Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Cortex- Upper limb: Shoulder > Flashcards

Cortex- Upper limb: Shoulder Flashcards

1
Q

what is the proper name for the shoulder joint

A

gleno-humeral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what forms the shoulder joint

A

humeral head

scapular glenoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what forms the shoulder girdle

A

scapular, clavicle, proximal humerous, supporting muscles (inc deltoid and rotator cuff muscles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

where does the clavicle attach to the scapular

A

to the acromion process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what four muscles make up the rotator cuff

A

supraspinatus, infraspinatus, terers minor and subscapularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

where do the supraspinatus, infraspinatus and teres minor attach to

A

the greater tuberosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the role of supraspinatus

A

initial (first 15 degrees) abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the role of infraspinatus and teres minor

A

external rotators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

where does subscapularis attach and what is its role

A

lesser tuberosity

principal internal rotator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the role of the rotator cuff

A

pull humeral head into the glenoid to provide a stable fulcrum for the deltoid to abduct the arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why can acute or degenerative tears happen to the rotator cuffs

A

as they are under significant repeated stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what causes chronic rotator cuff insufficiency and what can it lead to

A

altered shoulder biomechanics

glenohumeral OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which joints in shoulder can be affected by OA

A

glenohumeral and acromiocalvicular joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what usually causes shoulder pain in younger patients

A

instability of the joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what usually causes shoulder pain in middle aged patients

A

rotator cuff tears and frozen shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what usually causes shoulder pain in elderly patients

A

OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what causes a painful arc

A

impingement syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is impingement syndrome

A

where the tendons of the rotator cuff (predominantly supraspinatus) are compressed in the tight subacromial space during movement, producing pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when in impingement syndrome does the patient typically feel pain during the arc- why

A

between 60 to 120 degrees of abduction

as an inflamed area of supraspinatus passes through the space during movement producing pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what can cause impingement syndrome

A

tendonitis subacromial bursitis

acromioclavicular OA with inferior osteophyte

a hooked acromion rotator cuff tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

describe the pain in impingement syndrome

A

radiates to the deltoid and upper arm

tenderness may be felt below the lateral edge of the acromion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what test recreates the pain in impingement syndrome

A

hawkins- kennedy test (internally rotating the flexed shoulder)

23
Q

what should be excluded from the differential diagnosis list in impingement syndrome by history and exam

A

cervical radiculopathy

24
Q

what is the treatment for impingement syndrome

A

conservative in the first instance, majority settle with NSAIDs, analgesics, physio, (up to three) subacromial injection of steroid

25
Q

what treatment for cases of impingement syndrome that do not settle with conservative treatment

A

subacromial decompression surgery- creates more space for the tendon to pass through (can be done openly or via minimally invasive arthroscopic techniques

26
Q

why can the tendons of the rotator cuffs tear with minimal or no trauma

A

as a consequence of degenerative changes in the tendons

27
Q

what is the presentation of a rotator cuff tear

A

sudden jerk (bus stopping whilst holding onto rail) causing subsequent pan and weakness

patients usually over 40

28
Q

why do 20% of over 60s have asymptomatic cuff tears

A

due to tendon degeneration

29
Q

can rotator cuffs tear in the young

A

yes, uncommon, but can in significant injury

30
Q

what muscle is usually involved in rotator cuff tears

A

surpaspinatus

31
Q

what muscles can large rotator cuffs tears involve

A

subscapularis and infraspinatus

32
Q

what clinical signs might be seen in a rotator cuff tear

A

weakness of initial abduction (supraspinatus)

weakness of internal rotation (subscapularis)

weakness of external rotation (infraspinatus)

wasting of supraspinatus

33
Q

how are rotator cuff tears confirmed

A

ultrasound/ MRI

34
Q

what is the treatment for rotator cuff injuries

A

surgery- rotator cuff repair with subacromial decompression

non operative- physio, subacromial injection

35
Q

what is adhesive capulitis

A

frozen shoulder

36
Q

describe adhesive capulitis

A

progressive pain and stiffness of the shoulder in patients between 40 and 60 which resolves after 18-24 months

37
Q

what is the presentation and course of adhesive capsulitis

A

initially pain which will subside after 2-9 months
stiffness increases for 4-12 months
stiffness gradually thaws
normally good recovery of shoulder motion

38
Q

what in the principal sign of adhesive capsuilits

A

loss of external rotation

39
Q

loss of external rotation can also occur in OA, how can you differentiate this from adhesive capsulitis

A

OA tends to affect older patients

40
Q

what is the aetiology of adhesive capsulitis

A

unclear- may occur after surgery or injury
diabetic predisposed
associated with hypercholesterolaemia and dupuytrens

41
Q

what is the pathology of adhesive capsulitis

A

the capsule and glenohumeral ligaments become inflamed then thickened and contract

42
Q

what is the treatment for adhesive tendonitis

A

physio and analgesics

glenohumeral injections may help in the painful stage

if after painful stage patient cannot tolerate function loss caused by stiffness can undergo manipulation under anaesthetic (which tears capsule) or surgical capsular release (divides the capsule)

43
Q

what is acute calcific tendonitis

A

acute onset of severe shoulder pain

characterised by calcium deposition in the supraspinatus tendon

44
Q

where is the supraspinatus tenson seen on x ray

A

proximal to the greater tuberosity

45
Q

what is the treatment for acute calcific tendonitis

A

self limiting with pain easing as calcification resorbs

pain relief can be achieved with subacromial steroid and local anaethetic infection

46
Q

what is involved in shoulder instability

A

painful abnormal translocation movement or subluxation and/ or recurrent dislocation

47
Q

what are the two types of shoulder instability

A

traumatic, atraumatic

48
Q

describe traumatic instability

A

when patients experience a traumatic anterior dislocation- might stabilse with rest and physio but may no stabilise and develop recurrent dislocations or subluxations often with minimal force

49
Q

is the redislocation rate higher in traumatic instability in the old or young

A

young- 80% redislocation rate in under 20s

20% in over 30s

50
Q

what can stabilise the shoulder when there is reccurent dislocations due to traumatic instability

A

bankart repair- reattaches the labrum and capsule to the anterior glenoid which was torn in first dislocation

51
Q

what is atraumatic instability

A

patients with generalised ligametous laxity (idiopathic, ehlers-danlos, marfans) can have pain from multidirectional (anterior, posterior or inferior) subluxations or dislocations

52
Q

what are rare causes of shoulder pain

A

inflammation of the tendon of the long head of biceps (biceps tendonitis) causes anterior shoulder pain

tear in the glenoid labrum

53
Q

what can cause referred shoulder pain

A

neck problems, angina pectoris, diaphragmatic irritation (biliary colic, hepatic or subphrenic abscess)

MSK (71 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions