1
What is the first thing you have to do when you suspect a shoulder injury?
clear c-spine
What holds the long head of the bicep in the bicipital groove?
transverse humeral ligament
what is the job of the rotator cuff muscles?
keep the head of the humerus centered on the glenoid regardless of where it is in space
70% of rotator cuff tears are associated with what type of acromion?
hooked (type 3)
what is a siesta sign?
pain when arm is behind head when laying down
What can cause a posterior dislocation besides adduction and internal rotation?
seizures & electric shock
what helps stabilize the glenohumeral joint anteriorly and acts as a dynamic depressor of the humeral head?
long head of biceps
what is a hillsachs lesion?
dent in the humeral head
what is the greatest predictor of redislocation?
age
what is one of the key signs of a shoulder subluxer?
dead arm syndrome
what does TUBS and AMBRI stand for
TUBS = traumatic onset, unidirectional, bankart lesion requiring surgery
AMBRI = atraumatic cause, multidirectional, bilateral, rehabilitation, inferior capsular shift
What is the close packed, loose packed, and capsular pattern of the glenohumeral joint?
close = full abduction and lateral rotation
loose = 55 degrees of abduction and 30 degrees of horizontal adduction
capsular = lateral rotation, abduction, medial rotation
what are the two bands of the inferior glenohumeral ligament and when is each band tight?
posterior band tight on medial rotation
anterior band tight on lateral rotation
if you get superior and inferior motion with shear what is likely torn?
AC and CC
what can be pinched in primary impingement?
subacromial bursa, supraspinatus, and biceps long head
what are the three locations for TOS?
1. in between scalenes - brachial plexus and subclavian artery
2. in between first rib and clavicle
3. vein goes under coracoid and gets pinched between pec minor
Where is the bicep pulled when arm is externally rotated? internally rotated?
externally rotated = against greater tubercle
internally rotated = against lesser tubercle
what is a sprengels deformity?
small high undescended scapula
You have a 72 year old patient who experiences external rotation weakness and night pain.. what is likely wrong?
full thickness supraspinatus tear
what are the 2 painful arcs?
70-120
170-180
You have a football player who gets a stinger.. when is he allowed to return to play?
explain what SADDCE is?
1. acromioplasty - reshape acromion
2. debriede fibrotic bursa
3. cut the coracoacromial ligament
4. cut off the end of the clavicle
explain a force couple in the shoulder complex.
deltoid coming to deltoid tuberosity pulls arm up while rotator cuff pulls arm down and in
what are the origins and insertions of all of your rotator cuff muscles?
supraspinatus origin = supraspinous fossa
supraspinatus insertion = greater tubercle
infraspinatus origin = infraspinous fossa
infraspinatus insertion = greater tubercle
teres minor origin = upper 2/3 of lateral border of scapula
teres minor insertion = greater tubercle
subscapularis origin = subscapular fossa
subscapularis insertion = lesser tubercle
what is the motor and sensory checks for the axillary, musculocutaneous, radial, median, and ulnar nerves?
axillary motor = abduction
axillary sensory = small spot in middle of the deltoid
musculocutaneous motor = elbow flexion or supination
musculocutaneous sensory = lateral forearm
radial motor = extensor pollicus longus - have them hitch hike
radial sensory = posterior first web space
median motor = resist pulling thumb and pinky apart (opponeus pollicus)
median sensory = distal index/pointer finger
ulnar motor = spread their fingers
ulnar sensory = tip of the pinky