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MSK 2020 > Adult Shoulder Problems > Flashcards

Adult Shoulder Problems Flashcards

1
Q

what does the gleno-humeral joint contain?

A

humeral head

scapular glenoid

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2
Q

what does the shoulder girdle consist of?

A

scapula
clavicle
proximal humerus
supporting muscles (deltoid and rotator cuff)

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3
Q

role of supraspinatus

A

initiates abduction

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4
Q

role of subscapularis

A

internal rotation

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5
Q

role of infraspinatus

A

external rotation

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6
Q

role of teres minor

A

external rotation

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7
Q

which direction of dislocation is most common in the shoulder?

A

anterior

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8
Q

what causes an anterior shoulder dislocation?

A

fall with external rotation

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9
Q

what structure can be damaged in an anterior shoulder dislocation?

A

axillary nerve

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10
Q

how do you check whether the axillary nerve is damaged?

A

badge area sensory assessment

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11
Q

what conditions do recurrent dislocations happen in?

A

EDS

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12
Q

presentation of shoulder dislocation

A

deformity
anterior= Bankart lesion
posterior= hill-sachs lesion

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13
Q

which shoulder dislocation is rare?

A

inferior

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14
Q

what is a Bankart lesion?

A

damage to anteroinferior aspect of glenoid labrum

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15
Q

what is a Hill-Sachs lesion?

A

cortical depression of posterolateral humeral head

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16
Q

what sign is seen on XR for posterior shoulder dislocation?

A

light bulb sign

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17
Q

what must you palpate after shoulder dislocation?

A

vascular supply= colour/temperature

neurological= sensation and reflexes

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18
Q

management of shoulder dislocation

A

manipulation
sling
physiotherapy for core strengthening and scapula stabilising
surgery for bankart repair (reattaching labrum and capsule)

19
Q

manipulation methods for shoulder dislocation

A

Kocher
Hippocratic
Stimson

20
Q

what is Impingement cuff disease?

A

tendons of the rotator cuff are compressed in subacromial space during movements

21
Q

presentation of cuff impingement

A

pain in acromion that can radiate to deltoid and upper arm

22
Q

diagnosis of cuff impingement

A

Hawkin-Kennedy
Scarf and Jobes tests
painful arc 60-120 degrees abduction as supraspinatus passes through space

23
Q

management of cuff impingement

A

rest
analgesia
physiotherapy
surgical with decompression

24
Q

what can cause a cuff tear?

A

degeneration

injury

25
Q

which muscle in the rotator cuff is usually torn?

A

supraspinatus

26
Q

presentation of cuff tear

A

grey hair (cuff tear)
weakness
dull achy pain with difficulty sleeping on affected side and reaching overhead

27
Q

diagnosis of cuff tear

A
  1. Gerbet’s
  2. painful arc
  3. USS and MRI
28
Q

management of cuff tear

A 
rest
analgesia
sling 
physio
decompression surgically
29
Q

medical name of frozen shoulder

A

adhesive capsulitis

30
Q

what is adhesive capsulitis?

A

thickening of ligaments leading to tightening

31
Q

risk factors for adhesive capsulitis

A

DM
hyperlipidaemia
Dupytren’s
endocrine disease

32
Q

presentation of adhesive capsulitis

A

loss of external rotation
progressive pain and stiffness
painful arc on abduction 70-120 degrees

33
Q

management of adhesive capsulitis

A

physio
analgesia
can have surgery for capsular release

34
Q

what is acute calcific tendonitis

A

acute onset of shoulder pain due to Ca2+ deposits in supraspinatus tendon

35
Q

management of acute calcific tendoninitis

A

self-limiting as calcification resorbs

36
Q

what sign does biceps tendinopathy have?

A

Popeye sign

37
Q

what does tendonitis activate?

A

matrix metalloproteinases

38
Q

two examples of brachial plexus injuries

A
  1. Erb’s palsy

2. Klumpke’s palsy

39
Q

what is Erb’s palsy?

A

injury to C5-6

40
Q

presentation of Erb’s palsy

A

paralysis, weakness and burning in arm

41
Q

diagnosis of Erb’s palsy

A

EMG
NCS
MRI

42
Q

management of Erb’s palsy

A

physio
analgesia
surgical nerve graft

43
Q

what is Klumpke’s palsy

A

injury to C8-T1

44
Q

what does Klumpke’s palsy affect?

A

flexors of wrist and fingers (claw hand)

MSK 2020 (35 decks)

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