lesion?

Back 19

Glenoid Labrum Articular Defect

Front 20

shoulder brace for non-throwing athletes?

Back 20

Duke brace

Front 21

Shoulder brace for throwing athletes?

Back 21

Sully brace

Front 22

Evidence conclusions for shoulder stabilization procedures in high energy sports

Back 22

evidence supports operative fixation.

Front 23

Bankart lesion and displacement in IR vs ER?

Back 23

IR is displaced
ER is reduced

Front 24

Is need for immediate surgery for shoulder instability supported by the literature?

Back 24

Not at this time.

Front 25

best position to immobilize arm after shoulder dislocation?

Back 25

Adduction and External Rotation

Front 26

17yo linbacker primary ant shoulder dislocation requiring reduction but has no bone or rotator cuff issues - treatment algorithm?

Back 26

ROM, functional brace, return to play when pain free.

Front 27

50 yo w primary ant shoulder dis, was reduced then immobilized a few weeks. 3mos postop c/o pain w activity and at night + weakness w overhead activity. Most likely cause?

Back 27

Axillary nerve palsy (p188)

Front 28

Acute HAGL Rx?

Back 28

Open repair of lateral joint capsule disruption. (p188)

Front 29

When become concerned about Hill Sachs and need for grafting?

Back 29

25-35%

Front 30

Hill-Sachs Humeral defect surgical options?

Back 30

Capsular shift
Glenoid recon-ICBG?Latarjet
Oseoarticular allograft
Arthroplasty
RC "Rimplissage" (arthro place infraspin tendon into defect w suture anchors)

Front 31

Reverse Hill-Sachs defect/instab surgical options?

Back 31

LT Transfer (McGlaughlin)
Osteoarticular allograft
Arthroplasty
Arthrosurface HemiCAP

Front 32

Chronic locked A/P dislocations - when closed red?

Back 32

up to 4-6 weeks post injury, but then need to do open.

Front 33

Chronic lockd A/P dislocation surg Rx?

Back 33

Open red + transfer LT with subscap in young with defects 20-45% of humeral head

Front 34

Chronic locked A/P dislocation - when hemi?

Back 34

Only when defect >50-60%

Front 35

what anatomic item associated with higher rate recurrence after arthro stab?

Back 35

"Inverted Pear" glenoid deficiency

Front 36

ALPSA lesion?

Back 36

Anterior Labral Periosteal Sleeve Avulsion: avulsion of the anterior inferior labrum which heals medially on the scapular periosteum.

Front 37

Indications for fixation GT fx?

Back 37

>1cm? (look up)

Front 38

primary restraint to posterior translation?

Back 38

Subscapularis

Front 39

Post subluxation physical finding?

Back 39

reproducible click and pain with posterior stress or loading
+Kim sign.(Jerk test p 193)

Front 40

usual path for post instability?

Back 40

"reverse Bankart"

Front 41

Post glenoid bone loss surgical options?

Back 41

glenoid osteotomy
ICBG
acromial bone block

Front 42

Scapular dyskinesia types?

Back 42

inf/med
medial
sup/med

Front 43

Internal Shoulder Impingement?

Back 43

contact between articular side of the rotator cuff and the posterio-superior glenoid

Front 44

PE findings for internal impingement?

Back 44

dec IR
inc ER
+ relocation test
+ O'Brien test (SLAP)

Front 45

Trhowing injuries?

Back 45

ant laxity w hyperangulation
PostSup SLAP tears w undersurface cuff injury

Front 46

GIRD?

Back 46

Glenohumeral Internal Rotation Deficit

Front 47

Post/Inf capsule contracture -->

Back 47

loss of IR

Front 48

Why PIGHL contracture in throwers?

Back 48

repetitive overuse
muscular fatigue of RC & Scapular stabilizers
deceleration overloads muscles, caplule responds by hypertrophy

Front 49

Result of "peel-back" mechanism in throwers?

Back 49

type II SLAP

Front 50

Rx symptomatic posterior capsular contractures?

Back 50

90% respond to capsular stretching
10% need surgical release

Front 51

Structures at greatest risk for pitcher with pain in early acceleration phase?

Back 51

Posteriosuperior labrum
GT
articular side of RC

Front 52

"tumor of Luschka"

Back 52

Anterior Superior scapular osteophyte

Front 53

EMG of supraspinatus shows significant EMG activity. What would biceps show, w and w.o RCT?

Back 53

minimal activity

Front 54

MDI indications for surger?

Back 54

failed nonoperative treatment
prolonged symptoms unresponsive to PT
*need to assess motivation
*ability to participate in po rehab

Front 55

benefit glenoid vs humeral based MDI capsulorrhaphies?

Back 55

equal, dealer's choice
however, one study showed humeral-based best for excessive capsular redundancy