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Foundations 3 > Disorders and Injuries of the Shoulder part 1 > Flashcards

Disorders and Injuries of the Shoulder part 1 Flashcards

1
Q

What is the MC mechanism of injury for an Acromioclavicular joint

A

Direct force

Falls on AC joint with arm at side or collision sports

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2
Q

What is a Type I AC joint separation?

A

Sprain of Acromioclavicular ligament

AC joint is intact

Corococlavicular joint is intact

Pain w/o any deformities

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3
Q

what is a Type II AC joint separation

A

AC joint is disattached

Sprain of the corococlavicular ligament

Pain & deformity

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4
Q

What is a Type III AC joint separation?

A

Both AC ligament and Corococlavicular ligaments are disattached

AC join dislocated and shoulder is displaced inferiorly

Pain w/ deformity

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5
Q

What special tests can be used to assess an AC joint injury

A

Traction test
Cross arm Adduction test
Neers test
Modified Hawkins Kennedy test

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6
Q

Which test is the best to assess AC joint injury

A

Cross arm Adduction test

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7
Q

What are treatment options for Type I & II AC joint injuries

A

Non-operative is the standard of care

Ice and protection for 7-10 days
Return to sport or activity in 1-3 weeks

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8
Q

What is generally a non-operative treatment for Type III AC joint injuries?

A

Sling for 10-14 days

Return to activity in 3-4 weeks

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9
Q

When would surgery be appropriate for a Type III AC joint injury?

When would surgery be contraindicated?

A
  1. Throwing sport
  2. Overhead worker

Contraindicated in someone who plays contact sports due to risk of re-injury

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10
Q

What are complications that can arise from AC joint injuries?

A

Clavicular osteolysis

Acromioclavicular Osteoarthritis

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11
Q

How are osteolysis and osteoarthritis treated with AC join injuries?

A

Surgical resection of the affected bones

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12
Q

Which location by far is the most common location of a clavicular fracture?

A

Midshaft of the clavicle

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13
Q

What makes up the Allmans classifications for clavicular fractures?

A

Group 1 ==> Midshaft

Group 2==> Lateral portion of the clavicle

Group 3 ==> Medial portion of the clavicle

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14
Q

What are possible mechanisms of injury for a clavicular fracture?

A

Direct fall with arm at side

Direct blow

FOOSH

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15
Q

Upon inspection what things would you expect to see with a clavicular fracture?

A

Grinding with active ROM

Deformity at the midshaft

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16
Q

What findings would you expect to feel during palpation of a clavicular fracture?

A

Crepitus and tenderness

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17
Q

What must always be done when assessing a clavicular fracture during exam?

Why?

A

Neurovascular and Lung ascultations

Need to assess for brachial plexus injuries
Need to assess for subclavian vessels

18
Q

What x-ray views are need to assess a clavicular fracture?

Which is gives the best view?

A

AP

Cephalic Tilt view ==> more sensitive at detecting fracture

19
Q

What kind of treatment should be done for clavicular fractures?

A

NON-OPERATIVE

20
Q

What are non-operative treatment choices for clavicular fractures?

A

Sling

Figue 8 sling

BOTH WORK JUST FINE

21
Q

What are definitive reasons to surgically correct clavicular fractures

A
  1. Open fracture
  2. Tenting (yellowing for broken blood vessels
  3. Neurovascular injury - Brachial plexus
22
Q

What are other relative reasons for surgical treatment of a clavicular fracture?

A

Widley displaced fracture

Displaced lateral 1/3 fracture ==> Takes too long to heal on its own

Multiple fracture segments

Dominate extremity in overhead athletes

23
Q

Which type of shoulder dislocation is often MC

A

Anterior dislocation

24
Q

What are the causes of a shoulder displacement

A

Traumatic

Non-traumatic - seizures

25
Q

What are common etiologies for a posterior shoulder displacement?

A

Seizures

Electrical shocks

26
Q

What type of fracture has a higher prevalence during a posterior shoulder displacement?

A

Lesser tuberosity fractures

27
Q

What limitations do patietns with posterior shoulder injuries have?

A

Arm is abducted

Cannot externally rotate arm

28
Q

What is the mechanism of injury for a anterior displaced shoulder?

A

Abduction or

External Rotation

29
Q

What complications can occur with an anteriorly displaced shoulder?

A

Brachial plexus injury

30
Q

How does someone with an anterior shoulder dislocation present?

A

Flattened deltoid
Fullness to the chest (humeral is stuck in there)
Prominent Acromion
Guarding

31
Q

What exam needs to done before reducing an anteriorly displaced shoulder?

A

Neurovascular exam (brachial plexus injury?)

32
Q

What views need to be taken for a anteriorly displaced shoulder

A

AP view
Axillary view
Y-view (plain of the scapula)

33
Q

What exams are used to assess a shoulder dislocation?

A

Apprehension (pushes humeral head anteriorly during ER)
Jobe Relocation
Surprise
Sulcus sign

34
Q

What is a Bankart Lesion?

A

Dettachment of the anterior and inferior portion of the labrum from the glenoid

35
Q

What is the most common cause a instability with an anteriorly displaced shoulder?

A

Bankart lesion

36
Q

What is Hill-sachs lesion?

A

Posterior lateral compression fracture of the humeral head

37
Q

Prior to reduction what drug is given to sedate patients?

A

Fentanyl

38
Q

What reduction techniques are used to reduce anteriorly displace shoulders

A

Hippocratic (pulling one direction with towel in the other)

Stimson (sling)

Hennipen technique (abduct arm and externally rotate)

39
Q

What after care can be given after reduction of a displaced shoulder? What must the patient continously do while healing

A

Sling

Must extend elbow several times daily to prevent elbow stiffness

40
Q

What age group is most likely to have reoccurring shoulder displacements and why?

A

Age <30

Due to high rates of Bankart lesions

Foundations 3 (25 decks)

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