Study Shoulder Injuries (PTA 201) Flash Cards

 
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Shoulder Injuries (PTA 201)

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How long does rehabilitaion take for a shoulder dislocation?
2.5-4 MONTHS
What are the 3 phases of recovery for shoulder dislocations?
-PROTECTION PHASE
-CONTROLLED MOTION PHASE
-RETURN TO FUNCTION PHASE
Minimum protection phase/return to function phase for RC tears?
-12-16 WEEKS POSTOPERATIVELY
-PATIENTS
-PATIENTS NOT ALLOWED TO RETURN TO HIGH DEMAND ACTIVITIES FOR 6 MONTHS OR POSSIBLY 1 YEAR
For RC tears, vigorous stretching is not considered safe for about?
3-4 MONTHS
What is the criteria for progression for the RC moderate protection phase?
-A WELL HEALED INCISION
-MINIMAL PAIN WITH ASSISTED SHOULDER MOTIONS
-PROGRESSIVE IMPROVEMENT IN ROM
What is the focus of the second phase (moderate protection phase) of rehabilitation for RC tears?
-TO BEGIN TO DEVELOP STRENGTH, ENDURANCE, AND NEUROMUSCULAR CONTROL OF THE SHOULDER WHILE CONTINUING TO ATTAIN FULL OR NEARLY FULL, PAIN-FREE SHOULDER MOTION.
-EMPHASIS IS PLACED ON DEVELOPING CONTROL OF THE SCAPULAR STABILIZERS AND ROTATOR CUFF MUSCLES
The maximum protection phase for RC tears is?
-3-4 WEEKS AFTER A FULLY ARTHROSCOPIC OR MINI OPEN REPAIR OF SMALL OR MEDIUM TEARS

-6-8 WEEKS AFTER REPAIR OF LARGE OR MASSIVE TEARS
What is the priority during the initial phase of rehabilitation after a RC tear?
PROTECTION OF THE REPAIRED TENDON

(TENDON IS AT IT'S WEAKEST POINT APPROX 3 WEEKS AFTER SUGERY)
After repair of a large or massive cuff tear, avoid use of operated arm for functional activities that involve heavy resistance for?
12 MONTHS POSTOPERATIVELY
After repair of a full-thickness RC tear, you should delay dynamic strengthening (progressive resistive exercises)/PRE for a minimum of __________ for small tears, and __________ for large tears?
-8 WEEKS FOR SMALL TEARS
-3 MONTHS FOR LARGE TEARS
After repair of a full-thickness RC tear, there should be no weight bearing (closed chain) exercises or activities for how long?
6 WEEKS
After repair of a full-thickness RC tear, when is it ok for the patient to active shoulder or abduction flexion?
NOT UNTIL THE PATIENT CAN LIFT THE ARM WITHOUT HIKING THE SHOULDER
During the recovery of a full-thickness RC repair, you should only do PASSIVE and NO ASSISTED ROM for how long?
6-8 WEEKS
Teres major nerve?
LOWER SUBSCAPULAR NERVE
Subscapularis nerve?
UPPER AND LOWER SUBSCAPULAR NERVE
Levator scapula?
DORSAL SCAPULAR NERVE
Rhomboids nerve?
DORSAL SCAPULAR NERVE
Pectoralis major nerve?
LATERAL AND MEDIAL PECTORAL NERVE
Pectoralis minor nerve?
MEDIAL PECTORIAL NERVE
What is the most common structure involved with rotator cuff impingement?
SUPRASPINATUS TENDON
Secondary shoulder impingement?
RELATED TO GLENOHUMERAL INSTABILITY THAT CREATES A REDUCED SUBACROMIAL SPACE BECAUSE THE HUMERAL HEAD ELEVATES AND MINIMIZES THE AREA UNDER THE CORACOACROMIAL LIGAMENT.
Primary shoulder impingement?
REFERS TO MECHANICAL COMPRESSION OF THE ROTATOR CUFF TENDONS, PRIMARILY THE SUPRASPINATUS
Impingement refers to mechanical compression of the rotator cuff tendons, primarliy the supraspinatus tendon?
PRIMARY SHOULDER IMPINGEMENT
When can functional use be expected after a total shoulder arthroplasty?
AROUND 6 MONTHS POST-OPERATIVELY
Tx of total shoulder arthroplasty (week 6)?
-LIGHT RESISTANCE EXERCISES ARE INITIATED
-THERABAND FOR HOME USE
Tx of total shoulder arthroplasty (days 1-2)?
-GENTLE ACTIVE ASSISTED ROM AND ISOMETRIC EXERCISES
-MUSCLE CONTRACTIONS OF THE DELTOID ARE CONTRAINDICATED IN CASES OF RC TEAR (RARE)
Tx of total shoulder arthroplasty (second week)?
-SCAPULAR MOBILIZATION AND STABILIZATION EXERCISE ADDED
-QUANTITY AND QUALITY OF ISOMETRIC EXERCISE AND MOTION EXERCISES ARE PROGRESSED
Tx of total shoulder arthroplasty (first week)?
PATIENT IS ALLOWED TO DO AROM OF THE DISTAL EXTREMITIES
How is immobilization accomplished with a clavicle Fx?
WITH A FIGURE 8 BRACE
Clavicular Fx or normally seen in?
YOUNGER PATIENTES (<25)
What does scapular Fx Tx depend on?
WHETHER OR NOT THERE IS ASSOCIATED GH INSTABILITY
What is the 2nd most common scapula Fx?
GLENOID NECK FX
Scapular Fx?
-RESULT FROM DIRECT, SEVERE TRAUMA
-USUALLY ASSOCIATED WITH OTHER INJURIES TO ESPECIALLY THORAX
-BODY MOST COMMON
-TX CONSERVATIVELY
How many people does adhesive capsulitis effect?
2% OF POPULATION
11% OF PEOPLE WITH DIABETES
RSD
REFLEX SYMPATHETIC DYSTROPHY
Pt presentation of adhesive capsulitis?
-PROGRESSIVE SHOULDER PAIN
-SEVERE RESTRICTIONS IN AROM & PROM
Clinical presentation of adhesive capsulitis?
OCCURS MORE IN MIDDLE AGED POPULATION WITH FEMALES>MALES
Secondary adhesive capsulitis?
RESULTS FROM TRAUMA, IMMOBILIZATION, RSD, RA, ABDOMINAL DISORDERS, OR PSYCHOGENIC DISORDERS
Primary adhesive capsulitis?
UNKNOWN CAUSE: ASSOCIATED WITH DIABETES, HYPOTHYROIDISM AND CARDIOPULMONARY CONDITIONS
Two classifications of adhesive capsulitis?
-PRIMARY
-SECONDARY
Shoulder capsular pattern?
ER>ABD>IR
Adhesive capsulitis is AKA?
FROZEN SHOULDER
Clinical presentation of labrum tears?
SHARP POP OR CATCHING SENSATION IN THE SHOULDER DURING CERTAIN SHOULDER MOVEMENTS
MOI of labrum tears?
-OVERUSE
-TRAUMA
-SLAP LESIONS
Posterior dislocation rehab phase?
STRENGTHEN ANTAGONIST (ER/ADD)
Posterior dislocation minimum protection phase Tx?
-ISOMETRIC STRENGTHENING
-AROM AVOIDING MOTIONS WHICH PUT EXCESSIVE STRAIN ON POST CAPSULE
1. HORIZONTAL ADDUCTION
2. IR/ABD
Posterior dislocation max protection phase?
MAINTAIN DISTAL JOINT MOBILITY
Excessive humeral head displacement in the posterior direction?
POSTERIOR DISLOCATION
Instability occuring in more than one plane?
MULTI-DIRECTIONAL INSTABILITY
Anterior instability movements to avoid?
ABD & ER
Most common shoulder instability?
ANTERIOR INSTABILITY (95%)
Grade III shoulder instability?
A FEELING OF THE HUMERAL HEAD OVER RIDING THE RIM, BUT REMAINS DISLOCATED (50%)
Grade II shoulder instability?
A FEELING OF THE HUMERAL HEAD OVER RIDING THE RIM, BUT SPONTANEOUSLY REDUCES (>50%)
Grade I shoulder instability?
A FEELING OF THE HUMERAL HEAD RIDING UP INTO THE GLENOID RIM (25-50%)
A mild amount of translation?
NORMAL LAXITY (0-25%)
Volition?
SURGERY
AMBRI?
ATRAUMATIC MULTIDIRECTIONAL BILATERAL REHAB INFERIOR
TUBS?
TRAUMATIC UNIDIRCTIONAL BANKART SURGERY
A clinical condition in which unwanted translation of the humeral head on the glenoid compromises the comfort and function of the shoulder?
SHOULDER INSTABILITY
Shoulder instability classification depends on?
-ONSET
-DEGREE
-FREQUENCY
-VOLITION
-DIRECTION
Matsen?
SHOULDER LAXITY IS THE ABILITY OF THE HUMERAL HEAD TO BE PASSIVELY TRANSLATED ON THE GLENOID FOSSA
RC TX minimum protection phase?
-MINIMUM PROTECTION PHASE
1. INCREASE ROM
2. NORMALIZE SHOULDER KINEMATICS
3. STRENGTHER RC ANS PARASCAPULAR MUSCLES
4. IMPROVE THE RC ABILITY TO TOLERATE TENSION LOADING
RC surgery TX?
THE LENGTH OF REHAB DEPENDS ON THE PT'S AGE, TYPE OF TEAR, AND SURGICAL REPAIR
Conservative RC TX?
GOAL IS TO STRENGTHEN UNINJURED RC
-CONTROL INFLAMMATION (STEROID INJECTION)
ACTIVITY MODIFICATION-AVOID OVERHEAD ACTIVITIES
-MAINTAIN NORMAL SHOULDER KINEMATICS
-ANT/POST CAPSULE STRETCHING
Clinical presentation of RC tears?
-PAINFUL ARC
-DECREASE STRENGTH AND ROM
-FUNCTIONAL DISABILITIES
Classifications of RC tears?
-PARTIAL THICKNESS
-FULL THICKNESS
Stretch shortened tissues (impingement syndrome)?
-STRETCH THE INFERIOR CAPSULE
-INFERIOR JOINT MOBS
-IMPROVE IR ROM
-STRETCH IR OF THE SHOULDER
Scapular stabilization (impingement syndromes)?
-UPPER AND LOWER TRAPS
-LEV SCAPULA
-RHOMBOID MAJOR
-PECT MINOR
-MIDDLE AND LOWER SERRATUS ANTERIOR
Normalize any muslce imbalances (impingement syndromes)?
-DELTOID AND RC (FORCE COUPLE)
-STRENGTHEN HUMERAL DEPRESSORS (INFRASPINATUS AND TERES MINOR)
Tx goals for impingement?
-NORMALIZE ANY MUSCLE IMBALANCES
-SCAPULAR STABILIZATION
-STRETCH SHORTENED TISSUES
Impingement syndrome types?
-PRIMARY
-SECONDARY
-INTERNAL
Clinical presentation of impingement syndrome?
-PAINFUL ARC OF MOTION
-PAIN WITH COMBINED MOTIONS OF ABD AND IR
Tx Grade IV, V, VI AC injuries?
SURGERY
Tx grade III AC injuries?
SURGERY?
Tx grade I & II AC injuries?
CONSERVATIVE
Tx for AC joint dislocation/subluxation?
STRENGTHEN RC MUSCULATURE EXPECIALLY IR/ER
Tx for acute shoulder injuries?
-ACUTE PHASE: PRICE
-SUB-ACUTE: INCREASE ROM AND STRENGTHEN (GRADUALLY)
-MINIMAL PROTECTION PHASE: FUNCTIONAL ACTIVITIES
Overuse?
REPETITIVE MOVEMENTS
Overstreatched injuries?
(PASSIVE) EXTERNAL FORCE EXCEEDS PASSIVE INSUFFICIENCY
Overload injuries?
(ACTIVE) EXTERNAL STRESS EXCEEDS INTERNAL RESISTANCE TENSILE FAILURE
Hill-sachs lesion?
A COMPRESSION FX OF THE POSTEROLATERAL HUMERAL HEAD
Bankart lesion?
FX OF ANTERIOR RIM OF THE GLENOID WITH THE ATTACHED LABRUM
Slap lesion?
TEAR OF THE SUPERIOR LABRUM
Tear of the superior labrum?
SLAP LESION
Overuse syndromes?
-IMPINGEMENT
-RC TEARS
-LABRUM TEARS
-MULIT-DIRECTIONAL INSTABILITIES OF THE GH JOINT
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