Med Surg-Quiz 9 Flashcards
Caused by weakness of the scapular supporters: rhomboids, traps, **Serratus anterior
Outline of scapula is prominent and protruding from posterior thorax
Scapular Winging
most common (20:1) dislocation
Sternoclavicular Dislocation: Anterior dislocation
most severe complications (dislocation)
Sternoclavicular Dislocation: Posterior dislocation
Nerve and Vascular impingement
Thoracic Outlet Syndrome
Hypertrophied neck musculature (anterior scalenes, upper trapezius)
Hypertrophied anterior chest musculature leading to rounded shoulders/kyphotic posture
Most common etiologies for Thoracic Outlet Syndrome
bundle of peripheral nerves C5-T1; Known as a “Stinger” by ATC’s
Brachial Plexus Injury
Pinching pain in shoulder, especially with abduction
Impingement Syndrome
Impingement: 1⁰ = mechanical wear and tear; this may be indicated
acromioplasty
- Painful arc- within 60-120⁰ of shoulder abd.
Impingement Syndrome: Clinical Manifestations
“Frozen shoulder.”
Adhesive Capsulitis
inflammation of the bicipital tendon within the bicipital groove of the shoulder. Due to muscle imbalances and small area of the groove. Proximal anterior pain to palpation of tendon
Bicipital Tendonitis
usually from subdeltoid or subacromial bursa. Increased friction against the bursa from muscle imbalances cause inflammation. Proximal lateral pain.
Shoulder Bursitis
when any of the 4 rotator cuff muscles develop tendinitis from muscle imbalances. Referred pain to mid-deltoid region.
Rotator Cuff Tendinitis
the humerus glides out of the glenoid fossa. Possible tears of the labrum or other supportive ligaments and tendons. Most susceptible in ER , flexion and ABD. (throwing position). May be from trauma or from laxity due to repetitive stress.
Glenohumeral Dislocation
the humerus temporarily dislocates, but then re-sets itself.
Strengthen for stability or may require surgery.
Avoid ER, flex and ABD combo. “Triple Whammie”
Glenohumeral Subluxation
a tear to the anterior labrum of the shoulder via the inferior glenohumeral ligament.
Bankart Lesion
Impaction fracture. Damage to the head of the humerus after anterior dislocation.
Hill-Sachs Lesion
“Superior Labrum Anterior to Posterior”. Detachment of the proximal attachment of the long head of the biceps at the labrum.
SLAP repair
Common in young athletes (Little League Shoulder); repetitive throwing motions (forceful medial rotation combined with adduction) damage epiphyseal plates of proximal humerus.
Begins as pain with throwing. DO NOT IGNORE!!!
**ABSOLUTE REST from throwing is REQUIRED for the bone to heal without disrupting growth plates. Bone may require 8-12 months to reossify properly and remodel. Patient education!
Proximal Humeral Fracture
replacement of the humeral head with a metal implant and resurfacing of the glenoid fossa with plastic “cover”
TSA
replacement of humeral head only
Hemiarthroplasty
C6-C8; through carpal tunnel to hand;Most common type of UE nerve injury
Common Neural Tension: Median nerve
Compression injury to median nerve
Carpal Tunnel Syndrome
Progresses from activity-induced symptoms to constant symptoms of pain/paresthesia along median nerve innervations; thumb and first 2 digits Increased pain at night Decreased grip Decreased wrist flexion Loss of hand dexterity
Carpal Tunnel Syndrome: Patient presentation
Presents as medial elbow pain with hand weakness.
Common Neural Tension: Ulnar nerve
“Tennis elbow”; Degenerative, inflammatory condition of the extensor carpi radialis brevis. Pain with resisted wrist extension.
Lateral Epicondylitis
“Golfer’s Elbow”; degenerative, inflammatory condition affecting the flexor carpi radialis and pronator teres tendons. Presents as tender point pain at medial epicondyle tendon insertions. Pain with resisted wrist flexion and pronation.
Medial Epicondylitis
Fracture of the distal radius with anterior displacement.
FOOSH injury.
Colle’s Fracture
Most common carpal bone fracture; Pain in anatomical snuff box
Scaphoid Fracture
Finkelstein’s sign: adduct thumb inside the fist and perform ulnar deviation. Increased pain is positive Finkelstein.
De Quervain’s Syndrome
Rupture of the central band of the extensor hood, causing flexed PIP and extended DIP
Boutenniere Deformity
bowstring tightness of the extensor hood, causing hyperextension of PIP and flexion of the DIP.
Swan Neck Deformity
