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JG Year 1 > 119 Shoulder trauma > Flashcards

119 Shoulder trauma Flashcards

1
Q

What is this?

A

Hill-Sach’s lesion - when the posterior part of the humeral head hits the glenoid head during dislocation causing a cortical depression #

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2
Q

What is an apprehension test in Msk?

A

Placing the humeral head in a position of imminent subluxation or dislocation which makes the pt recognise the familiar pattern of instability and react with anticipated fear.

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3
Q

What is classed as a recurrent dislocation?

A

>3 dislocations

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4
Q

Which nerve supplies the biceps brachii, coracobrachialis and brachialis?

A

Musculocutaneous

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5
Q

What area is of skin is supplied by the axillary nerve?

A

Regimental badge area

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6
Q

What is the clinical presentation of damage to the ulnar nerve?

A

Ulnar claw

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7
Q

What is the risk of dislocation of the SC joint in a posterior direction?

A

Damage to the big vessels posterior to the joint

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8
Q

What runs in the bicipital groove?

A

Long head of biceps tendon

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9
Q

Which ligament is the strongest?

  • AC
  • coracoclavicular
A

Coracoclavicular

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10
Q

What is the direction of the humeral head during an anterior dislocation?

A

Antero-inferior

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11
Q

What is a Bankart lesion?

A

Labral tear from the glenoid

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12
Q

Which muscle is weakened following damage to the axillary nerve?

Which muscle compensates in this situation?

A
  • deltoid
  • trapezius compensates
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13
Q

What is a prefixed brachial plexus?

A

Contribution of anterior ramus of C4

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14
Q

What does a lesion to the upper parts of the brachial plexus cause?

A

Erb’s palsy

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15
Q

What does a lesion to the lower parts of the brachial plexus cause?

A

Klemperer palsy - results in ulnar claw

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16
Q

What can deposits of pyrophosphate from tendons cause if they’re shed into the subachromial bursa?

A

Bursitis with severe pain and shoulder restriction

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17
Q
  • What is adhesive capsulitis?
  • When can it develop?
A
  • Frozen shoulder
  • Following
    • rotator cuff injuries
    • hemiplagia
    • chest/breast surgery
    • MI
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18
Q

What are the differences between young and mature cartilage?

A
  • young:
    • abundent in cells
    • low ECM
    • no tide mark
    • no zonal morphology
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19
Q

What does the the tidemark in articular cartilage restrict?

A

Chondrocytes access to nutrients from the vasculature of the subchondral bone

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20
Q

Where does cartilage get its nutrients from?

A

Synovial fluids from synovial capsule vessels

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21
Q

What are the changes which happen in articular cartilage with ageing?

(5 listes)

A
  1. cell metabolism slows and number decreases
  2. collagen matrix proteins cross-link
  3. reduction in type IX collagen
  4. biochemical changes in aggrecan
  5. degradation products decrease
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22
Q

What is formed by the modification of hydroxyl using residues in the collagen chains?

A

Pyridinoline cross-links in mature cartilage

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23
Q

What is the role of transglutaminases in mature cartilage?

A

Enzymatically cross-link martix proteins (between lysine and glutamine)

24
Q

What are the changes to chondroitin sulphate in ageing cartilage?

A

They become shorter

25
Q

What changes happen to the keratan sulphate as cartilage ages?

A

Increases in size

26
Q

Name 2 types of matrix proteinases

A
  • ADAMTS
  • metalloproteinases
27
Q

Which 2 minerals are required for MMPs and ADAMTS?

A

Zinc and/or calcium

28
Q

What are the 4 types of MMPs in cartilage metabolism?

A
  1. collagenases
  2. gelatinases
  3. stromelysins
  4. membrane bound MMPs
29
Q

What are the 2 principal matrix proteinases for aggrecan metabolism?

A
  • ADAMTS4
  • ADAMTS5
30
Q

Why does articular cartilage lack a perchondrium?

A

Perichondrium contains bvs and nerves - cartilage needs to remain avascular and aneural to be able to function in resisting compressive loads - would occlude vbs.

31
Q

What is the classic first sign of OA in cartilage?

A

Surface fissures in the articular cartilage + chondrocyte clustering

32
Q

What is the territorial matrix in hyaline cartilage?

A

The matrix immediately surrounding the cells

33
Q

What is the name of the cavity in which the chondrocytes lie?

A

Lacunae

34
Q

Where can elastic cartilage be found?

A

Epiglottis

External ear

External auditory canal

35
Q

Apart from IVD, where else is fibrocartilage found?

A

Ligament/tendon entheses + anywhere tendon presses against bone

36
Q

What is synovium?

A
  • Thin membrane in synovial joints which lines the joint capsule
  • 1-3 layers of macrophage and fibroblast-like cells which produce the synovial fluid
37
Q

What are Benninghoff arcades?

A

Collagen fibre organisation in articular cartilage

38
Q

What makes up the ‘wet’ weight of articular cartilage?

(5 listed)

A
  • 70% water
  • 20% collagens
  • 7% PGs
  • 2% cells
  • 1% other proteins
39
Q

What makes up the ‘dry’ weight of articular cartilage?

A
  • 75% collagens
  • 22% PGs
  • 3% other proteins
40
Q

What type of collagen is type IX? Function?

A

FACIT collagen - binds to type II collagen and is important in organisating fibrils

41
Q

What is the function of the N globular domain in type IX collagen?

A

Anchors type II to the other matrix components

42
Q

Where else in the body does type IX and type II interact?

A
  • Cornea
  • vitreous humour of the eye
43
Q

Where is type VI collagen found?

A

In pericellular matrix - forms hine fibrils in lacunae and around cells

44
Q

What is collagen type XI involved with?

A

Fibril nucleation

45
Q

Name 3 small leucine rich PGs

A
  • decorin
  • biglycan
  • fibromodulin
46
Q

Which chemical groups link GAGs to protein cores in cartilage?

(2)

A
  • Hydroxyl groups of serine/threonine
  • Amine groups of asparagine
47
Q

Which groups on the GAGs provide them with polyanionin properties?

A
  • carboxyl
  • sulphate
48
Q

What is the role of biglycan and where is it found?

A
  • Small leucine rich PG
  • found in per-cellular regions
  • binds GFs near cell surface receptors
49
Q

What are canaliculi?

A

Canals which house long cell processes of the osteocytes which communicate via gap junctions

50
Q

What lies in the spaces between the trabeculae?

A

Bone marrow

51
Q

What are trabeculae composed of?

A

Lamallae of bone with lacunae containing osteocytes

52
Q

From which type of cell are osteocytes derived from?

A

Osteoblasts

53
Q

Which cell type is responsible for resorbing bone?

A

Osteoclasts

54
Q

What is osteoid?

A

Uncalcified matrix in developing spongy bone

55
Q

What is a Howship’s lacuna?

How is it formed?

A
  • Lacuna in which the osteoclast lies
  • result of bone erosion activity of the osteoclast

JG Year 1 (27 decks)

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