quiz #2 – shoulder 101

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BPT
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66433
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quiz #2 – shoulder 101
Updated:
2011-02-18 13:10:36
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orthopedics
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shoulder 101 – Dr. Matthew Rose
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  1. name the four joints at articulate within the shoulder girdle
    • sternoclavicular joint
    • acromioclavicular joint
    • glenohumeral joint
    • scapulothoracic joint
  2. how many muscles are associated with the shoulder joint
    30
  3. how many bones
    three
  4. what are some of the things that should be determined when taking a history
    • nature of injury – acute or chronic, combination
    • duration of injury
    • activities affected or affecting activities
    • associated symptoms – neck, numbness, vascular
    • treatments tried
  5. what are some basic principles to remember when doing an exam
    • shirt off
    • symmetry
    • bony and muscle contours
    • palpation
    • manual muscle testing
    • laxity/stability – sulcus, hyper laxity, schucking
  6. how many degrees of flexion is there in the shoulder
    180
  7. how many degrees of extension is there in the shoulder
    50
  8. how many degrees of abduction is there in the shoulder
    180
  9. how many degrees of a adduction is there in the shoulder
    50
  10. how many degrees of internal rotation is there in the shoulder
    90
  11. how many degrees of external rotation is there in the shoulder
    90
  12. Speed's Test assesses what conditions
    • SLAP Lesions
    • labral pathology
    • biceps tendon
  13. Sulcus Sign assesses what conditions
    • multidirectional instability
    • laxity
  14. what are the characteristics of scapular dysfunction
    • tightness anteriorly
    • forward had
    • overdeveloped pectoralis major and minor
    • smaller window of the shoulder
    • "like firing a cannon out of the canoe"
  15. what are the radiographic evaluations of the shoulder
    • Xrays 3 views
    • arthrogram
    • MRI
    • MRI with arthrogram
    • CT
  16. true or false – arthrography were used prominently prior to MRIs
    true
  17. Arthrograms are good for what populations
    patients with pacemakers and patients who are claustrophobic
  18. true or false – MRIs are the most informative method of viewing the shoulder
    true – however only as good as interpretation and quality of the scan
  19. AC Joint injuries are also called
    shoulder separations
  20. AC joint injuries are usually caused by
    force applied to the acromiom -fall on the superior aspect
  21. what is this deformity
    AC step deformity
  22. what is the treatment for AC joint injuries; grade 1 and 2
    • nonoperative
    • sling
    • ice, NSAIDs
    • one – two weeks start range of motion
    • progressive strengthening when pain free
  23. what is the treatment for AC joint injuries; grade 3
    • controversial
    • sling 3 - 6 weeks
    • surgery – screws, tape, suture, allographs reinforcement
  24. what is the treatment for AC joint injuries grade 4, 5, and 6
    surgery
  25. true or false – impingement injuries, it is hard to determine between impingement or rotator cuff lesion
    true
  26. what is the primary cause of most cuff tears and biceps lesions
    outlet impingement
  27. what is the ideology of impingement and rotator cuff tears
    • anatomic and mechanical - Spurs, overuse, often in painters
    • overuse
    • vascular – smokers
    • tramatic
  28. what percentage of the population has type I, type II, and type III acromions?
    • 17%
    • 42%
    • 39%
  29. what is the percentage for rotator cuff tears in type I, type II, and type III acromions
    • 3%
    • 24%
    • 70%
  30. what percentage of patients with confirmed rotator cuff tears had AC Spurs
    51%
  31. true or false – 10 to 14% of normal AC joints have osteophytes
    true
  32. what are the characteristics of primary impingement
    • repetitious micro trauma - Cuff
    • tendinitis and bursitis - impingement
    • tendinitis and bursitis is mostly caused by overhead motion
  33. what are the characteristics of secondary impingement: theory 1
    • rotator cuff weakness
    • scapular stabilizer weakness
    • rotator cuff fatigue
  34. what are the characteristics of secondary impingement: theory 2
    • clinical or sub clinical instability leads to intrinsic tension overload and/or superior humeral head migration which leads to impingement
    • often seen in throwing athletes
  35. what are the stages of impingement syndrome
    • Stage I - edema and hemorrhage
    • Stage II -- Fibrosis and Tendonitis
    • Stage III- Bone Spurs and tendon rapture
  36. what are the characteristics of impingement stage I
    • < 25 years of age
    • overuse etiology
    • Reversible
    • conservative treatment
  37. what are the characteristics of impingement stage II
    • 25 – 40 years of age
    • recurrent pain with activity
    • bursectomy or CA ligament resection
    • Subacromial decompression
  38. what are the characteristics of impingement stage III
    • > 40 years of age
    • progressive disability
    • partial or complete tears
    • subacromial decompression and rotator cuff repair
  39. W ahat is the non-operative treatment of impingment syndrome
    • Relative rest
    • NSAID's
    • steroid injections - in sub acromial space
    • physical therapy
    • surgery if not improved with time
  40. what are the three types of rotator cuff tears
    • bursal surface
    • undersurface
    • full thickness
  41. what are the advantages of acromioplast arthroscopicy
    • improved cosmesis
    • decreased deltoid opening
    • shortens hospital stay
    • earlier active motion and more aggressive with a RROM
  42. true or false – pain is related to the size of the tear
    false – pain is not related to tire size
  43. true or false – small tears in the rotator cuff will not usually enlarge with time
    false – small tears usually will enlarge with time
  44. true or false – surgery is better earlier than later when it concerns the rotator cuff
    true
  45. what does TUBS stand for
    • traumatic
    • unidirectional
    • Bankart
    • Surgery
  46. what does AMBRII stand for
    • a traumatic/acquired
    • multidirectional
    • bilateral
    • rehab
    • inferior capsular shift
    • interval closure
  47. true or false – the shoulder is usually instable anteriorly and inferiorly
    true
  48. dislocation
    the joint surfaces are no longer in contact and the joint requires reduction to reassociate the articular surfaces
  49. subluxation
    the joint does not frankly dislocate. His slips or translates greater than normal. The joint surface may lose contact however they self reduce
  50. hill sachs lesion
    defect on posterior aspect of humeral head
  51. reverse hill sachs
    well defect on anterior aspect of humeral head
  52. SLAP Lesion
    type I – ?
    type II - ?
    type III -
    type IV -
    • degen tearing, but intact biceps
    • detachment from glenoid
    • buckethandle tear
    • care extends into biceps tendon
  53. what kind of surgery is done for type I SLAP lesions
    Debride
  54. what kind of surgeries done for type II, III, and IV
    surgical repair
  55. what is this condition
    biceps tendon rupture
  56. how much strength is lost a patient suffers from bicep tendon rupture
    • 20% decrease in flexion strength
    • popeye muscle
    • cosmetic deformity
  57. adhesive capsulitis is also called
    frozen shoulder
  58. adhesive capsulitis is associated with
    hyperthyroidism, diabetes, breast surgery, autoimmune

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