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Conditions (2nd year) > Conditions Of The Shoulder > Flashcards

Conditions Of The Shoulder Flashcards

0
Q

GH joint sprain MOI

A

Arm is forcibly abducted (GH external rotated)

- anterior capsule & GH ligament causing numeral head to ‘slip out’ of glenoid fossa

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1
Q

What are the 4 joints of the shoulder?

A

Sternoclavicular
Acromioclavicular
Glenohumeral
Scapula thoracic

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2
Q

GH joint sprain S&Sx

A

Pain in anterior GH
Pain w/ reproduced MOI (abd&ext rot)
Joint laxity
Pain, swelling, & decreased ROM

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3
Q

GH joint sprain management

A

PIER
Immobilization 12-24 hrs
Pain free ROM
Delay external rotation & abduction for 3 weeks, allow capsule to heal

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4
Q

Anterior Instability MOI

A

Blow to post-lateral aspect, forces head of humerus anteriorly in relation to glenoid fossa
Abduction, external rotation & extension

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5
Q

Anterior Instability S&Sx

A

Failure of MGHL, IGHL
Head of humerus lies adjacent to coracoid process
Humerus slides ant. IGHL avulsed from ant. Lip of labrum (Bankart Lesion)

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6
Q

Posterior Instability MOI

A

Occurs when humerus is flexed & int rotated w/ post forces directed along long axis of humerus

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7
Q

Inferior Instability MOI

A

Rare

Primary restraint to motion in superior GH ligament

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8
Q

Multidirectional Instability MOI

A

Damage takes place in more than one plane

Normally ant/post dislocations are associated w/pre-existing inferior laxity or laxity in opposite direction

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9
Q

Multidirectional Instability S&Sx

A

Pain/clicking w/ simple tasks

Need to identify multidirectional instability to address all areas of weakness

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10
Q

Multidirectional Instability Management

A

Conservative

Surgery for those who do not respond to conservative Rx

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11
Q

Sternoclavicular Joint Sprain MOI

A

Compression related to a direct blow
-individual side lying & player falls on top
Indirect force due to FOOSH
- anterior displacement

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12
Q

Sternoclavicular Joint Sprain S&Sx

A

G1: TOP w/no visible deformity
G2: joint subluxation (bruising, swelling & pain/ pain w/ cross-flexion, joint compression
G3: prominent displacement, may involve #, unable to perform scapular protraction, numbness, tingling due to compression of thoracic inlet

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13
Q

Sternoclavicular Joint Sprain Management

A

G1: PIER, sling (1-2 weeks)
G2: longer immobilization (3-6 weeks) - sling/ figure 8 brace
G3: immediate reduction by MD, immobilization,

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14
Q

AC joint Sprain MOI

A

Fall on tip of acromion, fall transmitted along axis of humerus w/lumbar adduction

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15
Q

AC joint sprain Sx

A

G1: no disruption of AC/CCL min swelling, pain past 90* abduction
G2: AC ligament, CCL rupture, clavicle rides above level of acromion, minor step/gap at joint line, pain increases
G3: rupture of AC joint ligament, CCL & tearing of deltoid fascia, may involve neurological Sx

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16
Q

AC Joint Sprain Management

A

G1&2: PIER, sling (1-3 weeks), RTP: Pad/tape to prevent further injury, Approximate ends of injury w/ pressure & compression
G2+: May be managed both operatively & non
G3: Surgery w/immobilization 4-6 weeks, strengthening (pre-surgery)

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17
Q

Acute Dislocations MOI

A

May be associated w/# or nerve damage, may require EAP to be activated

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18
Q

Acute Dislocations S&Sx

A 
Intense pain,
Tingling/numbness
Prominent acromion, humeral head palpated in axilla 
Arm held at 20-30* abduct (ant disloc)
Arm held in full adduct (post disloc)
Ant delt is flat (post disloc)
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19
Q

Acute Dislocations Management

A

1st time disloc = immediate referral
Treat as a # & splint in position of comfort
PIER unless neurological components affected

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20
Q

What is Hill Sachs Leision

A

Small defect found in humeral head after ant disloc
Caused by impact of humeral head on glenoid fossa
Rarely symptomatic may lead to degeneration of joint

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21
Q

How do you test for an Acute dislocation?

A

Apprehension test
Posterior apprehension
Sulcus Sign

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22
Q

Chronic Dislocations MOI

A

Ant disloc, intracapsular
Same MOI as acute
As # increase force needed to produce injury decrease

23
Q

Chronic Dislocations S&Sx

A

Pain, crepitation, clicking as arm shifts back to appropriate position,
Individual voluntary decreases disloc

24
Q

Chronic Dislocations Management

A

If injury does not reduce, sling & swathe, PIER & refer
Restore normal motion w/ strengthening
Surgery may be warranted if instability persists

25
Q

Glenoid Labrum Tears MOI

A

Tearing of labrum & IGHL (Bankart)
Associated with trauma & ant instability
Injury to superior labrum
Disrupts LH biceps (SLAP) lesion

26
Q

Glenoid Labrum Tears S&Sx

A

Pain, weakness when arm is over head (abd& external rotation)
Results of disloc/subluxation

27
Q

Glenoid Labrum Tears Management

A

Conservative Rx, rest, NSAIDs

Surgery may be warranted if individual doesnt respond

28
Q

How does bursitis of the shoulder occur

A

Works w/ impingement syndrome

Usually subacromial bursa-impinged w/ over head activities

29
Q

Bursitis S&Sx

A

Sudden shoulder pain w/ initiation, acceleration of throwing motion
Pt. tenderness ant & lateral edges of acromion
Painful arc
Pain referred to distal deltoid attachment

30
Q

Bursitis Management

A

Acute care protocol
R/O other conditions
Find cause,treat cause

31
Q

What Special test can you perform to test for Bursitis of the shoulder?

A 
Hawkins Kennedy (supraspinatus/biceps)
Drop Arm (supraspinatus)
empty Can (supraspinatus)
32
Q

Bicipital Tendonopathy MOI

A

Repetitive overuse during rapid motion involving elbow flexion & supination
Irritation occurs as tendon moves in Bicipital groove

33
Q

Bicipital Tendonopathy S&Sx

A

TOP Bicipital groove

+ve yergasons & speeds test

34
Q

Bicipital Tendonopathy Management

A

Restriction of rotational activities
Due to potential vascular impingement when arm is fully addicted, slightly abducted in sling if immobilized
PIER, modalities

35
Q

Traumatic Clavicular # MOI

A

Frequently occur in middle 1/3 of clavicle (where it changes direction)

36
Q

Traumatic Clavicular # S&Sx

A

Swelling, ecchymosis deformity

Pain w/GH movement

37
Q

Traumatic Clavicular # Management

A

Immobilization in cling & swathe

Following Ax by GP, figure 8 brace

38
Q

Scapular # MOI

A

Avulsion # of coracoid

Direct contact

39
Q

Scapular # S&Sx

A

Minimal displacement, localized hemorrhage
Individual reluctant to abduct GH
Pain
R/O underlying pulmonary injury

40
Q

Scapular # Management

A

Immobilize in sling & swathe

Refer to MD

41
Q

Epiphyseal & Avulsion # MOI

A

Epiphyseal centres at shoulder remain unfused longer period of time
Prox humeral epiphysis close at 18-21
Little league shoulder to repetitive med. rot. & adduction
Avulsion to coracoid process w/young adults w/repetitive forceful throwing

42
Q

Epiphyseal & Avulsion # S&Sx

A

Acute shoulder pain when attempting to throw hard
Pain w/deep palpating in axilla
Avulsion #, pain w/palpating at site

43
Q

Epiphyseal & Avulsion # Management

A

Immobilize in sling & swathe

PIER

44
Q

Torticollis MOI

A

Scoliosis of c-spine, SCM
Deformity in which head tilts toward one shoulder & chin rotates toward opposite shoulder
“Wry neck” result of muscular strain following exposure to cold/sleeping w/neck in abnormal position

45
Q

Torticollis S&Sx

A

Abnormal neck position

46
Q

Torticollis Management

A

Usually resolves spontaneously in 2 weeks

Modalities & ROM

47
Q

C-spine Sprain MOI

A

Extreme motion or violent muscle contraction

Maintaining head in one position, may also produce sprain

48
Q

C-spine Sprain S&Sx

A

Pain
Stiffness
No neuro

49
Q

C-spine Sprain Management

A

Modalities

Limiting ROM

50
Q

C-spine Strain MOI

A

Usually involves SCM/upper traps
May also involve scalenes, levator scap
Same MOI as sprain

51
Q

C-spine Strain S&Sx

A

Pain
Stiffness
Restricted ROM
Muscle spasm

52
Q

C-spine Strain Management

A

Modalities
C-collar
Strengthening

53
Q

Throacic Outlet Compression Syndrome Etiology

A

Nerves &/or vessels become compressed in proximal neck/axilla I. 2 forms:

1) Neurological - stretch or compression of nerve
2) Vascular - Impingement of subclavian artery/vein

54
Q

Throacic Outlet Compression Syndrome S&Sx

A

Nerve- aching pain, pins & needles/numbness, weakness
Vascular - blockage of subclavian vein (Edema/stiff hand)
- occlusion of artery (rapid onset, coldness/numbness arm, fatigue)

55
Q

Throacic Outlet Compression Syndrome Management

A

Conservative Rx - Ax muscle strengthening & posture

Conditions (2nd year) (6 decks)

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