Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

pt momints ver 2.0 > MS1: Affectations of Shoulder > Flashcards

MS1: Affectations of Shoulder Flashcards

(74 cards)

Start Studying
1
Q

what are the functions of the shoulder

A

position hand
suspend UE
provide sufficient fixation for motion of UE and trunk
fulcrum for arm elevation

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

what are the 3 bones of shoulder joint

A

humerus, clavicle and scapula

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

what are the 3 true joints of the shoulder

A

SC - plane
AC - plane
GH - ball nd socket

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

what is the pseudojoint of the shoulder

A

scapulothoracic
- elev/depress
- protract/retract
- up/down rotation

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

describe the clavicle

A

s-shaped; strut bone that connects UE to trunk

last bone to ossify - starts at 5 months ends at 22-25 sa sternal end

most commonly fractured
- FOOSH: impact straight to shoulder
- fall on point of shoulder; most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the allman classification of clavicular fracture

A

group 1: fracture of medial third
- most common; 80%

group 2: fracture of distal third
- disrupts CC or AC ligaments
- 12-28%

group 3: proximal third; sternal end
- 3-6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the signs and symptoms of clavicular fracture

A

pain and swelling
tenderness
deformity

affected extremity is splinted close to the body and supported by contralateral UE
- tucked shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the diagnosis and management for clavicular fractures

A

diagnosis: xray and CT scan

non-surgical: immobilize w sling for 6-8 wks
surgical: pinning and plating
- open fracture
- neurovascular affectation
- skin tenting > puncture
- midshaft displacement or shortening is 1-2 cm
- type 2 fractures
- non union symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe the scapula

A

insertion site for 17 muscles

coracoid and acromion

fracture is uncommon bc muscles protect it
- 76%: thoracic SCI
- 54%: pulmonary contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is floating shoulder

A

2 or more fractures in SSSC

naiiwan yung scapula

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

what is SSSC composed of

A

glenoid process
coracoid process
CA ligament
distal clavicle
AC joint
acromion process

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

what are the SSx of floating shoulder and scapular fractures

A

pain and swelling
UE tucked and supported by other UE
painful ROM
comolli sign - triangular swelling of posterior thorax over scapula > hematoma > compartment psi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the management of scapular fractures

A

non-surgical: most common; sling for 4-6 wks

surgical: ORIF
- displaced fracture
- intraarticular fracture and displacement
- acromion fracture > impingement
- floating shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe proximal humeral fracture

A

most common at surgical neck; neer’s 3
least common at anatomical neck; neer’s 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the complications of PHF

A

vascular injury: axillary a.
nerve injury: axillary n.

myositis ossificans: bone forms in muscle > pain in abd/add
shoulder stiffness from immob

osteonecrosis common in anatomical neck fracture

non union or malunion

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

what is the management for PHF

A

non-operative: for minimally displaced
- sling > early ROM from 7-10 days if fracture is stable to prevent stiffness

surgical: ORIF or arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe the glenoid fossa

A

surrounded by fibrocartilage - LABRUM
- deepens socket by 50%
- retroverted to 5 deg
- pear shaped

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

what are the ligaments found at anterior scapula

A

superior GH
> foramen of rouvier
middle GH
> foramen of weitbrech
inferior GH
- most important; primary restraint for ant/post dislocation and sublaxation

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

what are the supporting ligaments of humerus and scapula

A

CC: conoid and trapezoid
- primary support of AC joint

CA: roof of shoulder
- prevents separation of AC

CH: restrains biceps tendon w/in the groove

TH: perpendicular to biceps tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the scapular pivoters

A

traps
rhomboids
serratus anterior
levator scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the humeral propellers IR

A
  • subscapularis
  • anterior deltoid
  • pec major
  • lats
  • teres major
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the humeral propellers ER

A

infraspinatus
teres minor
posterior deltoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the shoulder protectors

A

fine tunes HH position during arm elevation

SITS muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

discuss the insertions and functions of the rotator cuff muscles

A

SIT: greater tuberosity
subscap: lesser

supraspin - intitates abd
infra and teres minor: ER
subscap: IR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are the static restraints of the shoulder
glenoid labrum articular version nd conformity neftive intra articular psi capsule ligaments
26
what are the dynamic restraints of the shoulder
SITS biceps tendon scapulothoracic motion
27
describe supraspinatus tendinitis
most common inflammatory problem in shoulder from chronic wear nd tear of supraspinatus tendon as it passes under acromion
28
what are the subacromial syndromes
DD for supraspinatus tendinitis - rotator cuff degeneration - calcific tendinitis: ca deposits - subacromial and subdeltoid bursitis - adhesive capsulitis - AC joint degeneration
29
what is the etiology of supraspinatus tendinitis
35-50 yo women > men; sedentary individuals young pitchers and swimmers
30
what is the pathogenesis of supraspinatus tendinitis
chronic wear and tear during overhead activites circulation is impaired during shoulder abd painful arc on resisted abd; 60-120 deg recurrent impingement > degenerative and inflammatory changes in the RC and subacromial bursa > subacromial syndromes
31
describe acute calcific tendinitis
DD - supraspin tendin; pag kita calcification sa xray edi ACT acute - gradual onset over hours to days - most painful in shoulder
32
what are the SSx of acute calcific tendinitis
preceded by strain or unaccustomed use of shoulder pain over subacromial area radiates to deltoid insertion, localized pain distal to tip of acromion sleep disturbed by pain rotation or abd limited by pain
33
what is the diagnosis and treatment of ACT
xrays - amorphous calcium phosphate salt in supraspinatus symptoms subside sponatenously after 5-10 days onset - may lead to adhesive capsulitis
34
what are the treatments for supraspinatus tendinitis
rest and protection of shoulder w sling; short duration axillary pillow; medj abd early gentle ROM; avoid capsulitis analgesics: 2-3 days ice packs after 48 hrs heat
35
what is the treatment for ACT
ultrasound guided aspiration using saline + steroid; most effective - yields milky white suspension of Ca salts
36
describe chronic degenerative tendinitis
sequelae of ACT; whole rotator cuffs develops over months pain less intense but interferes w arm use awakened when turning to shoulder at night painful arc: 60-90 deg DD: 1sr few wks supraspin tendi > chronic degen
37
how to diagnose for CDT
MRI and CT scan: osteophyte formation and degen of AC joint protracted course > adhesive capsulitis
38
wha are the treatments for subacromical syndromes
conservative - avoidance of overhead use - most heat and analgesics - initial circumduction pendulum; passive = maintains elasticity surgical: associated w impingement syndrome - anterior acromioplasty - resection of CA ligament - RC tear reapir - aspirate calcium
39
describe bicipital tendinitis
inflammation of tendon sheath from flex nd supinate; friction in bicipital groove results in adhesion of the tendon to the bicipital groove and RC may occur bilaterally women > men early 40s
40
what is the pathogenesis of bicipital tendinitis
inadequate depth of bicipital groove abnormal ridges along groove normal physiologic wear and tear fraying, shredding and fasciculation of tendon > adhesions occur associated w impingement syndrome
41
what is the SSx of bicipital tendinitis
insidous onset or precipitated by strenous activity over more anterior and medial region of shoulder of biceps and forearm tenderness over intertubercular sulcus when rolling biceps tendon w fingers; supinate to feel
42
how to test for bicipital tendinitis
speeds: pt arm at 90 shoulder flex and has to resist motion into extension while supinated yergasons: pt elbow in 90 deg flexion; ER while supinating against resistance
43
what is the treatment for bicipital tendinitis
conservative - rest, moist heat - avoid painful ROM - NSAID + therapy - steroids + anesthetic surgical: failed conservatice - biceps tenodesis w reaatachment below bicipital groove or coracoid
44
describe adhesive capsulitis
starts w/ any of the subacromial syndromes chronic; worsens over 3-12 moments > gradual improvement > normal or near pain LOM women > men > 40 yo
45
what is the pathogenesis of adhesive capsulitis
low grade inflammation from immob - edema, fibrosis, round cell infiltration LOM head fixed at glenoid ER LIMITED bc od CH and subscap contracture articular surfaces are intact
46
what is the SSx of adhesive capsulitis
onset followed by direct or indirect trauma associated w CVA, MI and cervical root affectations; any that causes immob LOM > frozen shoulder night time pain dec active and passive ROM; ER and abd
47
what are the 3 phases of adhesive capsulitis
freezing: acute/painful - lasts 3-9 mo. - gradual onset of pain at rest, + stifness at all planes; unable to sleep frozen: adhesive/stiffening - 4-12 mo. - pain subsides - progressive loss of GH motion - pain at extremes of movement thawing: resolution - 12-42 mo. - motion gradually improves - complete recovery may not occur
48
what is the conservative treatment of adhesive capsulitis
w/o treat > 2-3 yrs conservative - moist heat - gravity free excerices w/in pain free range; pendulum - AIF and analgesics - steroids - anti grav in later
49
what is the non conservative treatment of adhesive capsulitis
anesthetic block of suprascap nerve @ fossa ; temporary manipulation while pt sleeps; contra in acute hydrodilatation surgical: failed non-op - MUA - arthrocscopic capsular release - acromioplasty - AC joint resection
50
describe rotator cuff tears
always trauma - esp young sudden powerful arm elevation elderly - extensive tears w minor trauma due to degeneration; incidence inc w age partial thickness tears are more frequent; progression to full 28-53%
51
what is the etiology for rotator cuff occurs
laborers > 40 yo. transient sharp pain for days/months tenderness below acromion sulcus appreciated betw acromion nd RC tendon
52
what are the SSx of RC tear
weak abd inability to initiate and maintains abd painful arc - GH: 60-120 - AC: 170-180 atrophy of supraspin and infra in later cases; drop arm test
53
what is the treatment of RC tear
MRI - gold standanrd nonoperative - avoid provocative motions - splint in abd - NSAIDs - physical therapy - corticosteroid injection operative: arthroscopic - failed non-op - acute traumatic tears in young - acute loss of strength and motion - good quality of muscles w/o fatty infiltration and arthritis
54
describe the shoulder hand syndrome
shoulder pain w homolateral hand pain and swelling - frozen shoulder - hand: sudecks atrophy; pain, swell, vasomotor instability, trophic changes, patchy osteoporosis sequelae of shoulder lesion, MI, CVA, trauma, cervical arthritis
55
what is the etiology of shoulder hand syndrome
5th decade or older pain, tenderness, stiff shoulder hand swelling and edema of hand atrophy and finger flex deformity and extension contracture of MCP; may be permanent SSx may occur together or may mauna
56
what is the pathogenesis of SHS
sympathetic dysfunction due to injury or compression immobilized shoulder > frozen shoulder > swelling of hands > limited finger motion reflex-like response to pain by sympathetic nerves > vasomotor reax that reduces blood flow to tissue in pain
57
what are the diagnosis and DD of SHS
xray: osteoporosis and normal/minimal joint changes labs: ESR is normal DD: - RA - thoracic outlet syndrome - scleroderma - post-infarct sclerodactyly
58
what are the stages of SHS
1. burning hand pain, cold and clammy, sensitive tou touch/pressure 2. hand appears white, creaseless, thick skin, inc cold and stiff 3. hand is pale, thin, atrophied
59
discuss treatment and prognosis of SHS
conservative - relieve provocative if known - brief splint and PT ROM daily - eliminate inflammation and relieve pain - regain strength and encourage motion - inc peripheral circulation: sympatholytic drugs, sympathetic ganglia block, ganglionectomy, periarterial sympathectomy prognosis - good - recovery slow: some w permanent stifness - psych factor: poorly motivated > poor recov
60
describe rupture of bicepsbrachii
infrequent men 40-60 yo involves dominant side distal bicep tendon avulses from radial tuberosity @ bicipital groove assoc w degenerative
61
where can rupture of biceps occur
at/near origin bicipital groove musculotendinous junction via singe traumatic event; unexpected extension applied to 90 deg flexion
62
SSx of biceps tendon rupture
sharp pain and audible snap local tenderness popeyes sign weakness in flexion and supination insertion > loss of flexion strength rupture of long head = 20% loss of flexion
63
diagnosis and treatment of biceps tendon rupture
xray: avulsion of glenoid rim non-surgical: strength regained after 4-6 mo. young - surgical repair - tenodesis: fixed at coracoid or floor of bicipital groove
64
describe anterior dislocation of shoukder
most common; abd, ext, ER and force from back traumatic and unilat; may injure axillary n.
65
describe posterior dislocation of shoulder
assoc w seizures or electrical shock bc pt is pushed dow or anterior force
66
what are usually assoc w shoulder disloc
bankart lesion - injury to the labrum due to repeated anterior dislocs - leads to recurrent disloc in patients arnd 30 yo. hill sachs lesion - humeral head gets impacted during anterior disloc fracture of greater tuberosity
67
what is the epidemiology of reccurent SD
50-57% high for acute disloc < 20 yo. immob after reduction for 3 wks dec chance more common anterior SD
68
describe RSD
succesive dislocs require lesser force; w/o movement pain decs in mga sunod and reduction easier atrophy will develop sudden pain and audible click when abd and ER
69
what are risk factors for RSD
incomplete healed tears relaxation of capsular ligaments shoulder muscle weakness congenital or acquired changes in head or glenoid fossa
70
what is shoulder arthroplasty
TSA is surgical typically reserved for elderly patients w/ cuff deficiency or arthritic shoulders
71
what are indications for TSA
tumors RA pagets osteonecrosis of humeral ehead fracture and recurrent disloc unremitting pain more than LOM loss of function failure of conservative
72
what are the requirements for TSA
strengths of - SITS - deltoid - traps - rhomboids - serratus ant - lats - pec major and minor shoulder stretching before operation may improve postsurgical function
73
what are the two types of shoulder arthroplasty
partial: head of humerus replaced w metal head and stem total: replacing both joint surfaces; metal head and stem w plastic glenoid
74
what are the contraindication for TSA
active sepsis of joint severe osteoporosis charcot joint obesity >200 lbs. bedfast poor cognition baka pwede lesser invasive; osteotomy children; active growth plates

pt momints ver 2.0 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions