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Clin Med MSK: > Disorders of the UE > Flashcards

Disorders of the UE Flashcards

1
Q

What are the muscles of the RTC

A

SITS
supraspinatus
infraspinatus
teres minor
subscapularis

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2
Q

what is the insertion and MOA for supraspinatus

A

Greater tuberosity (GT)
ABduction

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3
Q

what is the insertion and MOA for Infraspinatus

A

GT
ER

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4
Q

what is the insertion and MOA for Teres Minor

A

GT
ER

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5
Q

what is the insertion and MOA for Subscapularis

A

Lower Tuberosity (LT)
IR

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6
Q

what is the most common muscle inflamed in the RTC

A

supraspinatus

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7
Q

what type of injury causes RTC tendonitis

A

overuse injury
repetitive overhead activity, lifting, athletes with repetitive shoulder movement

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8
Q

What is the presentation for RTC tendonitis

A

unknown onset of shoulder pain - commonly anterior and lateral and pain with physical activity

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9
Q

what is present on the physical exam for RTC tendonitis

A

point tenderness over supraspinatus/GT, reduced ROM, esp ABduction, weakness

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10
Q

What special tests are used for assessing the supraspinatus

A

Hawkins-Kennedy, Neer and Empty Can test

all positive for pain and or weakness

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11
Q

What is the treatment of RTC tendonitis

A

activity modification and rest, NSAIDs, subacromial injection, PT for strengthening and stretching

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12
Q

What is the number one cause of shoulder pain

A

subacromial impingement

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13
Q

What is important with the presentation of subacromial impingement

A

night time pain otherwise presents with shoulder pain, pain with overhead activities

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14
Q

what special tests are positive with subacromial impingement

A

Neer and Hawkins- Kennedy test with tenderness over the greater tuberosity

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15
Q

What is the treatment for subacromial impingement

A

first line is conservative treatment and if failure, operative for subacromial decompression

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16
Q

what is the least likely muscle to tear in a RTCT

A

subscapularis

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17
Q

what is the presentation of RTCT

A

similar to tendonitis and impingement with night pain and +/- weakness and/or loss of ROM

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18
Q

What special tests are positive for RTCT

A

empty can, Drop arm, Infraspinatus and lift off test all positive with RTCT

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19
Q

What is the treatment for RTCT

A

first line is conservative
partial tears with subacromial impingement - subacromial decompression
complete and/or significant symptomatic tears - RTCR, tendon transfers and Reverse TSA

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20
Q

What special tests are used for biceps tendonitis

A

speeds test and yergasons test

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21
Q

what is the MOI for bicep tendon rupture

A

sudden or prolonged bicep contraction against resistance

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22
Q

what injury is commonly seen with the “pop eye” deformity

A

biceps tendon rupture

23
Q

What is the MOI for AC joint injuries

A

direct blow to the shoulder, fall onto shoulder, FOOSH

24
Q

treatment of AC joint injury

A

most treated non-op (type 1-3) with conservative management, operative at type 4-6 or failed non-op

25
Q

What is the MOI for SC joint dislocation

A

MVC or sports injury (direct blow)

26
Q

what is essential to be assessed for SC joint dislocation

A

neurovascular status - brachial plexus and major vascular structures nearby

27
Q

what are the complications wtih SC joint dislocation

A

pneumothorax, SVC injury, Esophageal injury, compression of subclavian artery or carotid artery, voice changes and venous congestion

28
Q

what is the best test to assess for SC joint dislocation

A

CT Scan is the best

29
Q

what is the treatment of SC joint dislocation

A

closed or ORIF - often thoracic surgeon/cardiology

30
Q

What special tests are used for dislocation patients

A

apprehension test and sulcus sign

31
Q

what is something to be aware of with a clavicle fracture

A

risk for pneumothorax from fracture fragment - diminished breath sounds on affected side

32
Q

when os operative treatment necessary for clavicle fracutres

A

open fracture, pending open fractures (skin tenting), associated neurovascular injury, significant displacement

33
Q

What does the axillary nerve innervate

A

deltoid

34
Q

What is important to check with a humerus fracture

A

neurovascular assessment for median, radial and ulnar nerve function

35
Q

What is lateral epicondylitis

A

tennis elbow - inflammation of the extensor tendon insertion

36
Q

what is medial epicondylitis

A

golfers elbow - inflammation of the flexor tendon insertion site (medial epicondyle)

37
Q

when is Nursemaids elbow most common

A

kids 6 months to 6 years - peak incidence ages 2-3

38
Q

what is the MOI for Nursemaids elbow

A

longitudinal traction to extended elbow

39
Q

What type direction is most common for elbow dislocations

A

posterior dislocation is 80-90%

40
Q

what are the three points of articulation in the elbow

A

ulnotrochlear
radiocapitellar
proximal radioulnar

41
Q

what is the common MOI for elbow dislocation

A

FOOSH is the most common

42
Q

When do you need to assess neurovascular status for elbow dislocations

A

pre-reduction and post-reduction

43
Q

when is operative treatment necessary for elbow dislocations

A

if neurovascular deficit, associated fracture or unstable

44
Q

What are the common MOI for radial and ulnar shaft fractures

A

MVC including motorcycle
sports injuries
night stick injury
falls from height

45
Q

what do you need to assess for with radial and ulnar shaft fractures

A

neurovascular status and compartment syndrome

46
Q

what tool can you use to assess ganglion cysts

A

transilluminates with light

47
Q

what part of the hand does the median nerve affect

A

thumb through to the medial aspect of the ring finger

48
Q

special tests for CTS

A

Tinels and Phalens test

49
Q

what ligament is cut during CTR

A

transverse carpal ligament

50
Q

What is a colles frature

A

dorsal displacement

51
Q

what is a smiths frature

A

volar displacement

52
Q

what is another name for navicular fracture

A

scaphoid fracture

53
Q

DeQuervains is inflammation of what tendon sheath

A

1st MCP joint

54
Q

What test is used for the diagnosis of DeQuervains

A

Finkelsteins

Clin Med MSK: (14 decks)

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