Exam 3 Flashcards
1
Q
In the shoulder, you have ______ over ______.
A
mobility over stability
2
Q
The shoulder lacks _______ bony structure like a large socket and has ________ contact with the ______ skeleton.
A
intrinsic
minimal
axial
3
Q
What does the shoulder rely on for stability?
A
ligaments and muscles
4
Q
What do most shoulder injuries result from?
A
lack of stability
5
Q
What is the bony anatomy of the shoulder?
A
- humerus
- scapula (glenoid, acromion, coracoid, scapular body)
- clavicle
- sternum
6
Q
What are the joints of the shoulder?
A
- glenohumeral
- acromioclavicular
- sternoclavicular
- scapulothoracic articulation
7
Q
What are the SITS muscles?
A
- suprascapularis
- infraspinatus
- teres minor
- subscapularis
8
Q
What are the movements of the SITS muscles?
A
- suprascapularis = abduction/external rot
- infraspinatus = external rot
- teres minor = external rot
- subscapularis = internal rot
9
Q
True or False:
Rotator cuff muscles help to center the head of the humerus on the glenoid fossa (arthrokinematics).
A
True
10
Q
True or False:
In arthrokinematics, for shoulder flexion, the head of the humerus glides posteriorly up to 90 degrees then glides inferiorly after 90 degrees.
A
True
11
Q
True or False:
In arthrokinematics, for abduction, the head of the humerus glides inferiorly
A
True
12
Q
True or False:
In arthrokinematics, for external rotation, the head of the humerus glides anteriorly as it rolls posteriorly.
A
True
13
Q
True or False:
In arthrokinematics, for internal rotation, the head of the humerus glides posteriorly as it rolls anteirorly
A
True
14
Q
True or False:
In arthrokinematics, for extension, the head of the humerus glides anteriorly and medially
A
True
15
Q
For scapulohumoral rhythm, what two joints must function together?
A
GH and scapulothoracic articulation
16
Q
What is the ratio between GH elevation and scapular rotation?
A
2:1
17
Q
To accomplish 180 degrees of GH elevation….
A
120 degrees from GH mvmt and 60 degrees from scapular rotation
18
Q
Where is the subacromial bursa located?
A
above the supraspinatus tendon
19
Q
What does the subacromial bursa do?
A
buffers tendons contact with acromion process
20
Q
What can an inflamed subacromial bursa lead to?
A
RTC impingement
21
Q
What is the past medical history of shoulder injuries?
A
- AC or GH injury can alter biomechanics
- cervical spine pathologies (can radiate pain to upper extremity)
22
Q
What is the history of present condition for shoulder injuries?
A
- location of pain
- MOI
- onset
- symptoms
23
Q
What does inspection of the anterior shoulder consist of?
A
- level of shoulders
- position of the head
- position of the arm
- contour of the clavicles
- symmetry of the deltoid group
24
Q
What does inspection of the posterior shoulder consist of?
A
- alignmet of the vertebral column
- position of the scapular (winged)
- muscle development
- position of the humerus
25
What can you palpate in the anterior shoulder? (10)
1. sternoclavicular joint
2. clavicular shaft
3. acromion process
4. AC joint
5. coracoid process
6. humeral head
7. greater tuberosity
8. lesser tuberosity
9. humeral shaft
10. shoulder musculature
26
What can you palpate in the posterior shoulder? (5)
1. spine of scapula
2. superior angle
3. inferior angle
4. medial border
5. posterior muscles
27
For joint and muscle assessment, what are the motion for AROM in the shoulder?
- flex/ext
- ab/add
- int/ext rot
- horizontal ab/add
28
For pathologies of the shoulder and related special tests, what other instabilities do you look at for GH instability?
- anterior instability
- posterior instability
- inferior instability
- multidirectional instability
29
For pathologies of the shoulder and related special tests, what do you look at for rotator cuff pathology?
- impingement syndrome
- rotator cuff tendinopathy
- subacromial bursitis
30
What does a SLAP lesion stand for?
supeiror labrum anterior to posterior lesion
31
For pathologies of the shoulder and related special tests, what should you know about biceps tendon pathology?
- bicipital tendinopathy
- causes: RTC dysfunction & impingement
- SLAP lesions
32
What is a SLAP lesion?
tears of the superior aspect of the glenoid labrum that extend anteriorly and posteriorly to the biceps insertion
33
What does a winged scapula result from?
weak serratus anterior
34
The cubital fossa is a triangular area demarcated by the _________ muscle laterally and the _________ ____ medially.
Lateral = brachioradialis
Medial = pronator teres
35
In the cubital fossa, the _________ artery and its two subdivisions (radial and ulnar arteries), the _________ nerve, and the ________________ nerve pass through this fossa
1. brachial artery
2. median nerve
3. musculocutaneous
36
What is the past medical history for the elbow?
- seasonal pain
- cervical injury
- general medical health
- vascular, neurological, or systemic conditions
37
What is the history of present condition for the elbow?
- location of symptoms
- onset
- MOI
- technique
- associated sounds and sensations
38
What does inspection of the elbow consist of?
- functional observation
- anterior structures (carrying angles cubitus val/var)
- cubital fossa
- medial structures (medial epicondyle, flexor muscle mass)
39
What does inspection of the elbow consist of for the lateral side?
- alignment of wrist and forearm
- cubital recurvatum
- extensor muscle mass
40
What does inspection of the elbow consist of for the posterior side?
- bony alignment
- olecranon process and bursa
41
What are the 3 types of bursitis in the elbow?
- student's elbow (elbows on table)
- miner's elbow
- draftsman's elbow
42
What are the palpation sites for the elbow?
- medial and lateral epicondyles
- olecranon process
- ulnar
- radius
43
What are the movements of the elbow?
- flex/ext
- pro/sup
44
What are the joint stability tests for elbow?
- medial and lateral ligament laxity
45
What is the MOI of elbow dislocations?
axial force through the forearm with the elbow flexed
- extremely painful
- obvious deformity
46
What does the terrible triad consist of?
- dislocation
- fracture of radial head
- fracture of coronoid process
47
What does FOOSH stand for?
fall on outstretched hand
48
What sides of the elbow can you obtain epicondylitis on?
medial and lateral
49
What does lateral epicondylitis consist of?
"tennis elbow"
- inflammation or repetitive stress at the lateral epicondyle
- swelling
- tender to palpation
- pain with active wrist extension
50
What does medial epicondylitis consist of?
"little leaguer's elbow"
- tender to palpation
- neuropathy of the ulnar nerve
51
In what age group is a distal biceps tendon rupture most common in and what gender?
males over 40 years old
52
What is the MOI of a distal biceps tendon rupture?
eccentric loading of the biceps brachii when the elbow is flexed to 90 degrees
53
True or False:
A distal biceps tendon rupture can be complete or partial.
True
54
What are the signs and symptoms of a distal biceps tendon rupture?
- pain
- "pop" within elbow
- palpable defect
55
What is the usual treatment option of a distal biceps tendon rupture?
surgical repair
56
What happens to the elbow when there is osteochondritis dessicans of the capitulum?
increased valgus loading, compressing the radial head and capitulum within overhead throwing
- disrupts blood flow, creating defect over time
57
What are signs and symptoms of osteochondritis dessicans of the capitulum?
- lateral elbow pain (increases with activity)
- flexion contracture
**loose body warrants surgical removal
58
What are the 4 nerve pathologies of the elbow?
1. ulnar nerve pathology
2. radial nerve pathology
3. median nerve pathology
4. forearm compartment syndrome
59
True or False:
The wrist is very complex due to the numerous joints combined to work as one
True
60
What are all 8 bones in the hand?
Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate
61
What is the midcarpal joint?
between the two rows of carpal bones. Plane joints that allow gliding motion, assist with wrist motions
62
In the snuff box, what tendon does the medial border consist of?
tendon of the extensor pollicis longus
63
In the snuff box, what tendons does the lateral border consist of?
tendons of the extensor pollics brevis and abductor pollicis longus
64
In the snuff box, what does the floor consist of?
carpal bones; scaphoid and trapezium
65
What does the radial nerve do?
wrist and finger extension (wraps around arm)
66
What does the median nerve do?
thenar eminence, opposition, pincer grip
67
What does the ulnar nerve do?
hypothenar eminence intrinsic muscles, power grip (pinky and ring fingers don't work when ulnar nerve is damaged)
68
Where do you take the radial pulse?
on the wrist just under the thumb
69
What is the past history of the wrist?
- loss of function from previous injury
- general medical health
- RA (ulnar dev of fingers)
- PVD (peripheral vascular disease)
- Raynaud's phenomenon
70
What is the history of present condition of the wrist?
- location
- MOI
- relevant sounds or sensations
- duration of symptoms
- description of symptoms
- changes in activity
71
What does inspection consist of for the wrist as a whole?
- functional observation
- general inspection
- posturing of the wrist and hand
- gross deformity
- lacerations or scars
72
What does inspection consist of for the wrist and hand specifically?
- continutiy of the distal radius and ulna
- continuity of the carpals and metacarpals
- alignment of the phalanges
- posture of wrist and hand
- ganglion cyst
73
Which two of the carpal bones are most easy to palpate?
scaphoid and pisiform
74
What is a scaphoid fracture consist of/how does it happen?
FOOSH
- fracture of scaphoid which you can palpate in the snuff box. occurs with fall on hand in extension. most commonly fractured carpal bone
75
What is Colles's fracture and how does it happen?
- fracture of radius just above the wrist
- fall with wrist extended
76
What nerve is impinged with carpal tunnel syndrome?
median nerve
77
How does carpal tunnel syndrome occur?
repetitive activities
78
What is a transverse carpal ligament release?
In carpal tunnel release surgery, the surgeon cuts the transverse carpal ligament, a band of tissue on the palm side of the carpal tunnel. This takes pressure off the median nerve and relieves symptoms.
79
What is wrist drop?
radial nerve palsy
Saturday night palsy
honeymoon palsy
crutch palsy
- in all cases the radial nerve is entrapped and damaged.
** terminal end of the posterior cord of the brachial plexus, fracture distal humerus. Usually alcohol is involved
80
What are the movements of the wrist?
- flex/ext
- pro/sup
- rad/uln deviation
