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my MSK > CORTEXT: upper limb > Flashcards

CORTEXT: upper limb Flashcards

1
Q

Supraspinatus, infraspinatus and teres minor attach to the _____ _______ of the humerus.

A

greater tuberosity

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2
Q

Supraspinatus initiates ________, whilst infraspinatus and teres minor are _______ _______

A

supraspinatus - abduction

infraspinatus and teres minor - external rotation

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3
Q

In Impingement syndrome, the _____ ______ tendons are compressed in the __________ space during movement, causing pain.

A

rotator cuff tendons

subacromial

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4
Q

Where does impingement pain commonly radiate to?

A

The deltoid and upper arm

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5
Q

What tests are useful in confirming a diagnosis of impinged shoulder?

A

Hawkins’-Kennedy test
-internally rotate a flexed shoulder

Painful arc

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6
Q

What conservative treatment is used for impingement syndrome?

A

NSAIDs and analgesics
Physiotherapy
Subacromial steroid injections (x3)

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7
Q

What age group is most commonly affected by frozen shoulder - adhesive capsulitis?

A

40-60 year olds

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8
Q

What is a typical history of presenting complaint in frozen shoulder?

A
  1. Freezing: initial pain for 2-9 months which subsides
  2. Frozen: increasing stiffness (4-12 months)
  3. Thawing: stiffness alleviates shoulder motion is retained
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9
Q

What movement is predominantly lost in Frozen shoulder?

A

External rotation

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10
Q

The pathology of frozen shoulder is the inflammation, thickening and contraction of the _______ ______ and _________ ligaments, w

A

shoulder capsule
and
glenohumeral ligaments

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11
Q

Subacromial steroid injections may be used in treatment of frozen shoulder, especially during the painful phase (T/F).

A

False

-gleno-humeral injections are used

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12
Q

What treatment may relieve the stiffness in frozen shoulder?

A
  • manipulation under anaesthesia

- surgical capsular release (divide the capsule)

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13
Q

A painful condition associated with calcium deposits in the supraspinatus tendon (seen on X-ray) describes….

How is the pain relieved?

A

Acute calcific tendonitis

Subacromial steroid and local anaesthetic injection

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14
Q

What surgical procedure may be carried out in a young patient with recurrent shoulder dislocation?

A

Bankart repair

-reattach labrum and capsule to the anterior glenoid (this was torn off during the first dislocation)

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15
Q

Inlfammation of what tendon can cause anterior shoulder pain?

A

biceps brachii tendon

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16
Q

What is the Popeye deformity?

A

A bunched biceps muscle due to the rupture of the proxmal biceps tendon

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17
Q

What is a SLAP lesion?

A

Tear in the glenoid at the attachment point of long biceps tendon.

‘superor labral tear from anterior to posterior’

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18
Q

The carpal tunnels is formed by the _____ bones and the ________ ________

A

carpal bones and

flexor retinaculum

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19
Q

What nerve passes within the carpal tunnel?

A

Median nerve

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20
Q

What is carpal tunnel syndrome associated with?

A

Rheumatoid arthritis
Fluid retention (pregnancy, chronic renal failure, diabetes, hypothyroidism)
Wrist fractures

21
Q

What are the clinical signs of Carpal tunnel syndrome?

A
  • pins and needles in thumb and raidal 2.5 fingers

- thenar muscle wasting and weakness

22
Q

What tests can be perfored to aid diagnosis of carpal tunnel syndrome?

A

Tinel’s test
-percuss over median nerve

Phalen’s test
-hold wrist hyperflexed

23
Q

What is divided in surgical Carpal tunnel decompression?

A

Transverse carpal ligament

24
Q

What are the symptoms of Cubital tunnels syndrome?

A

Paraesthesia of the ulnar 1.5 fingers

Weakness of:

  • 1st dorsal interosseous (abducts index finger)
  • adductor pollicis
25
Q

Tinel’s test may be performed to confirm the diagnosis of Cubital tunnel syndrome. Where should it be performed?

A

Percussion over the cubital tunnel, behind the medial epicondyle of the humerus

26
Q

What articulations compose the Elbow joint? What are the movements at each one?

A

Ulno-humeral joint
-flexion/extension

Radio-capitellar

  • supination/ pronation
  • between radius and capitullum of humerus
27
Q

What is the insertion point of triceps brachii?

A

Olechranon process of the ulna

28
Q

What is the insertion of the brachialis?

A

Coronoid process of the ulna

29
Q

What is the main supinator muscle?

A

Biceps brachii

30
Q

_____ ______ proximally and ______ ______distally pronate the forearm.

A

Pronator teres proximally

Pronator quadratus distally

31
Q

The common origin of the extensor muscles of the forearm is the _____ ______, whilst the common origin of the flexors of the forearm is the _____ _______

A

lateral epicodyle

medial epicondyle

32
Q

Tennis elbow affects the _____ ______

A

lateral epicondyle

-micro-tears in the common extensor origin

33
Q

Golfers elbow affects the….

A

medial epicondyle

34
Q

What surgery may be performed to treat Rheumatoid Arthritis of the radio-capitellar joint?

A

Excision of the radial head

35
Q

Dupuytrens’s contracture is most common in males (T/F)

A

True

10:1

36
Q

What may be noted on examination of patient with Dupuytren’s contracture?

A

Palpable nodules
Puckered skin, adgerent to the disease fascia
Ring and little finger affected

37
Q

What is Trigger finger?

A

Tendonitis of a flexor tendon resulting in nedule formation, which catches in the A1 pulley of the tendon sheath.

38
Q

What treatments are available for trigger finger?

A

Steroid injection into tendon sheath

Surgical incision of the A1 pulley

39
Q

What joints in the hands are most commonly affected in OA?

A

DIP joints

40
Q

What are Heberden’s nodes?

A

Bony thickening of DIPJs

41
Q

What joints are Bouchard nodes present at?

A

PIPJs

42
Q

___ joints are spared by Rheumatoid Arthrits.

A

DIP joints

43
Q

What is the progression of RA in the hands?

A
  1. Synovitis and tenosynovitis
    - sweling and pain
  2. Erosion of the joints
    - articular cartilage is eroded off by inflammation
  3. Joint instability and tendon rupture
    - extensor tendons may rupture
44
Q

DMARDs are…

A

disease modifying anti-rheumatoid drugs

45
Q

What’s Boutonniere deformity?

A

Flexion at PIPJ with hyperextension at DIPJ

-RA sign

46
Q

What is Swan neck deformity?

A

hyperextension at PIPJ with flexion at DIPJ

47
Q

Mucinous cysts commonly occuring at the wrist describes…

A

Ganglion cyst

48
Q

Well circumscirbed tumours, commonly occuring around the PIP joint, with multinucleate giant cells and haemosiderin on histology describes….

A

Giant cell tumour of the tendon sheath

my MSK (55 decks)

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