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NM3 midterm

Shoulder, Elbow, Wrist

Position in joint ROM where there is the LEAST amount of stress Loose packed (resting)
Position in which the majority of the joint structures are under Maximum tension Close packed
Position of join in which ligaments in poition of greatest Laxity Loose packed (resting)
Position in which joint surfaces cannot be separated by distractive forces (no accessory movement possible) Close Packed
If a joint is swollen, which position cannot be achieved? Close packed
Stretching or tearing of a ligament is termed Sprain
Stretching or tearing of a musculo-tendinous structure is termed Strain
Symptoms of pain, muscle spasm, loss of strength and limited ROM are associated with Sprain or Strain? Strain
Sprain symptoms pain, inflammation and in some cases inability to move limb
Sprains occur when a joint is __________ forced beyond its normal ROM
Grade? Some fbers are torn, moderatly painful & swollen, function and strength mostly unaffected Grade I sprain or strain
Grade? Soft tissue is totally torn, considerable loss of function and strength Grade III
Grade? Many fibers are torn, site is painful& swollen, some loss of function and strength Grade II
Which grade(s) of sprain/strain often require surgical repair Grade III
What is commonly cuased by repetition of movement or excessive pressure Bursitis
What are the most common sites for bursitis Elbow and knee
Can traumatic injury cause bursitis? Yes
Can arthritic bone spurs cause bursitis yes
When looking for tendonitis, Increased H2O content, disorganized collagen matrix can by detected by ? Ultrasonography or MRI
Chronic overuse of tendons leads to _________ within the collagen matrix Microscopic tears
Partial tendon tears heal by the rapid production of __________________ disorganized type-III collagen
Tendons and ligaments are ________(fast or slow) to heal when injured and ________ (often or rarely) regain their original strength very slow and rarely regain
Three phases of tissue healing and how many days for each? Inflammatory 2-5days, Proliferative 2days-3weeks, Remodeling 3weeks- 2years
Scar tissue is _____% as strong as original tissue 80%
Signs of inflammation SHARP, what does each letter represent? Swelling, Heat, Altered function, Redness, Pain
Controlling ________ will help minimize amout of scar tissue produced? Inflammation
What is PRICE used for and what does each letter represent controlling inflammation; Protect, Rest, Ice, Compress, Elevate
NSAID's effect on tissue repair poor healing
Capsular pattern of Glenohumeral joint (in order of restriction) lateral rotation, abduction, medial rotation
Surrounds and slightly deepens the glenoid cavity of scapula Labrum (fibrocartilage)
Close packed position of Glenohumeral joint Full abduction and lateral rotation
What joint augments the ROM of the humerus? AC joint & sternoclavicular joint
The AC joint depends on _______ for stability and strength Ligaments
Close packed position of AC joint 90 degrees abduction
What joint along with AC joint allows humerus a full 180degree Abduction sternoclavicular joint
The sternoclavicular join depends on _______ for strength ligaments
Capsular pattern of AC and sternoclavicular joint Pain at exterme ROM especially with Horizontal flexion and full Elevation
Loose packed position of AC and SC joint Arm by side in normal standing position
Close packed position of SC joint full elevation
Scapulothoracic joint capsular pattern NONE! Not a true joint
Scapulothoracic joint lies 20-30degrees forward relative to ________ plane sagittal plane
Shoulder ligaments: Coracohumeral, Coracoacromial, Coracolavicular(conoid, trapezoid), Transverse humeral, Acromioclavicular
What are the 6 primary movers and stabilizers muscles of shoulder Rotator Cuff, Deltoid, long head of Biceps
What are the rotator cuff muscles SITS -Supraspinatus, Infraspinatus, Teres minor, Subscapularis
How many muscles directly control motion of shoulder 11 (6 of which are the primary movers)
what are the 11 muscles that directly control motion of shoulder SITS, Deltoid, Long head of Biceps, Teres major, Latissimus dorsi, Pectoralis major, CoracoBrachialis, Triceps
What muscle O- upper lateral border of scapula and I- greater tuberosity Teres minor
Nerve supply of Teres Minor and deltoids Axillary (c5,6)
What shoulder muscle is supplied by Suprascapular N. c5,6 Supraspinatus and Infraspinatus
Supra&Infraspinatus Insert at greater tuberosity of humerus
Insertion and Action of subscapularis Lesser Tuberosity, internal rotation
Origin of Long head of biceps Supraglenoid tubercle of scapula
What muscle inserts at the radial tuberosity of radius? Long head of biceps
Nerve supply and action of long head of biceps Musculocutaneous (c5,6), Flexion, Supination
Motion of Glenohumeral joint (3) Rotation, Rolling, Translation or gliding
The painful arc may be caused by Subacromial bursitis, Calcium deposits or ____________ Rotator cuff tendonitis
The painful arc results from pinching of inflammed or tender structures under the __________ and ___________ Acromion process and coracoAcromial ligament
How many degrees of abduction in the painful Arc is there NO initial pinching? 45-60 degrees
What degrees in the painful arc are structures pinched? 60-120 degrees
What could be the cause if pain is greater as full elevation is reached in the painful arc AC problem
In shoulder impigment, pain is localized to __________ Anterior shoulder
In what condition does the scapula move more than the humerus (as in frozen shoulder) Reverse Scapulohumeral Rhythm
In Reverse Scapulohumeral Rhythm patient appears to "______" entire shoulder complex Hike
What muscle in external rotation can be used as a "cheater" during Abduction Biceps
What syndrome results from compression of inflamed tissue in suprahumeral space Impingement syndrome
What activities aggrevate/cause impingement syndrome of the shoulder Overhead activies
Structures impinged in shoulder are Biceps tendon, Supraspinatus tendon and ______________ Subacromial bursa
What structural causes may lead to shoulder impingment syndrome Acromion process changes or variants, subacromial inflammation process
Shoulder impingment syndrome is primarily due to a subacromial imingement with what motion? Elevation and interal rotation
T or F Instability often co-exists in impingement syndrome TRUE
Stage 1 of impingement syndrome signs and age Edema and Hemorrhage, Age <25
Stage 2 of impingement syndrome signs and age Pathologic changes in tendon and joint Age 25-40
Stage 3 of impingment syndrome signs and age Tendon rupture or tear Age >50
Tests for impingement syndrome Painful arc, Hawkins-Kennedy test, Neer's, Impingement relief test
Two types of instability Traumatic and non-traumatic
Instability with past history of shoulder dislocation or recurrent? Traumatic instability
With traumatic instability the most common dislocation is Anterior dislocation (90-95%)
Often when there is dislocation of shoulder the Glenoid labrum is torn, which test are used to determine Crank, O'brien
Non-traumatic shoulder instability is often termed "born loose"
Evaluation with non-traumatic shoulder instability are load and shift, positive sulcus sign Bilaterally
Adhesive capsulitis is also known as frozen shoulder
Stage 1 of adhesive capsulitis acute inflammatory
Stage 2 of adhesive capsulitis Stiffening (1-3months post acute phase)
Stage 3 of adhesive capsulitis thawing, pt has less pain
Patients most often present in the stiffening stage of adhesive capsulitis with equal loss of active and passive ROM
Supraspinatus rotator cuff tear is associated with ____________ 95% of the time Impingement syndrome
Orthos for rotator cuff tear Empty can (supraspinatus) Lift Off (Subscapularis)
Created by: kfrancis