Introduction to shoulder surgery Flashcards

1
Q

Why is shoulder pain important?

A

3rd most common MSK consultation in GP practice

1% adults each year visit GP with shoulder pain

25% of adults self reported prevalence of shoulder pain

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2
Q

List some risk factors for shoulder pain

A

Sports related injuries
Traumatic injuries
Degenerative conditions
Work related condition

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3
Q

List some common shoulder symptoms

A

Pain
Stiffness
Weakness
Instability

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4
Q

List some causes of shoulder pathology in the glenohumeral joint

A

Arthritis
Instability
Frozen Shoulder

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5
Q

List some causes of shoulder pathology in the rotator cuff muscles

A

Tears
Bursitis
impingement
calcific tendonitis

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6
Q

List some other causes of shoulder pathology

A

Bone trauma

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7
Q

Name the bones which form the shoulder region

A

Clavicle
Scapula
Humerus

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8
Q

What is the function of the shoulder?

A

Designed for a range of movement

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9
Q

Describe the stability of the shoulder joint

A

Inherently unstable

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10
Q

What stabilises the shoulder joint?

A
Rotator cuff (dynamic) 
Capsule and labrum (static)
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11
Q

Name the rotator cuff muscles

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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12
Q

What do all the rotator cuff muscles form?

A

Rotator cable

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13
Q

What is the importance of the rotator cuff muscles forming the rotator cable?

A

Gives it more strength

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14
Q

Describe rotator cuff biomechanics

A

As the rotator cuff muscles fire they produce a force
Moves the humeral head towards the socket
Keeps it pressed against the socket

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15
Q

What is the function of the rotator cuff?

A

Stabilise the glenohumeral joint

Provide a fulcrum for power muscles to move the arm

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16
Q

Name the muscles which function with rotator cuff

A
Deltoid
Pectoralis minor
Pectoralis major
Latissimus dorsi 
Teres major
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17
Q

Name the superficial power muscles

A

Deltoid
Pectoralis major
Latissimus dorsi

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18
Q

Name some rotator cuff disorders

A

Subacrominal impingement
Rotator cuff tears
Calcific tendonitis

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19
Q

Describe the prevalence of Subacrominal impingement

A

Common

20
Q

What is Subacrominal impingement?

A

Pain on abduction and rotation of the arm

Felt over the deltoid

21
Q

Name some extrinsic causes of Subacrominal impingement

A

Bony spurs

22
Q

Name some intrinsic causes of Subacrominal impingement

A

Tendiopathy/cuff weakness

23
Q

Give the non-surgical treatment of Subacrominal impingement

A

Activity modification

Physiotherapy

24
Q

Give the surgical treatment of Subacrominal impingement

A

Subacromial decompression Debridement of bony and soft tissue impinging areas

25
Q

Name the most common rotator cuff tears

A

Supraspinatus/infraspinatus

26
Q

Give the symptom of rotator cuff tears

A

Weakness and pain

27
Q

What percentage of people in their 60s have a full thickness tear?

A

15%

28
Q

When would you repair a rotator cuff tear?

A

If it is symptomatic

29
Q

List some glenohumeral disorders

A

Arthritis
Frozen shoulder
Instability

30
Q

Name the 3 types of glenohumeral arthritis

A

Osteoarthritis
Rheumatoid arthritis
Post traumatic arthritis

31
Q

List the symptoms of arthritis

A

Stiffness
Crepitus & grinding
Pain at rest and at night
Pain with activity

32
Q

Name the two types of shoulder replacement

A

Anatomic

Reversed

33
Q

Describe anatomic shoulder replacement

A

Fulcrum for power muscles provided by rotator cuff

34
Q

Describe reversed anatomic shoulder replacement

A

Creates a mechanical fulcrum for power muscles

35
Q

Give the symptoms of frozen shoulder

A

Stiffness

Pain

36
Q

What motion is lost in frozen shoulder

A

Passive motion (external rotation)

37
Q

Describe frozen shoulder on Xray

A

Normal

38
Q

Which patients is frozen shoulder common in?

A

40-60 year olds
Women
Diabetics

39
Q

What is frozen shoulder?

A

Inflammation and thickening of capsule

40
Q

List the non-surgical treatments of frozen shoulder

A

Natural history is to resolve over 2 years
Injections
Hydro dilatation

41
Q

List the surgical treatments of frozen shoulder

A

Capsular release and manipulation

42
Q

What is the most common type of shoulder dislocation?

A

Anterior

43
Q

What happens if the shoulder dislocation occurs at young age?

A

Higher chance of recurrence

44
Q

List some risk factors of shoulder dislocation

A

Collision sports

Hyper laxity

45
Q

Name some surgical treatments of shoulder dislocation

A

Arthroscopic stabilisation - labral repair
Open stabilisation - capsule tightening
Bony procedures - augmenting glenoid

46
Q

Give the name of a bankart lesion

A

Anterior labral tear

47
Q

What can shoulder trauma result in?

A

fractures
dislocation
soft tissue injuries