SKEB 2513 Basic Rehabilitation: Musculoskeletal Conditions

Questions and Answers

What are the primary causes of shoulder impingement?

Abnormal glenohumeral and scapulothoracic motion

Trauma to the lateral ligaments of the ankle joint

Excessive ankle plantar flexion, supination, and inversion

Subacromial and subcoracoid impingement of the rotator cuff (correct)

Type II acromion impingement is flat. Is this statement true or false?

False

What special test/examination is used to detect shoulder impingement when the examiner passively induces 160 degrees of shoulder flexion while stabilizing the scapula?

Neer sign

For lateral ankle sprains, forced ankle plantar flexion, supination, and inversion can sprain the ______ ligaments.

lateral Signup and view all the answers

Match the following ankle sprain grades with their descriptions:

Grade I = Mild sprains with no ligamentous laxity Grade II = Moderate sprains with tear of anterior talofibular ligament Grade III = Severe sprains with tears of anterior talofibular + calcaneofibular ligaments Signup and view all the answers

What is the cause of pain for almost 40% of chronic low back pain sufferers?

Discogenic low back pain Signup and view all the answers

What are some symptoms of radiculopathy? (Select all that apply)

Burning sensations Signup and view all the answers

Discogenic low back pain is caused by the normal aging process or by excessive or repetitive trauma leading to disc dehydration and an increase in collagen concentration. Changes in intervertebral discs may affect neighboring structures, thus eliciting pain indirectly. Aging, obesity, smoking, and excessive axial loads can accelerate the degeneration of the intervertebral discs due to __________.

disc dehydration and an increase in collagen concentration Signup and view all the answers

Radiographs show only structural changes such as loss of disc height.

True Signup and view all the answers

Match the following treatments with their respective functions:

Nonsteroidal anti-inflammatory drugs (NSAIDs) = First-line agents for pain management Physical therapy = Stabilization of core muscles and emphasis on neutral to extension bias position Epidural steroids injections = Providing symptomatic relief of radicular pain Surgery (discectomy/fusion) = Recommended for progressive or worsening neurologic symptoms Signup and view all the answers

Study Notes

Rehabilitation of Musculoskeletal Conditions

Shoulder Impingement

General Consideration: Primary causes of shoulder impingement include subacromial or subcoracoid impingement of the rotator cuff, with secondary causes being abnormal glenohumeral and scapulothoracic motion.
Static Stabilizers: The glenoid labrum and glenohumeral ligaments are static stabilizers of the shoulder.
Dynamic Stabilizers: The rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) are dynamic stabilizers of the shoulder.
Pathogenesis: The deltoid and supraspinatus muscles provide superior translational forces to the humeral head, while the infraspinatus, teres minor, and subscapularis muscles provide inferior translational forces. Unopposed superior translational forces can lead to supraspinatus impingement.
Clinical Findings: Signs and symptoms include pain on resisted motion, and a positive finding in special tests such as Neer's sign, Hawkins' sign, Empty Can test, and Speed's test.
Imaging Studies: Radiographs can show narrowing of the subacromial space, while MRI can demonstrate both bony and soft tissue abnormalities.
Treatment and Rehabilitation: Treatment options include nonsteroidal anti-inflammatory drugs, physical therapy, and surgery.

Ankle Sprain

General Consideration: Lateral ankle sprains are the most common type of ankle sprain, accounting for 85% of ankle sprain injuries.
Pathogenesis: Forced ankle plantar flexion, supination, and inversion can lead to spraining of the lateral ligaments.
Clinical Findings: Signs and symptoms include swelling, ecchymosis, and limited range of motion. Special tests such as the anterior drawer test, talar tilt test, external rotation test, and squeeze test can help diagnose ankle sprains.
Grades of Ankle Sprains: Ankle sprains can be classified into three grades: Grade I (mild), Grade II (moderate), and Grade III (severe).
Imaging Studies: Radiographs can rule out fractures, while MRI can provide insight into osteochondral defects, bone bruises, and stress or occult fractures.
Treatment and Rehabilitation: Treatment options include nonsteroidal anti-inflammatory drugs, physical therapy, and rehabilitation programs that focus on pain control, gait normalization, and return to daily activities and sports.

Discogenic Low Back Pain

General Consideration: Discogenic low back pain is caused by a degenerated or herniated intervertebral disc, and can affect up to 40% of chronic low back pain sufferers.
Pathogenesis: Degenerative disc disease, intervertebral disc disruption, and disc herniation can lead to discogenic low back pain.
Clinical Findings: Signs and symptoms include axial low back pain with or without radiation to the limb, tenderness over the spinous processes and paraspinal muscles, and pain exacerbated by trunk flexion and relieved by extension.
Imaging Studies: Radiographs can show structural changes, while MRI can demonstrate both bony and soft tissue abnormalities.
Treatment and Rehabilitation: Treatment options include nonsteroidal anti-inflammatory drugs, physical therapy, and rehabilitation programs that focus on stabilization of core muscles, proper spinal bracing, and traction. In severe cases, surgery may be necessary.

Description

This quiz covers the rehabilitation of common musculoskeletal conditions, including shoulder impingement, ankle sprain, and discogenic low back pain. It focuses on general considerations, pathogenesis, clinical findings, treatment, and rehabilitation. Intended learning outcomes include describing general pathogenesis and more.