Arm Flashcards
Rupture of Biceps tendon
What is it?
What causes it?
What is the sign?
- rupture of long head of bicep tendon
- minimal injury of aged 50 yrs above
- Popeye sign
Anterior dislocation of shoulder
What causes it?
What shoulder dislocation is common and why?
What is the presentation of anterior dislocation?
What is Bankart lesion/labral tear?
What is a hil-sachs lesion?
- Direct blow to posterior shoulder
- Anterior. Glenoid fossa shallow, joint is weak inferiorly.
- External rotation, abduction
- glenoid labrum torn due to force of humeral head poppingout of socket
- Humeral head dislocate anteriorly > infraspinatus and teres minor muscle contract > posterior aspect of humeral head jam at anterior lip of glenoid fossa
Posterior dislocation of shoulder
What causes it?
What is the presentation?
- epileptic seizures, lightning strike, blow to anterior shoulder
- internally rotated, adducted
Inferior dislocations of shoulder
What causes it?
What are the associated injuries?
- forceful traction on arm when it’s fully extended over head
- damage to nerves, rotator cuff tears, blood vessels
Soulder dislocation
What are the complications?
- Recurrent dislocation - damage to stabilising tissues surrounding shoulder
- Axillary artery damage
- Axillary nerve damage
- Fractures
- Rotator cuff muscle tears
Clavicle fractures
Where is the fracture common?
What causes it?
What happen to position of arm and clavicular fragments in displaced mid-clavicular fracture?
- middle third of clavicle
- falls onto outstretched hand
- sternocleidomastoid muscle elevates medial fragment
Shoulder drops - weight of upper limb
Arm adducted - pec major
Rotator cuff tear
What is it?
Which tendon is most affected?
What are the causes?
Describe the degenerative-microtrauma model
What are the risk factors?
What is the symptom?
- tear of 1 or more of tendons of 4 rotator cuff muscles
- supraspinatus tendon
- Age-related degeneration - blood supply to muscles dec. > impair healing ability
- age related tendon degeneration + chronic microtrauma > partial tendon tear > full rotator cuff tear > inflammatory cells recruited > oxidative stress > tenocyte formation > further degeneration
- recurrent lifting and repetitive overhead activity (swimming, volleyball, tennis)
- anterolateral shoulder pain, radiate down the arm
Impingement syndrome
What is it?
What causes it?
What are the symptoms?
What does impingement of supraspinatus tendon cause?
- supraspinatus tendon impinges on coracoacromial arch > irritation > inflammation
- thickening of coracoacromial ligament, supraspinatus tendon inflammation, subacromial osteophytes
- dull pain during shoulder flexion, abduction, popping sensation during shoulder movement
- painful arc between 60-120 abduction
Calcific supraspinatus tendinopathy
What is it?
What is the symptom?
What is the pathophysiology?
What is the treatment?
- Hydroxyapatite deposits in supraspinatus tendon
- acute/chronic pain, aggravated by abducting or flexing arm above shoulder level, stiffness, snapping sensation
- hypoxia > tenocytes transform to chondrocyte > cartilage laid in tendon
- rest and analgesia
Adhesive capsulitis
What is the alternative term?
What is it?
How is the pain presented?
What are the risk factors?
What are the treatments?
- Frozen shoulder
- capsule of glenohumeral joint becomes inflammed and stiff > restricts movement > chronic pain
- constant, worsen at night, exacerbated by movement and cold
- female, epilepsy, DM, trauma to shoulder
- physiotherapy, analgesia, anti-inflammatory medication
Osteoarthritis of shoulder
Who does it normally affect?
Which joint is commonly affected?
What is the treatment ladder?
- >50 yrs
- acromioclavicular joint
- activity modification > analgesia > NSAID > steroid injection > hyaluronic acid injection > arthroscopy
