Clinical Skills: Hip and Shoulder

Question 1

what would you expect to see in the affected leg of a patient with a fracture of the neck of the femur?

Answer 1

externally rotated foot
shortened leg
bruising
severe pain

Question 2

how would deal with a fracture of the neck of the femur?

Answer 2

analgesia
morphine
X ray

Question 3

why is the shoulder more likely to dislocate than the hip?

Answer 3

socket is shallow so ball doesnt fit as well

Question 4

do shoulder dislocations most ocmmonly happen anteriorly or posteriorly?

Answer 4

anteriorly

Question 5

what does a poditive sulcus sign look like?

Answer 5

squared off as muscles are laxed

Question 6

what does the subscapularis do?

Answer 6

internal rotation

Question 7

what does the supraspinatus do?

Answer 7

abduction up to 15 degrees

Question 8

what does the infraspinatus do?

Answer 8

external rotation

Question 9

what does the teres minor do?

Answer 9

external rotation

Question 10

instability tests for shoulder?

Answer 10

sulcus test
anterior/posterior draw test
anterior/posterior apprehension test

Question 11

impingement tests for shoulder?

Answer 11

Painful arc on abduction
Hawkins-Kennedy test
Jobes test
Scarf test

Question 12

what does the scarf test look for?

Answer 12

ACJ pathology/ OA

Question 13

what does the jobes test look for?

Answer 13

supraspinatus tear

Question 14

what angle is muscle pain experienced at in painful arc syndrome?

Answer 14

80-150 degrees

Question 15

what nerve is hip to knee referral pain from?

Answer 15

obturator nerve

Question 16

where is hip pain typically felt and why?

Answer 16

groin
knee if child
trochanter if bursitis
buttock if SI joint

Question 17

what is the cause of a trendelenburg gait?

Answer 17

weakness in the abductors

Question 18

what nerve’s damage is commonly the cause of a trendelenburg gait?

Answer 18

superior gluteal nerve

Question 19

does sufe need an operation?

Answer 19

yes

Question 20

does perthes need an operation?

Answer 20

no

Question 21

symptoms of SUFE?

Answer 21

knee pain in an obese child

Question 22

what causes perthes?

Answer 22

avascular necrosis of the femoral head

Question 23

what would happen to movement in a supraspinatus tear?

Answer 23

can’t initiate abduction

Question 24

what arm movement goes first in OA?

Answer 24

internal rotation

Question 25

what age do people usually get a rotator cuff tear?

Answer 25

elderly

Question 26

treatment for a shoulder impingement?

Answer 26

analgesics
mobilisation

if still bad after 3 months, steroid into subacromial space

Question 27

how does a shoulder progress into frozen shoulder?

Answer 27

bad pain but movement fine
pain gets worse, movement worse
pain goes, no movement

Question 28

how long can a frozen shoulder take to settle?

Answer 28

12-18 months

Question 29

treatment for frozen shoulder?

Answer 29

injected steroids

manipulation under anaesthesia

Question 30

where are steroids injected into in frozen shoulder?

Answer 30

glenohumeral joint