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NM3 midterm
Shoulder, Elbow, Wrist
| Question | Answer |
|---|---|
| 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
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