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UE Ortho

Impingement Syndrome

Reversible cuff edema, hemorrhage...what stage of shoulder impingement? stage I
Irreversible fibrosis, tendinitis...what stage of shoulder impingement? Stage II
Partial or complete tear...what stage of shoulder impingement? Stage III
What is the most common acromial morphology? type II 43%
Where is the avascular zone of the supraspinatus? 1cm proximal to the insertion into the greater tuberosity
Where is the avascular zone of the biceps? region of tendon that passes over humeral head
What does the following describe? Age-related thinning, degeneration, and weakening, Permits proximal humeral migration into the CA arch, Vicious circle leading to full-thickness tears RC tendinopathy
What stage of impingement does the following describe? < 25 y/o, Reversible lesion, Pain after (progressing to during) activity, Often overhead sports/activities. Stage I: reversible cuff edema, hemorrage
What stage of impingement does the following describe? 26‐40 y/o, Prolonged history, Discomfort often worse at night, May have pain after activity or at rest, Inability to perform maneuver that elicits pain (overhead activities) Stage II: irreversible fibrosis, tendinitis
What stage of impingement does the following describe? >40 y/o, May/may not have weakness (cuff integrity), Significant cuff degeneration or partial cuff tears (avg. 50 y/o), Full thickness tears(Avg. 60 y/o) Stage III: partial or complete tears
Pain during activity, at rest, at night, Frequently biceps involvement, AC pain, Pain‐related weakness, Minor insults may extend a degenerative/partial RC tear...what stage of impingement does this describe? Stage III
What percent of cuff tears occur in sedentary individuals? 70%
Are RC tears always symptomatic? no
T or F? RC degeneration is a natural phenomenon of aging. T
According to the Neer 1980 study, does the prescence of massive rotator cuff tears imply progression to cuff tear arthropathy? no
Impingement may lead to _____ rupture? biceps
How can a biceps rupture cause a RC impingement. part of the biceps function is to depress the humeral head, rupture causes superior mvmt of the humeral head and can cause impingement
In young pts, what kind of trauma is required to tear the biceps? violent
What is the common tear location of a biceps tear? at the musculotendinous junction
Is impingement a common cause of biceps tears in the young? no
Impingement of the rotator cuff (or biceps) beneath the coracoacromial arch is what king of impingement? primary or secondary? primary
What kind of impingement is associated with alterations in: Anterior 1/3rd of acromion, Coracoacromial ligament, AC joint?(primary or secondary) Primary impingement
What kind of impingement is caused by a relative decrease in the subacromial space due to glenohumeral instability or functional scapulothoracic instability?(primary or secondary) secondary
_____= open surgical procedure that will allow for better fixation, but more precautions after surgery (active/resisted flex b/c delt released from ant acromion. Arthrotomy
_____= surgical procedure where visualization is great and allows for less precautions in rehab, but fixation not as good as open technique. Arthroscopy
_____= surgical procedure where deltoid splitting is used for visualization; involveds supraspinatus +/- infra, T minor (depends on size of tear) Mini-open rotator cuff repair
Created by: txst fall 2009