Clinical Anatomy: Shoulder and Arm Flashcards
Where are clavicle fractures most common? What are potential complications?
Middle 3rd. Distal end displaces inferiorly and anteriorly if not immobilized results in bump deformities.
How are clavicle fractures treated?
Immobilized with a figure 8 splint or sling.
Since it cannot be cast the healing period is painful and so regular medication is needed for sleeping.
When is orthopaedic surgery indicated with clavicle fractures?
When it is near the AC joint (distal part)
Where are dislocations more common?
Hand
Elbow
Shoulder
How is a dislocated finger fixed?
Usually it can be stretched out then placed back into the socket
How are ligaments often damaged?
When a ligament is repeatedly stretched or stretched beyond its yield point the ligament becomes lax and non-functioning.
Joint lacks support and is prone to recurring injury.
How can a lax ligament be fixed?
No exercises can shorten a lax ligament (requires surgery) But stronger muscles can support the joint.
Taping provides a good short-term solution.
How is a shoulder dislocation treated?
By careful closed reduction. (pain goes away immediately)
Muscles in the area are then strengthened and taping is used for a while.
Sometimes surgery needs to be done due to ligament laxity which needs to be tightened.
When do shoulder labrum tears typically happen?
During dislocations or injuries to the glenoid rim.
What causes damage to tissue rim of glenoid?
Falling on outstretched arm
Direct blow to the shoulder
Sudden pull such as when trying to lift a heavy object
Violent overhand reach such as when trying to stop a fall or slide
What causes damage to tissue rim of glenoid? (examples)
Falling on outstretched arm
Direct blow to the shoulder
Sudden pull such as when trying to lift a heavy object
Violent overhand reach such as when trying to stop a fall or slide
What causes labral tears?
Throwing motion or weight lifting repetitively.
What is a bankart lesion?
Tear of rim below middle of glenoid socket also involves the inferior glenohumeral ligament is called bankart lesion
What is a SLAP lesion?
SLAP lesion results and is a tear of the rim above the middle of the socket that may involve the biceps tendon
How are labral tears repaired surgically?
Arthroscopig surgery, if the injury is confined to the rim itself (no tear of biceps tendon) the shoulder is still stable the torn flap is removed and other problems are fixed.
If tear extends to biceps tendon the tendon is detached the tendon is repaired because at this point the shoulder is unstable.
How is the biceps tendon repaired?
Surgeon transfers tendon to safe location using absorbable tacks, screws, or sutures.
What are burners and stingers?
Burning or stinging. Usually these injuries are temporary and quickly go away and are caused by minor nerve injuries from stretching suddenly
What are the symptoms of nerve injuries?
Pain
Anaesthesia (numbness)
Parasthesia in arm and forearm - depending on which nerve is affected.
What is spinal stenosis?
Small intervertebral foramen in the cervical region created with bone degeneration
What kind of injuries can cause nerve injury symptoms?
Spinal stenosis
Severe anterior joint dislocations
Where are overuse injuries located most often?
Overuse injuries related to work tasks are predominantly located in the upper limb and can affect:
Cervical spine
Brachial plexus
Peripheral nerves
Synovial joints
Tendons and muscles
Majority of injuries are muscular or neurological in nature with symptoms relating to specific area of injury.
What causes overuse injuries?
Whether sport or work overuse injuries are caused through some combination of the following factors:
High strain
High repetition
Holding long isometric contractions
Maintaining poor posture
Direct pressure on nerves
Prolonged exposure to discrete or whole body vibrations.
(A worker can’t stop playing for a few weeks until the pain subsides)
What are the common outcomes of overuse?
Muscle fatigue
Inflammation of the tendon sheath or tissue
Inflammation of muscle-tendon junction and adjacent tissue
Over time this can result in restricted mobility, injury and even disability.
How does the body normally react to stress?
Inflammatory response:
Acute inflammation resulting in swelling, redness, heat and pain.
Vasodilation of the small blood vessels increasing blood supply to the area.
Increasing vascular permeability to protein
Filtration of fluid into tissue
Phagocytosis (removal of damaged tissue)
Tissue repair
