Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Musculoskeletal, Skin > 091014 clinical upper extr injury > Flashcards

091014 clinical upper extr injury Flashcards

1
Q

types of fracture mechanisms

A

acute fracture : suddent impact of large force exceeding the strength of bone

stress fracture : repeititive submaximal stresses

pathologic: normal forces to diseased bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

fracture hx

A

acute-sudden blow

chronic-repetitive activity; increase in activity duration, intensity, or frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

fracture exam

A

deformities (if bleeding with or w/o a fragment, you should suspect open fracture, which is an orthopedic emergency. NEEDS to be washed out ASAP)

bony point tenderness (just at one spot)

pain w/ loading the bone (indirect loading is very useful-like the axial loading test, bump test, fulcrum test, hop test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how to treat a fracture?

A

in general, immobilization

avoidance of NSAIDs (some animal studies show NSAIDs interfere w bony healing through prostaglandins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

fall on an outstreched hand-what are you concerned about?

A

scaphoid fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

bones with vulnerable blood supply

A

scaphoid
talus
femoral head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what blood vessel supplies to scaphoid?

A

radial artery’s branch called the palmar carpal branch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what can a scaphoid fracture cause in terms of damage?

A

can disrupt blood supply going to distal ends of scaphoid, as the fracture is usually mid-scaphoid

then you would get necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

snuffbox contents

A

radial nerve
cephalic vein
radial artery
scaphoid bone (deepest)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how would you be able to tell its a scaphoid frac?

A

if pressure on anatomic snuffbox elicits pain

can have radial nerve paresthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what to do for scaphoid frac

A

need to put on splint b/c these fractures (due to tenuous blood supply) won’t heal very well if you don’t protect them. if it were a sprain, you may just watch and observe, but here, it’s critical to immobilize

can follow w/ MRI to see the blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which artery supplies the femoral head?

A

medial circumflex femoral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

with full range of motion, you can rule out

A

dislocation (w/ acute dislocation, it will be painful and the pt wouldn’t let you move it around much)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when can you have accelerated arthritis at an early age?

A

with trauma (ex-with repeated dislocations, articular cartilage will be damaged and worn away)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

arthritis pt hx

A

stiffness, especially after rest

worse after prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

exam findings of arthritis

A

joint line tenderness
mild swelling
deformity

KEY: symptoms with BOTH passive and active mvmt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

physical therapy may be good for arthritis b/c

A

teaches how to use body in right manner

and also, build stronger muscles so can absorb shock better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what can you use for OA?

A

cortisone (for acute flares, or if someone has special occasion coming up)-can cause chondrocyte cell death though

NSAIDs

surgical replacement

physical therapy

dietary supplements (glucosamine, chondroitin-they make up articular cartilage)

viscosupllement (injections w/ hyaluronic acid, a building block of articular surface)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

frozen shoulder is due to

A

capsulitis (joint capsule thickening, giving rise to inflam and scarring)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

cause of capsulitis

A

idiopathic or post injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

capsulitis hx

A

limited range of motion (hurts to raise arm overhead)

early stage: painful w/ decreased ROM (freeze phase)

then later, frozen phase: non painful with decreased ROM

then later, thawing phase: non painful with improving ROM (the condition reverts on its own)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

capsulitis exam findings

A

decreased ROM
gradually tightening endpoint
otherwise consistent with underling etiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

diagnosis of adhesive capsulitis

A

difficult w/o clinician giving background; usually radiology can say it’s consistent with but not that this IS capsulitis

24
Q

capsulitis treatment

A

maintain ROM (what they came in with)
pain control
reassure and and educate

25
Q

popped shoulder 2 weeks ago in a construction worker two wks ago when pulling on a bolt

full ROM, normal muscle strength,

diagnosis?

A

long head biceps tendon rupture (refer back to picture in slides)

26
Q

differentiating btwn long head and short head biceps tendon tears at the proximal end

A

short head would result in muscle lump that is higher

27
Q

treatment of long head of biceps tendon rupture?

A

NSAIDs can be used for the pain
platelet rich plasma or autologous blood injection can be used

physical therapy
or do nothing (can do fairly well with this)

28
Q

to cinsider when treating musclotendinous ruptures

A

impact of absence of muscle
presence of alternative muscles
functional requirements of pt

29
Q

enthesopathy

A

disorder of muscular or tendinous bony attachment

30
Q

tendinitis

A

acute inflam of tendon (traumatic-blow or pull)

31
Q

tendinosis

A

chronic degeneration of tendon

many injuries may be acute on a chronic underlying condition

32
Q

40 year old golfer feels pain on left elbow; recently was hit by a golf ball in this area

exam shows 2 cm area of pain over distal humerus and lateral proximal radius, pain with resisted wrist and middle finger extension and with supination, no pain with varus or valgus stress

A

lateral epicondylitis

can’t be fracture b/c it’s diffuse (2 cm)

33
Q

strains usually happen with what mechanism?

A

eccentric muscle contraction

34
Q

strain is

A

muscle fiber damage from overstretching

symptoms of stiffness, bruising, swelling, soreness

35
Q

for what case is the risk vs benefit ratio of NSAIDs most favorable?

A

acute patellar tendinitis

NOT chronic condition (b/c less inflam there). NOT immediate post-op pain (use stronger drugs and also NSAIDs have bleeding side effect). NOT stress fracture

36
Q

with joint sprain, what can you observe?

A

pain and limited ROM

37
Q

AC sprain most commonly caused by

A

fall directly onto shoulder

38
Q

presentation of AC sprain

A

pain w/ overhead motions

deformity of superior shoulder

39
Q

exam findings of AC sprain

A

pain and deformity at AC joint
pain with cross body adduction of arm (postive cross chest test)

painful arc of abduction over 150 degrees

40
Q

AC injury grading

A

grade I-stretched AC ligament
grade II- torn AC ligament and coracoclavicular ligament stretched

grade III-torn both ligaments

41
Q

sprain

A

ligamentous damage from overloading

symptoms are instability or laxity, swelling

42
Q

sprain grades

A

grade I: microscopic damage. on exam, no increased laxity but get pain with stress

grade II: grossly see a partial tear. on exam, has increased laxity (opening and looseness) and pain

grade III: complete tear. exam shows significant laxity.

43
Q

anterior shoulder dislocation possible sequelae

A

chip fractures in humeral head or glenoid b/c humeral head bumps into glenoid (coranoid process is in the way so it comes inferior and anterior)

44
Q

what nerve can get copmressed with anterior shoulder dislocation

A

axillary nerve (which innervates deltoids and brings sensory info from area over deltoids)

45
Q

joint stability types

A

dislocation-complete displacement

subluxation-transient, partial displacement and then slips back into proper place (never loses contact with the joint)

laxity-normal variant in joint looseness

46
Q

shoulder disolocation causes

A

forced extension, abduction, and external rotation of arm (open arm tackle or fall onto abducted arm)

direct blow to posterior shoulder

47
Q

diff btwn ligament sprain and dislocation

A

sprain-limited ROM

dislocation-won’t want to move

48
Q

exam findings for shoulder dislocation

A

arm hand by opposite hand in slight abduction and exterrnal rotation

asymmetry-altered shoulder contour including prominent acromion; humeral head anterior to acromion and adjacent to coracoid

check sensation of axillary and musculocutaneous nerves

positive apprehension test- a feeling of instability with stress

49
Q

paresthesia

A

tingling sensation

50
Q

carpal tunnel syndrome

A

median nerve problem as it goes through carpal tunnel-if have activities that increase pressure within the tunnel, resulting in nerve compression

will cause paresthesia in volar aspect of hand distal thumb, index finger, middle finger, and half of ring finger

51
Q

rotator cuff injuries-why can you still ability to move against resistance?

A

b/c deltoid is still good

52
Q

rotator cuff injuries-will surgery be needed?

A

no, unless you want it. you can still have function w/o surgery

if you do want surgery (like if you were an assembly line worker and needed it for repetitive work), though, it should be done soon because otherwise the muscle scars down and you can’t bring it back to full length

53
Q

acute complete rotator cuff tear will present with

A

maybe some weakness initially, but w/ physical therapy, get back to function

pain w/ overhead motions

54
Q

most common rotator cuff muscle tear

A

supraspinatus

55
Q

if subacromial space is obliterated, suggests?

A

rotator cuff tear

Musculoskeletal, Skin (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions