Shoulder- CHT

MATCH THE NERVE WITH THE MUSCLE IT INNERVATES A) LONG THORACIC B) SUBSCAPULAR C) RADIAL D) SUPRASCAPULAR ------------------------- 1. ANCONEUS 2. SERRATUS ANTERIOR 3. TERES MAJOR 4. SUPRASPINATUS

1. Anconeus = Radial Nerve © 2. Serratus Anterior = Long Thoracic (A) 3. Teres Major = Subscapular (B) 4. Supraspinatus = Suprascapular (D)

DEFINE THE "TERRIBLE TRIAD" IN A PATIENT OVER 40 YEARS OF AGE.

1. Anterior shoulder dislocation 2. Rotator cuff tear 3. Neurologic injury This should be considered in any patient over 35 years who reports persistent pain and weakness after shoulder dislocation.

NAME THE SPECIAL TESTS FOR SHOULDER INSTABILITY

1. Apprehension test: anterior instability 2. Jobe relocation test: anterior instability 3. Load and shift test: anterior and posterior instability 4. Sulcus test: Inferior instability

DESCRIBE THE GLENOHUMERAL JOINT

1. Ball and socket joint 2. Sacrifices stability for mobility 3. Sub acromial space contents: a. RTC tendons b. Long head of the biceps c. Subacromial -subdeltoid bursa d. Subcoracoid bursa 4. Stabilizing structures include: a. Glenoid labrum b. capsuloligamentous complex c. rotator cuff d. biceps tendon

DEFINE STAGE 3 IMPINGEMENT O F THE SHOULDER

1. Bone spurs are typically present 2. Clinical presentation as stage II with weak/painful resisted tests. 3. If not responsive to conservative treatment, surgical consideration.

DEFINE STAGE 1 IMPINGEMENT OF THE SHOULDER

1. Edema and inflammation of the rotator cuff and subacromial 2. Typically less than 25 years old with precipitation factor 3. Pain in anterior lateral shoulder 4. painful arc of motion 60-120 degrees of elevation 5. Positive impingement sign 6. Tenderness to palpation of subacromial space 7. Muscle spasm of upper trap, levator and subscap

DEFINE STAGE II IMPINGEMENT OF THE SHOULDER

1. Fibrosis of glenohumeral capsule and subacromial bursa and tendonitis of tendons 2. Typically 10-40 years old 3. Clinical presentation same as stage I with loss of ROM with capsular pattern.

LIST THE REASONS FOR A REVERSE TOTAL SHOULDER ARTHROPLASTY

1. Irreparable RTC damage 2. Complex fracture 3. Revision of a previously failed conventional TSA

LIST THE MUSCLES OF DOWNWARD ROTATION OF THE SCAPULA

1. Levator scapulae 2. Rhomboid major 3. Rhomboid minor 4. Pectoralis

LIST THE MUSCLES OF SCAPULAR ELEVATION

1. Levator scapulae 2. Upper trapezius 3. Rhomboid major 4. Rhomboid minor

LIST THE MUSCLES OF SCAPULAR RETRACTION (ADDUCTION)

1. Middle trapezius 2. Rhomboid major 3. Rhomboid minor 4. Lower Trap

LIST THE MUSCLES OF SCAPULAR DEPRESSION

1. Pectoralis minor 2. Pectoralis major 3. Lower trapezius 4. Serratus anterior 5. Latissimus dorsi

LIST THE MUSCLES OF SCAPULAR PROTRACTION (ABDUCTION)

1. Serratus anterior 2. Pectoralis minor 3. Pectoralis major 4. Latissimus dorsi

DESCRIBE NON-OPERATIVE TREATMENT FOR A ROTATOR CUFF TENDINITIS/IMPINGEMENT

1. Strengthening the RTC, deltoid, and scapulothoracic stabilizers. 2. Stretching pectoralis minor

DESCRIBE THE ACROMIOCLAVICULAR (AC) JOINT

1. Synovial plane joint 2. Movement: slides and rotates during shoulder motion 3. Stabilizing structures: a. Intraarticular disk b. Joint capsule c. Acromioclavicular ligament d. Coracoclavicular ligament

LIST THE MUSCLES OF UPWARD ROTATION OF THE SCAPULA

1. Upper trapezius 2. Lower trapezius 3. Serratus anterior

MATCH EACH SHOULDER TEST TO THE CORRECT INTERPRETATION OF THE TEST: A) APPREHENSION TEST (CRANK TEST) B) HAWKINS-KENNEDY IMPINGEMENT TEST C) SPEED'S TEST D) JAHNKE TEST ----------------------- 1. Subluxation 2. Bicipital Groove Tendonitis 3. Supraspinatus Tendinitis 4. Anterior Instability

4. Apprehension Test (Crank Test) - Anterior instability 3. Hawkins-Kennedy - Supraspinatus Tendinitis 2. Speed's Test - Bicipital Groove Tendonitis 1. Jahnke Test - Posterior Subluxation.

AFTER A BANKART LESION REPAIR OF THE SHOULDER, WHAT IS THE EARLIEST RECOMMENDED TIME TO BEGIN EXTERNAL ROTATION BEYOND 0 DEGREES.

6 Weeks Gentle Codman exercises begin at approx. 2 weeks, with gradual progression of ROM exercises. Gentle strengthening exercise is initiated at 6 weeks.

WHAT PERCENTAGE OF CVA PATIENTS WILL EXPERIENCE SHOULDER PAIN?

72% The overall goal of treatment for these patients is to maintain a functional ROM that will , at least, allow for self care.

DEFINE THE ADSON MANEUVER

A common test for identifying TOS. The radial pulse is monitored while the head is rotated toward the involved shoulder. The patient extends the head, and the shoulder is placed in EXT and ER as the patient takes a deep breath and holds it. If the radial pulse decreases or is absent, the test is positive. In some individuals, it may be necessary to rotate the head to the opposite side to have the effect on the radial pulse. Both positions must be tested.

WHAT IS THE SULCUS SIGN?

A dimple lateral to the acromion seen with caudal distraction of the humerus. It should be ablated with external rotation in a normal shoulder.

WHAT IS THE DIFFERENCE BETWEEN A MINI-OPEN AND A STANDARD-OPEN ROTATOR CUFF REPAIR?

A mini-open rotator cuff repair involves splitting, not detaching the deltoid. Rehabilitation is more rapid because the deltoid does not need to be protected during postoperative therapy.

DEFINE THE TERM "SLAP" LESION

A tear of the superior labrum, anterior to posterior. This tear usually is diagnosed with magnetic resonance imaging.

SCAPULOTHORACIC STRENGTHENING WOULD INCLUDE ALL OF THE FOLLOWING EXCEPT... A) FORWARD FLEXION AND CORONAL ABDUCTION WITH THERABAND B) SEATED ROW C) PUSH UP PLUS D) PRESS UP PLUS

A) Forward flexion and coronal abduction with theraband IR, ER, forward flexion, coronal abduction, extension, and PNF D2 flexion all strengthen the rotator cuff and deltoid and NOT the scapulothoracic region.

WHICH IS A CRITICAL REHABILITATION EXERCISE USED FOR PERISCAPULAR STRENGTHENING AND TREATMENT OF GLENOHUMERAL INSTABILITY A) PUSH-UP PLUS B) PULL-UPS C) EXTERNAL ROTATION ISOKINETICS D) SHOULDER SHRUGS

A) Push-up plus

DEFINE THE ACROMNYM AMBRII

AMBRII A - Asymmetrical M - Multidirectional B - Bilateral R - Rehabilitation I - Inferior capsule I - Interval closure This refers to instabilities that are traumatic.

WHAT IS THE SUGGESTED POSITION OF THE SHOULDER FOR ARTHRODESIS OF THE SHOULDER ACCORDING TO ROWE?

Abduction = 20 degrees Flexion = 30 degrees Internal Rotation = 40 degrees

WHAT IS THE IDEAL GLENOHUMERAL ANGULAR POSITION FOR SHOULDER ARTHRODESIS (FUSION)?

Abduction = 30 degrees Flexion = 30 degrees Internal Rotation = 30 degrees

WHICH NERVE INNERVATES THE UPPER TRAPEZIUS?

Accessory Nerve

WHAT IS A BANKART LESION?

An avulsion of the attachment of the anteroinferior glenohumeral ligament to the glenoid labrum from the anterior glenoid neck due to anterior dislocation of the shoulder.

WHAT IS A "HILL-SACHS" LESION?

An impaction fracture of the humeral head sustained during glenohumeral dislocation. When large, it may need bone grafting to prevent re-dislocation.

WITH INJURY TO THE INFRASPINATUS MUSCLE, WHERE MIGHT ONE HAVE REFERRED PAIN?

Anterior deltoid region, shoulder joint, medial border of scapula and front and lateral aspects of the forearm.

Name the muscles of the rotator cuff

Anterior to posterior: 1. Subscapularis 2. Supraspinatus 3. Infraspinatus 4. Teres Minor

WHICH TEST WOULD BE APPROPRIATE TO USE WHEN EVALUATING A PATIENT WITH SUSPECTED ANTERIOR SHOULDER INSTABILITY?

Apprehension test (crank test)

WHICH NERVE IS MOST COMONLY INJURED IN FRACTURES AROUND THE PROXIMAL HUMERUS ?

Axillary Nerve

WHAT COMBINATION OF NERVES WOULD HAVE TO BE DAMAGED TO INHIBIT ABDUCTION OF THE SHOULDER? A) MUSCULOCUTANEOUS AND UPPER AND LOWER SUBSCAPULAR B) AXILLARY AND SUPRASCAPULAR C) SUPRASCAPULAR AND LONG THORACIC D) AXILLARY AND UPPER AND LOWER SUBSCAPULAR

B) Axillary and suprascapular The suprascapular nerve supplies the supraspinatus muscle which is responsible for abduction initiation. The axillary nerve innervates the deltoid, whose middle portion is a primary abductor. Injuries to both of these nerves inhibit abduction of the shoulder.

WHICH OF THE FOLLOWING IS NOT AN EXERCISE USED TO STRENGTHEN SERRATUS ANTERIOR? A) DYNAMIC HUG WITH THERABAND B) SIDELYING er WITH TOWEL ROLL IN AXILLA C) SUPINE STRAIGHT ARM PUNCHES TOWARD CEILING D) PUSH UP WITH A PLUS

B) Sideling ER with towel roll in axilla Sydelying ER with a towel role will strengthen the RTC specifically infraspinatus and teres minor, not serratus anterior.

IMPINGEMENT SYNDROME AT THE SHOULDER MAY BE CAUSED BY WHICH OF THE FOLLOWING A) DECREASED SUBOCCIPITAL SPACE B) WEAKNESS IN THE ROTATOR CUFF C) WEAKNESS OF DELTOID MUSCULATURE

B) Weakness of the rotator cuff Weakness of the rotator cuff can cause instability when the deltoid overpowers the cuff muscles, this allows the humeral head to "ride up" during deltoid contraction and results in impingement. When abduction of the shoulder occurs, the tuberosity approximates the acromion and several structures may be pinched between the tuberosity and the coracoclavicular ligament.

WHY IS A PROXIMAL HUMERAL FX MORE DANGEROUS THAN A HUMERAL SHAFT OR A DISTAL HUMERUS FX?

Because of the proximity of the axillary blood vessels and the brachial plexus, a fracture to the proximal humerus may result in severe hemorrhaging or paralysis.

WHEN THE BICEPS IS TAKEN OFF OF ITS INSERTION INTO THE HUMERAL HEAD DURING SURGERY AND THEN ANCHORED BACK INTO THE BONE, THE PROCEDURE IS CALLED A...

Biceps Tenodesis

WHICH OF THE LATERAL THIRD CLAVICLE FRACTURES ARE TYPICALLY TREATED SURGICALLY? A) COMMINUTED FRACTURES B) MINIMALLY DISPLACED FRACTURES C) FRACTURES WITH CORACOCLAVICULAR LIGAMENT DISRUPTION D) OBLIQUE FRACTURES

C) Fractures with coracoclavicular ligament disruption

WHAT IS THE DIFRERENCE BETWEEN AN MINI-OPEN ROTATOR CUFF REPAIR AND A STANDARD OPEN ROTATOR CUFF REPAIR? A) A MINI REPAIR IS USED ON A SMALLER TEAR B) STANDARD RTC REPAIR USES BONE TUNNELS C) MINI REPAIR INVOLVES DELTOID SPLIT, NOT DETACHMENT D) MINI REPAIR IS USED IN SMALLER PATIENTS

C) Mini repair involves deltoid split, not detachment

WHAT ARE THE SYMPTOMS OF ARTERIAL OBSTRUCTION?

Coolness, cold sensitivity, numbness in the hand and exertional fatigue.

WHAT ARE THE SYMPTOMS OF VENOUS OBSTRUCTION?

Cyanotic discoloration, arm edema, finger stiffness, and a feeling of heaviness.

WHICH OF THE FOLLOWING ACTIONS OCCURS WHEN THE INFRASPINATUS, SUBSCAPULARIS, AND TERES MINOR ALL CONTRACT AT THE SAME TIME? A) INTERNAL ROTATION B) FLEXION C) EXTERNAL ROATION D) DEPRESSION OF THE HUMERAL HEAD IN THE GLENOID FOSSA

D) Depression of the humeral head in the glenoid fossa

FOR INITIAL EVALUATION ON A PATIENT DIAGNOSED WITH SHOULDER IMPINGEMENT, WHICH OF THE FOLLOWING TESTS WOULD YOU CONSIDER PERFORMING TO CONFIRM THE DIAGNOSIS? A) WHIPPLE TEST B) SPEED TEST C) NAPOLEON TEST D) HAWKINS-KENNEDY TEST

D) Hawkins-Kennedy Test Flex the shoulder to 90 degrees and flex the elbow to 90 degrees and passively internally rotate the arm. Pain is indicative of shoulder impingement.

WHICH NERVE INNERVATES THE RHOMBOID MAJOR AND RHOMBOID MINOR?

Dorsal subscapular nerve

WHAT IS THE SHOULDER CAPSULAR PATTERN?

ER>ABD>IR A capsular pattern is the reproducible limitation of joint movements when the joint capsule is the limiting structure. A non-capsular pattern is a pattern of limitation of joint movement that is not the result of the joint capsule.

WHICH TEST WOULD BE APPROPRIATE TO USE WHEN EVALUATING A PATIENT WITH SUSPECTED ROTATOR CUFF INJURY?

Empty can test Drop-arm test

TRUE OR FALSE? OSTEOARTHRITIS OF THE GLENOHUMERAL JOINT CAN BE IDENTIFIED BY SHARP, INTERMITTNET PAIN, OFTEN WHEN THE JOINT IS AT REST.

FALSE Osteoarthritis of the GH joint causes a non-localizing toothache-like pain that is aggravated by motion and may result in muscle atrophy and contractures. Crepitation is noted with motion. Treatment consists of gentle therapy and pain relieving measures.

TRUE OR FALSE? FOR PRIMARY ADHESIVE CAPSULITIS, AGGRESSIVE PASSIVE STRETCHING SHOULD BE USED.

FALSE Therapy should include modalities such as heat, ultrasound, and massage of trigger points to increase soft tissue extensibility. NSAIDS and cortisone injections can enhance therapy tolerance. Gentle passive and active ROM exercises should be used. If significant improvement is not attained after 6 months, MUA may be considered.

WHICH TYPE OF LATERAL THIRD CLAVICLE FRACTURES ARE TYPICALLY TREATED SURGICALLY?

Fractures with coracoclavicular ligament disruption. Distal clavicular fractures are classified as types I, II, and III. Type II involves disruption of the coracoclavicular ligaments and leads to symptomatic inferior subluxation of the shoulder girdle. This commonly is treated with surgical repair.

WHAT ARE THE THREE PHASES OF SHOULDER REHABILITATION?

I. Passive or assistive exercises to maintain or gain motion. II. Active range of motion. III. Resistive exercises to gain strength.

WHAT HAPPENS TO THE CORACOACROMIAL LIGAMENT DURING SUBACROMIAL DECOMPRESSION?

It is detached from the acromion.

WHAT HAPPENS TO THE CORACOACROMIAL LIGAMENT DURING SUBACROMIAL DECOMPRESSION?

It is detached from the acromion. The coracoacromial ligament forms a sharp edge over the coracoacromial arch and must be cut and detached from the acromion during a subacromial decompression.

WHAT IS THE MOST COMMON MECHANISM OF INJURY TO THE AC JOINT?

Landing on the acromion during a fall or by a blow to the lateral shoulder.

WHICH OF THE FOLLOWING IS A PRIMARY SHOULDER EXTENSOR? TERES MINOR LONG HEAD OF THE TRICEPS LATISSIMUS DORSI TRAPEZIUS

Latissimus dorsi Primary extensors of the shoulder include: posterior deltoid, teres major, and latissimus dorsi. The teres minor and the long head of the triceps are secondary extensors.

LIST THE MUSCLES RESPONSIBLE FOR ABDUCTION OF THE SHOULDER JOINT.

Middle Deltoid and Supraspinatus

WHAT IS MDI AND DESCRIBE NON-OPERATIVE TREATMENT FOR MULTIDIRECTIONAL INSTABILITY OF THE SHOULDER AFTER ACUTE INJURY.

Multidirectional instability (MDI) of the shoulder is laxity of the shoulder joint due to increased mobility and joint weakness. Factors include congenital looseness, muscular imbalances, shoulder blade position, shoulder structure variations, and certain repetitive activities. 1. Arm sling for a few days to decrease pain. 2. Traction on the shoulder should be avoided. 3. RTC and periscapular muscle strengthening as pain decreases. 4. Traumatic dislocations respond less favorably to therapy than atraumatic dislocations.

WHICH TEST WOULD BE APPROPRIATE TO USE WHEN EVALUATING A PATIENT WITH SUSPECTED SLAP LESION?

O'Brien's Test A positive test occurs with pain reproduction or clicking in the shoulder with the first position and reduced/absent with the second position Depth of symptoms must also be assessed as superficial pain can indicate acromioclavicular joint symptoms and deep pain is more often a sign of a labral lesion

WHAT IS INTERNAL IMPINGEMENT?

Pain (typically seen in overhead throwing athletes) in the rotator cuff. The rotator cuff pathology is a consequence of either excessive glenohumeral motion or selective posterior capsular tightness. Internal impingement occurs when the arm is in - maximal ER - the infraspinatus can be compressed between the posterior superior glenoid rim and the humeral head.

AFTER ARTHROSCOPIC SURGERY FOR SUBACROMIAL DECOMPRESSION, HOW SOON SHOULD ROM EXERCISES BE STARTED?

Passive ROM exercises are initiated immediately after surgery, and are progressed to active exercises as soon as pain and motion will allow - typically in 4 to 5 days. Resistive exercises may be added at 3 to 4 weeks.

WITH INJURY TO THE SUBSCAPULARIS MUSCLE, WHERE MIGHT ONE HAVE REFERRED PAIN?

Posterior deltoid area, scapula, and posterior arm and wrist.

WHAT NERVE IS MOST COMMONLY INJURED WITH A FRACTURE OF THE HUMERAL SHAFT?

Radial Nerve The radial is intimately wrapped around the middle and distal third of the humerus. It may be injured with fractures in this region.

WHAT IS ROTATOR CUFF ARTHROPATHY?

Rotator cuff arthropathy is a degenerative condition in which a deficient/torn rotator cuff allows the humeral head to migrate superiorly and arthrosis develops.

DESCRIBE A S.I.C.K. SCAPULA

S.I.C.K. stands for scapula - infera, coracoid and dyskinesis It is an asymmetrical , malpositioned scapula caused by muscular overuse fatigue syndrome

THE SCAPULA WINGS WHEN WHICH MUSCLE IS PARALYZED OR WEAKENED?

Serratus anterior The serratus anterior holds the scapula in place as it slides over the rib cage. Winging of the scapula occurs when the serratus anterior muscle becomes weak from injury to the long thoracic nerve.

LIST THE ROTATOR CUFF TEAR CLASSIFICATION

Small - less than 1 cm in diameter Medium - 1 to 3 cm in diameter Large - 3 to 5 cm in diameter Massive - greater than 5 cm in diameter

WHAT CLINICAL TEST CAN HELP DIFFERENTIATE CERVICAL PAIN FROM PRIMARY SHOULDER PAIN?

Subacromial injection test. Relief of pain with a subacromial injection confirms shoulder pathology as the source of pain. Cervical pain will not be relieved by a subacromial injection.

DURING GLENOHUMERAL ARTHROPLASTY, WHICH IS THE ONLY MUSCLE TRANSECTED, THEN REPAIRED UPON CLOSURE?

Subscapularis

THE ROTATOR INTERVAL IS A POTENTIALLY PATHOLOGIC SPACE BETWEEN WHICH TWO STRUCTURES?

Supraspinatus and Subscapularis. The rotator interval is an anatomical space that is variably sized between the supraspinatus and the subscapularis. Injury to the rotator interval can result in posterioinferior instability.

DEFINE THE ACRONYM TUBS

T - Traumatic U - Unidirectional B - Bankart lesion S - Surgery This refers to instability of the shoulder caused by trauma

IN NORMAL SHOULDER BIOMECHANICS, BOTH THE DELTOID AND THE ROTATOR CUFF ALLOW ELEVATION OF THE HUMERUS TO OCCUR.

TRUE

TRUE OR FALSE? THE CONNECTION OF THE SUBSCAPULARIS TO THE HUMERUS IS THE MOST ANTERIOR ATTACHMENT OF THE FOUR MUSCLES THAT FORM THE ROTATOR CUFF

TRUE

TRUE OR FALSE? AFTER A BICEPS TENODESIS PROCEDURE, PROM EXERCISES ARE STARTED ON THE SECOND POSTOPERATIVE DAY FOR BOTH THE SHOULDER AND THE ELBOW.

TRUE PROM is started on the second postoperative day. The patient is taught to perform progressive elbow extension as pain allows. Full extension may not be achieved for 5 to 6 weeks. The patient is cautioned against active elbow flexion to protect the tenodesis.

DEFINE SPEED'S TEST

Tests for bicipital tendonitis - flex the shoulder to 90 degrees with the elbow straight, forearm supinated, the patient then resists a downward force. Pain at the proximal biceps indicated bicipital tendonitis.

DEFINE THE NEER IMPIINGEMENT TEST

Tests for shoulder impingement - Stabilize the acromion and flex the internally rotated shoulder with elbow straight. Pain elicited is considered a positive test.

DEFINE THE NEPOLEON TEST

Tests subscapularis - the patient demonstrates inability to bring the elbow anterior with the hand pressed against the belly.

DEFINE THE WHIPPLE TEST

Tests supraspinatus - The arm is elevated to 90 degrees and adducted so the hand is in front of the opposite shoulder, palm down and elbow straight. The patient then resists a downward force. Pain indicates supraspinatus involvement.

NAME THE THREE STRUCTURES THAT MAKE UP THE CORACOACROMIAL ARCH

The acromion, coracoacromial ligament, coracoid process

REPAIR OF A BANKART LESION INVOLVES REATTACHMENT OF WHAT STRUCTURES?

The anterioinferior labrum is reattached to the glenoid rim.

WHAT IS THE CLUNK TEST AND HOW IS IT PERFORMED?

The clunk test is performed by rotating (internally and externally) the flexed shoulder with the elbow extended. A feeling of a "clunk" in the joint is believed to indicate that a labral fragment has been caught in the glenohumeral joint.

DEFINE THE CLUNK TEST

The clunk/crank test is performed by rotating internally and eternally the flexed shoulder with the elbow extended. A feeling of a clunk in the joint is believed to indicate that the labral fragment has been caught in the glenohumeral joint. This would indicate a labral tear.

WHAT IS THE FUNCTION OF THE CORACOBRACHIALIS MUSCLE?

To assist flexion and adduction of the glenohumeral joint

TRUE OR FALSE? ROTATOR CUFF PATHOLOGY ALMOST ALWAYS OCCURS WITH A SUPRASPINATUS COMPONENT

True

TRUE OR FALSE? THE CORACOCLAVICULAR LIGAMENT IS THE ONLY NONCONTRACTILE STRUCTURE SUSPENDING THE SCAPULA FROM THE CLAVICLE?

True

HOW MANY TYPES OF AC JOINT INJURIES ARE THERE? NAME AND DISCRIBE EACH

Type I - Simple sprain without loss of joint congruity Type II - Disruption of the AC ligaments with subluxation of the joint and sprain of the coracoacromial ligament. Type III - Dislocation of the joint, superior displacement of the clavicle, both coracoclavicular ligaments are torn, AC ligaments and capsule are disrupted, ant. delt. is torn. Type IV - Type III AC joint but clavicle is dislocated posteriorly into part of the trapezius, ant. deltoid is torn. Type V - Severe type III injury to AC, clavicle is button- holed through trapezius all clavicular ligaments are torn. Type VI - Inferior subcoracoid dislocation of clavicle. All

OF THE 6 AC JOINT INJURY TYPES, WHICH CAN BE TREATED CONSERVATIVELY?

Type I, II, and III Types IV through VI may require surgical intervention

OF THE THREE TYPES OF ACROMION SHAPES, WHICH TWO ARE MOST OFTEN ASSOCIATED WITH ROTATOR CUFF TEARS?

Types II & III

What is an arthrodesis

surgical immobilization of a joint by fusion of the adjacent bones.

WHICH NERVE INNERVATES THE LATISSIMUS DORSI?

thoracodorsal nerve