CORTEXT: upper limb Flashcards
Supraspinatus, infraspinatus and teres minor attach to the _____ _______ of the humerus.
greater tuberosity
Supraspinatus initiates ________, whilst infraspinatus and teres minor are _______ _______
supraspinatus - abduction
infraspinatus and teres minor - external rotation
In Impingement syndrome, the _____ ______ tendons are compressed in the __________ space during movement, causing pain.
rotator cuff tendons
subacromial
Where does impingement pain commonly radiate to?
The deltoid and upper arm
What tests are useful in confirming a diagnosis of impinged shoulder?
Hawkins’-Kennedy test
-internally rotate a flexed shoulder
Painful arc
What conservative treatment is used for impingement syndrome?
NSAIDs and analgesics
Physiotherapy
Subacromial steroid injections (x3)
What age group is most commonly affected by frozen shoulder - adhesive capsulitis?
40-60 year olds
What is a typical history of presenting complaint in frozen shoulder?
- Freezing: initial pain for 2-9 months which subsides
- Frozen: increasing stiffness (4-12 months)
- Thawing: stiffness alleviates shoulder motion is retained
What movement is predominantly lost in Frozen shoulder?
External rotation
The pathology of frozen shoulder is the inflammation, thickening and contraction of the _______ ______ and _________ ligaments, w
shoulder capsule
and
glenohumeral ligaments
Subacromial steroid injections may be used in treatment of frozen shoulder, especially during the painful phase (T/F).
False
-gleno-humeral injections are used
What treatment may relieve the stiffness in frozen shoulder?
- manipulation under anaesthesia
- surgical capsular release (divide the capsule)
A painful condition associated with calcium deposits in the supraspinatus tendon (seen on X-ray) describes….
How is the pain relieved?
Acute calcific tendonitis
Subacromial steroid and local anaesthetic injection
What surgical procedure may be carried out in a young patient with recurrent shoulder dislocation?
Bankart repair
-reattach labrum and capsule to the anterior glenoid (this was torn off during the first dislocation)
Inlfammation of what tendon can cause anterior shoulder pain?
biceps brachii tendon
What is the Popeye deformity?
A bunched biceps muscle due to the rupture of the proxmal biceps tendon
What is a SLAP lesion?
Tear in the glenoid at the attachment point of long biceps tendon.
‘superor labral tear from anterior to posterior’
The carpal tunnels is formed by the _____ bones and the ________ ________
carpal bones and
flexor retinaculum
What nerve passes within the carpal tunnel?
Median nerve
What is carpal tunnel syndrome associated with?
Rheumatoid arthritis
Fluid retention (pregnancy, chronic renal failure, diabetes, hypothyroidism)
Wrist fractures
What are the clinical signs of Carpal tunnel syndrome?
- pins and needles in thumb and raidal 2.5 fingers
- thenar muscle wasting and weakness
What tests can be perfored to aid diagnosis of carpal tunnel syndrome?
Tinel’s test
-percuss over median nerve
Phalen’s test
-hold wrist hyperflexed
What is divided in surgical Carpal tunnel decompression?
Transverse carpal ligament
What are the symptoms of Cubital tunnels syndrome?
Paraesthesia of the ulnar 1.5 fingers
Weakness of:
- 1st dorsal interosseous (abducts index finger)
- adductor pollicis
