Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Bloc H - Movement > May30 M1-Shoulder Injuries > Flashcards

May30 M1-Shoulder Injuries Flashcards

1
Q

swimmer shoulder = what type of injury + def

A

overuse injury (short term compared to inflam things like RA)

  • bc of repetitive sub-maximal loading
  • tissue fatigue
  • inadequate recovery** (no rest)
  • chronic degradation of affected tissue***
  • no tissue adaptation
  • microtrauma to inflammatory response to tissue damage
  • cumulative mictrotrauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

tendinitis vs tendinosis

A
  • tendinitis = inflammation around tendon itself (tenosynovial fluid)
  • tendinosis = degeneration with microtears
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

tendinosis is not to be confused with what problem

A

acute sprains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

sprain def + testing

A
  • physical damage to passive soft tissue (ligaments, joint capsules) (sprain with p for passive)
  • test with ligament stress test, stability testing, palpation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

strain def + testing

A
  • physical damage to active soft tissue (muscle, tendon, myofascial)
  • test with strength testing, flexibility testing, palpation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

grading of sprains and strains

A
  • grade 1 = disruption of some fibers (acute microscopic tearing)
  • grade 2 = partial tear (considerable disruption) (macroscopic tearing)
  • grade 3 = complete tear (macroscopic tearing)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how swimmer shoulder (overuse injury) differs from acute tears

A
  • acute tear = know exactly when happened
  • overuse = gradual onset
  • overuse = pain at rest and at night
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

swimmer shoulder specific symptoms

A
  • pain occurs earlier in training with time
  • anterior or lateral pain
  • painful at certain mvmt
  • pain at rest
  • pain at night (indicates impingement)
  • RC weakness WITH PAIN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

RC muscles

A
  • subscapularis
  • infraspinatus
  • teres minor
  • supraspinatus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

most affected RC muscle in swimmer shoulder

A

supraspinatus. most likely impinged in subacromial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

things to assess on swimmer shoulder physical exam

A
  • impingement tests

- instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

management of swimmer shoulder

A

PHYSIOTHERAPY

  • active rest (rest but do other sport to stay active)
  • dry land training (cycling) especially lower extremities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what do PTs assess for swimmer shoulder

A
  • RC injury?
  • scapular stabilizer weakness (the primary problem in swimmer shoulder)?
  • passive soft tissues too loose or too tight?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

RC in swimmer shoulder

A
  • often affected but is not the cause
  • is affected secondarily to the first problem (which is scapular stabilizer weakness)
  • It is in ACUTE injuries that RC is affected first
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

structures in the subacromial space

A

bottom to top = humerus, then muscle (inflamed if impingement), then bursa filled with fluid, then hooked acromion linked to coracoacromial ligament)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

subacromial impingement is what

A
  • RC travelling between acromion and humeral head (supraspinatus m. or other m.)
  • reduced space in that area so muscle impinged and inflamed. less ROM bc hits the acromion earlier
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the cause of a long term (not acute) RC injury

A

an imbalance between stabilizer (the RC muscles) and mobilizer muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how can you assess for scapular stabilizer weakness

A

check for winging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how do you assess for posterior shoulder stiffness (seen not in swimmers but in throwing sports)

A
  • flex forearm 90 degress + ABDuct 90 degrees lie on bed
  • test ROM arm most to back and front (external and internal rot)
  • 0 degrees = hand to the sky
  • normal = 110 deg ext 70 deg int
  • abnormal = 135 deg ext 45 deg int (still 180 deg but lose internal rotation)
20
Q

cause of posterior shoulder stiffness

A

repetitive rotation causes stress on RC bc it is stretched at end of ROM or internal rotation

21
Q

posterior capsule tighteness is what

A

tightness of the glenohumeral capsule (ligament) in the back causing impingement (blocking humeral head on glenoid fossa bc pushing on humeral head forward)

22
Q

tx of overuse injuries

A
  • address the underlying weakness or problem
  • NSAID? (if yes, short term)
  • steroid injection?
  • surgery?
23
Q

tx of swimmer shoulder specifically

A
  • 7-10 days NSAIDs (NSAIDs for a year in RA, not here)
  • subacromial steroid injection (if constant pain and PT doesn’t help anymore)
  • surgery if pain persists (but is not common for tendinosis)
24
Q

surgery for swimmer shoulder is when

A
  • labral tear (tear of labrum, the cartilage)

- anatomic anomaly of acromion (hooked)

25
Q

most frequently dislocated joint

A

glenohumeral
-often anterior
-rarely posterior
(is a contact injury)

26
Q

what’s the vulnerable position for anterior dislocation of the shoulder

A

forced extension, ABDuction, external rotation

27
Q

diff hx you can see in anterior shoulder dislocation

A
  • acute trauma first time felt it popping
  • no acute trauma (dislocates with simple activities like putting jacket on)
  • recurrent dislocators (multidirectional instability)
28
Q

PE in anterior shoulder dislocation

A
  • tenderness around shoulder
  • pt passive and reluctant to moving
  • hollow below acromion
  • possible C5 axillary nerve damage (lose sensation on lateral shoulder)
29
Q

(imp) what’s a Bankart lesion

A

injury to anterior labrum due to anterior shoulder dislocation
labrum attachment to ant glenoid

30
Q

(imp) what’s a bony Bankart lesion

A

anterior glenoid rim fracture due to anterior shoulder dislocation

31
Q

what’s a Hill-Sachs lesion

A

impression (compression) fracture posterior superolateral side seen in anterior shoulder dislocation

32
Q

other problems seen in anterior shoulder dislocation

A
  • RC tears
  • greater tuberosity fractures
  • these are in elderly + can have axillary n. damage*
33
Q

imaging for anterior shoulder dislocation

A
  • XR trans-scapular Y views and AP, lateral, axillary view for bone
  • US or MRI for RC tear
  • CT or MRI for subtle fractures like Bankart (glenoid rim)
  • 3T MRI or MR-arthrogram for labral tear
34
Q

(EXAM) posterior shoulder disloation charact

A
  • from direct high energy trauma or seizures or electrocution
  • arm in internal rotation or ADDuction
  • sudden contraction of internal rotators which are stronger than external for example
35
Q

(EXAM) reverse Bankart lesion is what

A

injury to posterior labrum

labral attachment to posterior glenoid

36
Q

(EXAM) reverse bony bankart is what

A

posterior glenoid rim fracture

37
Q

reverse Hill-Sachs lesion is what

A

impression fracture antero-medially

38
Q

associated injuries with posterior shoulder dislocations

A
  • RC tears
  • LESSER tuberosity fractures
  • axillary n. damage is rare
39
Q

imaging for posterior shoulder dislocation.

A

same as anterior

40
Q

tx of acute shoulder dislocation

A
  • reduce (replace) the humerus. have to assess neurovascular status before and after
  • easier with less muscle spasm
41
Q

contraindications to reducing a shoulder dislocation

A
  • subclavicular or intrathoracic dislocation

- humeral neck fracture

42
Q

what do you do post shoulder reduction

A

sling immobilization for 1-3 weeks + PT

43
Q

(EXAM) education to give after shoulder dislocation

A
  • anterior = no abduction + external rotation for 6 weeks (stresses capsule and torn ligament)
  • posterior = avoid internal rotation and adduction for 6 weeks
44
Q

tx for recurrent shoulder dislocation

A
  • lot of PT
  • bracing
  • surgery (+ if assoc injury)
45
Q

early surgery for shoulder disloc reasons to do

A
  • avoids recurrent instability and dislocation which is common in young
  • more stable = less OA
46
Q

what’s an absolute indication for surgery in shoulder dislocation

A 
associated injuries (is the most important one)
\+ other things like failed rehab, etc.

Bloc H - Movement (48 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions