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KIN 428 > Midterm 1 > Flashcards

Midterm 1 Flashcards

1
Q

MSD

A

Musculoskeletal Disorder

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2
Q

WMSD

A

Work related Musculoskeletal Disorder

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3
Q

UEMSD

A

Upper Extremity Musculoskeletal Disorder

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4
Q

CTD

A

Cumulative Trauma Disorder

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5
Q

Two ways visible disease changes?

A

1) How much disease there is
Changes in population body weight, major shifts in working conditions
2) Awareness of disease
Able to see more clinical disease when people are able to know and identify it - i.e. carpel tunnel syndrome

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6
Q

Tissue Types for UEDs

A 
Tendon
Muscle
Nerve
Vascular
Bursal
Bone & Cartilage
Ligament
Fascia
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7
Q

Approximate cost of compensated shoulder injuries in Canada?

A

$60,000 direct cost + $60,000 indirect cost / injury

$1,170,000 Total

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8
Q

Function of tendon

A

transmit force from a muscle to a bone (only linearly, not transverse)

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9
Q

Tendon Disorders

A

Excessive / Incorrect Loading

Results inflammation and then deformation & tears

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10
Q

Function of muscle

A

Actuators of the lever system of the skeleton:

  • initiate/maintain motion/force transmission
  • joint stabilization
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11
Q

Muscle Disorders

A

external forces on passive tissues

straining sarcomeres with eccentric contractions

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12
Q

Function of nerves

A

send signals throughout the body

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13
Q

Nerve Disorders

A

Entrapment from muscle, bone, tendon, ligament

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14
Q

Function of vasculature

A

Material highway to/from cells for normal function

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15
Q

Vasculature Disorders

A

Ischemia through occlusion / constriction / obstruction

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16
Q

Function of Bursa

A

sac-like body cavity to reduce stress in a joint

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17
Q

Bursa Disorders

A

Friction and trauma

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18
Q

Function of Bone

A

Form - structure & protection
Function - muscle attachment to allow motion
Factories - production of material

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19
Q

Function of Cartilage

A

Force, support, shock absorption

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20
Q

Bone and Cartilage Disorders

A

Inflammation and degeneration

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21
Q

Stability and Mobility of the Shoulder

A

Most mobile

Most instable

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22
Q

Stability and Mobility of Sternoclavicular Joint

A

SC joint has good stability - provided by costoclavicular ligament
Very limited ROM

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23
Q

Degrees of Freedom for SC Joint

A

1 - Elevation / Depression (30-35)
2 - Anterior / Posterior (35)
3 - Long Axis (40-45)

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24
Q

Kinematic Redundancy

A

able to get to distal segment through multiple proximal segments
i.e. shoulder girdle to hand

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25
Q

Degrees of Freedom for Scapulothoracic Gliding Plane

A

1 + 2 - Translational
3 - Tipping
4 - Rotation
5 - Protraction / Retraction

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26
Q

GH Joint Movements

A

Abduction - 150
Flexion - 180
External/Internal Rotation - 90

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27
Q

GH Stability Contributors

A 
Muscle Action
Ligaments
Joint Suction
Adhesion
Bony Constraints
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28
Q

Functions of Shoulder Muscles

A

Position glenoid for maximum mobility
Articulate the upper arm
Ensure GH stability
provide humeral and whole arm stiffness

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29
Q

Bipedalism

A

Upper extremity functional differentation

Allows for tool use

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30
Q

Bone Structure of Chimpanzee compared to Human

A

More superior clavicle = more superior glenoid

Clavicle orients scapula posteriorly - deals with gravity forces better when quadriped

31
Q

What are the benefits to a suprolateral glenoid?

What are the benefits to a lateral glenoid?

A 
Superolateral = better at moving arms overhead, and body weight transferring (quadripedalism, swinging)
Lateral = better at bringing arms together to allow for intricate tool use in field of vision
32
Q

What are the benefits to a suprolateral glenoid?

What are the benefits to a lateral glenoid?

A 
Superolateral = better at moving arms overhead, and body weight transferring (quadripedalism, swinging)
Lateral = better at bringing arms together to allow for intricate tool use in field of vision
33
Q

Differences in hand and forearm musculature in Humans compared to Chimpanzees

A

short fascicle length = decreased shortening velocity = decreased force = increased precision
physiological cross-sectional area decreased = lower force capabilities
smaller motor unit size = precision control

34
Q

Differences in distal radial surface morphology?

A

Chimpanzees have a distal project which locks wrist in place to be able to transmit force while walking quadripedally, decrease wrist extension ability compared to humans

35
Q

Hand differences between chimpanzees and humans?

A

Longer grasping fingers in chimps = gross grip and weight support
Long thumb length in humans = precision grip and tool usage

36
Q

What are upper extremity advantages humans have?

A

Fine motor control = material manipulation and tool use

Long range, high speed throwing = distance protection

37
Q

Prevalence of Proximal Humerus Fractures

A

Low risk
Increases with age
Women at an increased risk - osteoporosis

38
Q

Mechanisms of Humerus Fractures

A

FOOSH

Trauma

39
Q

Classification types of Humerus Fractures

A

Kocher - based on location of break (greater tuberosity, lesser tuberosity, head, shaft)
Neer - based on number of fragments (2 part vs. 3 part vs. 4 part and classes based on what area fractured)
AO - based on vasculature supply (absence, partial isolation and complete de-vascularization)

40
Q

Clinical Features of Proximal Humerus Fractures

A 
Pain
Swelling
Tenderness
Crepitis
Ecchymosis
41
Q

Diagnosis of Proximal Humerus Fractures

A

X-Ray - 3 views

42
Q

Treatment of Proximal Humerus Fractures

A 
Initial immobilization - cast
Closed reduction
Skeletal Traction
ORIF
Internal prosthesis (complete joint replacement)
43
Q

Complications of Humeral Fractures

A 
Vascular injury
Brachial Plexus injury
Frozen shoulder
avascular necrosis
nonunion
malunion
44
Q

Prevalence of Scapula Fractures

A

Very rare
Hard to get to, very well protected by muscle + able to compensate for force by moving in 5 planes of motion
Typically at body or glenoid neck

45
Q

Mechanisms of Scapular Fractures

A

Lots of force required

46
Q

How does damage to glenoid occur with scapula fractures?

A

Glenoid rim = combination of compression and shear force

Glenoid fossa = lots of compression only

47
Q

Clinical Features of Scapular Fractures

A

Pain
Local tenderness
Swelling
Crepitus

48
Q

Diagnosis of Scapula Fracture

A

X-ray

49
Q

Classification of Scapula Fractures

A

Fractures at glenoid neck categorized by location
Type 1 = minimal displacement (more popular)
Type 2 = displacement

50
Q

Treatment of Scapula Fractures

A

Typically conservatively when nondisplaced

51
Q

Scapula Fractures and Double Displacement of the SSSC

A

Superior Shoulder Suspensory Complex makes a ring at the GH joint
Major instability of the shoulder occurs when ring becomes broken and incomplete

52
Q

Prevalence of Clavicle Fractures

A

Frequent fracture and shoulder injury

53
Q

Mechanisms of Clavicle Fractures

A

Direct and indirect force
FOOSH - main cause
Buckling of clavicle - forces applied at shoulder towards sternum
Stress Fractures

54
Q

Clinical Features of Clavicle Fractures

A 
Skin tenting
Drooping shoulder
Pain
Ecchymosis
Angled head to reduce trapezius pull
Fully supported arm weight
55
Q

Diagnosis of Clavicle Fractures

A

X-ray

56
Q

Classification of Clavicle Fractures

A

Group 1 = break at S bend (most common)
Further broken down to (A=transverse, B=Wedge, C=comminuted)
Group 2 = break at AC joint side
Further broken down to (Type 1 = intact AC, Type 2 = torn AC)
Group 3 = Break at SC joint side

57
Q

Treatment of Clavicle Fractures

A

Sling support
ORIF
OREF
Typically conservative

58
Q

Complications of Clavicle Fractures

A

Nonunion
Malunion
Neuro-vascular Sequelae
Post-traumatic arthritis

59
Q

Humeral Head Differences

A

Humans have lower torsion = increased internal/external rotation = increased angular displacement = increased throwing velocity

60
Q

Clavicle Differences

A

Chimps = thicker clavicle = increased force absorption = better at weight bearing

61
Q

Scapula Differences

A

Chimps = superiolateral glenoid = increased arm flexion / decreased arm extension = better overhead reaching
Superiolateral glenoid = pec major pulls medially + inferiorly = overhead reaching
humans = lateral glenoid = pec major horizontally adduction

62
Q

Supraspinatus Differences

A

Chimps = bigger = better at weight bearing through U.E.

63
Q

Forearms Differences

A

Primates able to supinate = tool use overall

Humans = less curves + lighter = less force required to move = increased precision movements

64
Q

Elbow Differences

A 
Humans = increased moment arm with flexed elbow
Chimps = increased moment arm with extended elbow
Chimps = deeper trochlear notch = increased stability with extended arm / decreased ROM of arm
65
Q

Laxity vs Instability

A 
Laxity = asymptomatic, passive translation in joint
Instability = pathological, pain/discomfort/excessive translation
66
Q

Laws of GH Stability

A

1 - Dislocations will not occur if the Net Humeral Joint Reaction Force (NHJRF) is directed within the effective glenoid arc
2 - Humeral head will remain centred in the glenoid fossa if the glenoid and humeral joint surfaces are congruent and NHJRF is directed within the effective glenoid arc

67
Q

Net Humeral Joint Reaction Force (NHJRF)

A

Combination of:

Active Muscle Contraction + Passive Muscle Stretch + Inertial Forces + Gravitational Forces + External Forces

68
Q

Effective Glenoid Arc

A

Arc of the glenoid available to support the head of the humerus in a given direction

69
Q

Components of GH Stability

A 
Statically: Articular Version
Articular Conformity
Labrum
Intra-Articular Pressure
Ligaments
Adhesion
Suction Cup
Dynamically: Active Muscle Contraction & Proprioception
70
Q

Articular Version

A

Orientation of glenoid

  • 30 degrees frontal plane
  • 3 degree upward rotation = small shelf for removing gravity force
71
Q

Articular Conformity

A

radii differences between humeral head and glenoid articular surface

72
Q

Labrum

A

Increases surface area = provides concavity compression

concavity compression = compression of labrum creates a deeper fossa for increased stability

73
Q

Intra-articular Pressure

A

limits translation + controls rotation
vital stability while inactive
medium pressure is desired

74
Q

Ligaments and Shoulder Stability

A

mostly passive - increasing ROM
keep joint in position
active during extreme postures - deviations from scapular plane and elevation

KIN 428 (1 decks)

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