Study PTA 201 Final (Shoulder) Flash Cards

 
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PTA 201 Final (Shoulder)

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What is normal ROM for ankle DF?
0-20 DEGREES
How do the quads work from heel strike to foot flat?
ECCENTRICALLY
What is the normal pulse for an infant?
100-130
What is the treatment of choice when treating a patient with multi-directional instability?
CONSERVATIVE
How long does the maximum protection phase for surgical repairs to large RC tears usually last?
6-8 WEEKS
What is the function of the lower trapezius?
-DEPRESSION OF THE SCAPULA
-UPWARD ROTATION OF THE SCAPULA
-RETRACTION OF THE SCAPULA
How do Codman Pendulum's work most effectively?
AS GRADE II OSCILLTION TECHNIQUES WHICH INHIBIT PAIN AND MAINTAIN JOINT MOBILITY
What muscles need to be strengthened if a patient shows excessive IR?
-INFRASPINATUS
-TERES MINOR
-POSTERIOR DELTOID
What muscles need to be strengthened if a patient has excessive shoulder protraction?
-RHOMBOID
-MIDDLE TRAP
-LOWER TRAP
What set of shoulder muscles should be targeted for strengthening on a patient with an anterior dislocation?
-TERES MAJOR
-SUBSCAPULARIS
-PECT MAJOR
A positive sulcus sign indicates injury to the superior glenohumeral ligament?
FALSE

INFERIOR GLENOHUMERAL LIGAMENT
What is the primary goal of a total shoulder replacement?
PAIN RELIEF
True/False

The drop arm test is a good test for determing the integrity of the rotator cuff?
TRUE
True/False

The subscapularis is commonly a source of pain and discomfort with impingement syndrome?
FASLE

SUPRASPINATUS
Advanced task specific strengthening activities dominate this phase of rehab after an RC repair?
MINIMUM PROTECTION PHASE
What muscles must first be targeted after an RC tear repair?
STRENGTHEN CUFF MUSCLES FIRST BEFORE DYNAMICALLY STRENGTHENING THE SHOULDER ABDUCTORS AND FLEXORS
For a post RC repair, when do strengthening exercises typically begin?
8 weeks post op
Begin to develop strength, endurance, and neuromuscular control of the shoulder. What phase of rehab is this most approprite for?
MODERATE PROTECTION PHASE
When can pendulum exercises typically start for a post RC repair?
-FIRST POSTOPERATIVE DAY (MAX PROTECTION PHASE)
What oscillation grade is used in the max protection phase of a RC tear?
GRADE I OSCILLATION (TO CONTROL PAIN AND INFLAMMATION)
With RC tears, how long does the max protection phase last for medium and large RC tears?
3-4 WEEKS (MEDIUM TEARS)
6-8 WEEKS (LARGE/MASSIVE TEARS)
What muscle group needs to be strong to stabilize the humeral head against anterior translation forces of the shoulder?
SUBSCAPULARIS & LONG HEAD OF BICEPS
What is a SLAP lesion?
A TEAR IN THE SUPERIOR LABRUM
What structures are most commonly injured do to an anterior shoulder dislocation?
-BRACHIAL PLEXUS
-AXILLARY NERVE
What kind of tissue do joint mobs stretch?
NON CONTRACTILE
What special tests can be used to diagnose impingement syndrome?
-EMPTY CAN TEST
-HAWKINS TEST
-NEER TEST
Name 3 symptoms associated with impingement syndrome?
-PAINFUL ARC OF MOTION
-INFLAMMATION
-DECREASED ROM
What muscle groups are targeted for anterior shoulder instability?
ADDUCTORS AND INTERNAL ROTATORS
AMBRI?
ATRAUMATIC MULTIDIRECTIONAL BILATERAL REHAB INFERIOR
TUBS?
TRAUMATIC UNIDIRECTIONAL BANKART SURGERY
When is the shoulder most vulnerable to an anterior shoulder dislocation?
WHILE THE SHOULDER IS IN THE POSITON OF ER AND 90 DEGRESS ABDUCTION
TRUE/FALSE

Use only passive and no assisted ROM for 6-8 weeks for a repair of a massive cuff tear or after a traditional open repair with deltoid detachment?
TRUE
ADL's after a full thickness RC repair?
AVOID USE OF OPERATED ARM FOR FUNCTIONAL ACTIVITIES THAT INVOLVE HEAVY RESISTANCE FOR 6-12 WEEKS POST OP
What are the guidlines for stretching a repaird full thickness RC repair?
AVOID VIGOROUS STRETCHING, THE USE OF CONTRACT-RELAX PROCEDURES OR GRADE III JOINT MOBILIZATIONS FOR AT LEAST 6 WEEKS POST OP.
Strengthening exercise guidlines after repair of a full thickness RC tear?
-ISOMETRIC RESISTANCE TO SCAPULOTHORACIC MUSCULATURE (ARM SUPPORTED)
-NO WEIGHT BEARING (CLOSED CHAIN) EXERCISES OR ACTIVITIES FOR 6 WEEKS
-DELAY DYNAMIC STRENGTHENING (PRE's) FOR A MINIMUM OF 8 WEEKS
Early shoulder motion guidlines after repair of a full thickness rotator cuff tear?
-PERFORM PASSIVE OR ASSISTED ROM WITHIN SAFE AND PAIN FREE RANGES
-ONLY PASSIVE AND NO ASSISTED ROM FOR 6-8 WEEKS
-MINIMIZE ANTERIOR TRANSLATION OF THE HUMERAL HEAD AND POTENTIAL FOR IMPINGEMENT. (SEE THAT THE HUMERUS IS POSITIONDED SLIGHTLY ANTERIOR TO THE FRONTAL PLANE OF THE BODY AND IN SLIGHT ABDUCTION) *SCAPTION
Surgical repair is not indicated in patients who are asymptomatic from an RC tear despite the persence of a tear confirmed by imaging?
TRUE
True/False

Partial thickness tears of the RC occur most often in young, active adults?
FALSE

FULL THICKNESS
Partial thickness tear?
EXTENDS INFERIORLY OR SUPERIORLY THROUGH ONLY A PORTION OF THE TENDON.
A complete tear, which extends the entire depth of the tendon?
FULL THICKNESS TEAR
What is the Tx of a rotator cuff in the minimum protection phase?
-INCREASE ROM
-NORMALIZE SHOULDER KINEMATICS
-STRENGTHEN RC AND PARASCAPULAR MUSCLES
-IMPROVE THE RC ABILITY TO TOLERATE TENSION LOADING
What determines the length of rehab after surgery of an RC injury?
DEPENDS ON THE PATIENT'S AGE, TYPE OF TEAR, AND SURGICAL REPAIR.
Conservative Tx for a rotator cuff injury?
*GOAL IS TO STRENGTHEN UNINJURED RC
-CONTROL INFLAMMATION (STEROID INJECTION)
-ACTIVITY MODIFICATION (AVOID OVERHEAD ACTIVITIES)
-MAINTAIN NORMAL SHOULDER MECHANICS
-ANT/POST CAPSULE STRETCHING
SURGERY (THE LENGTH OF REHAB DEPENDS ON THE PATIENTS AGE, TYPE OF TEAR, AND SURGICAL REPAIR.
True/False

An abducted shoulder will increase the blood flow to the supraspinatus tendon?
TRUE
What are the three clinical presentations of a rotator cuff tear?
-PAINFUL ARC
-DECREASED STRENGHT AND ROM
-FUNCTIONAL DISABILITIES
How long does it take to recover from a full thickness RC tear?
6 MONTHS
What are the two classifications of rotator cuff tears?
-PARTIAL THICKNESS
-FULL THICKNESS
SAD
SUB-ACROMIAL DECOMPRESSION
What kind of joint mobs need to be performed for shoulder impingement?
*STRETCH SHORTENED TISSUES
*INFERIOR JOINT MOBS
*STRETCH INTERNAL ROTATORS OF THE SHOULDER
Scapular stabilization muscles?
-UPPER AND LOWER TRAPS
-LEVATOR SCAPULA
-RHOMBOID MAJOR
-PECT MINOR
-MIDDLE AND LOWER SERRATUS ANTERIOR
What muscles need to be targeted with an impingement syndrome?
*SHOULDER EXTERNAL ROTATORS (INFRASPINATUS & TERES MINOR)

*NORMALIZE THE FORCE COUPLE BETWEEN THE DELTOID AND ROTATOR CUFF
Extrensic factors of shoulder impingement?
-POSTERIOR CAPSULE TIGHTNESS
-POOR NERUOMUSCULAR CONTROL OF THE ROTATOR CUFF OR SCAPULAR MUSCLES
-FAULTY SCAPULOTHORACIC POSTURE WITH MUSCLE IMBALANCES
-PARTIAL OR COMPLETE TEAR OF THE TISSUES IN THE SUPRAHUMERAL SPACE
Intrinsic factors of shoulder impingement?
-DIRECTLY ASSOCIATED WITH ENCROACHMENT OF THE SUBACROMIAL SPACE

-INCLUDES:
*VASCULAR CHANGES IN THE ROTATOR CUFF TENDON
*STRUCTURAL VARIATIONS IN THE ACROMION
*HYPERTROPHIC DEGENERATIVE CHANGES OF THE AC JOINT, CORACOAROMIAL ARCH, OR HUMERAL HEAD

(ALL OF THESE FACTORS DECREASE THE SUPRAHUMERAL SPACE AND OFTEN HAVE TO BE DEALT WITH SURGICALLY)
What is believed to be the cause of primary shoulder impingement?
OCCURS AS A RESULT OF MECHANICAL WEAR OF THE ROTATOR CUFF AGAINTS THE ANTEROINFERIOR ONE THIRD OF THE ACROMION IN THE SUPRAHUMERAL SPACE DURING ELEVATION ACTIVITIES OF THE HUMERUS.
Neer's Classification of Rotator Cuff Disease (Stage 3)?
BONE SPURS AND TENDON RUPTURE (PATIENT USUALLY > 40 YEARS OF AGE)
Neer's Classification of Rotator Cuff Disease (Stage 2)?
TENDINITIS/BURSITIS AND FIBROSIS (PATIENT USUALLY 25-40 YEARS OF AGE)
Neer's Classification of Rotator Cuff Disease (Stage 1)?
EDEMA, HEMORRHAGE (PATIENTS USUALLY > 25 YEARS OF AGE)
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