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Elective 2 EOR > MSK > Flashcards

MSK Flashcards

1
Q

What nerve injury must you r/o in humeral shaft fractures?

A

Radial

  • check deltoid sensation, brachial plexus injury
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2
Q

What nerves can be injured in proximal humerus/humeral head fractures?

A

Radial, axillary

  • brachial plexus injuries
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3
Q

What is a common clinical manifestation seen in someone w/ an injured radial nerve?

A

“wrist drop”

  • Radial nerve supplies the extensor muscles
  • Arm usually held in adducted position too
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4
Q

Humeral fractures: What is the MOI?

A

FOOSH, direct trauma

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5
Q

How do you treat humeral fractures?

A

Sugar tong splint
Coaptation sling
Ortho fu 24-48hr

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6
Q

What is the MC fractured bone in children, adolescents, and newborns?

A

Clavicle

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7
Q

Clavicle fractures: What is the MOI?

A

Mid-high energy impact

  • In children < 2, suspect child abuse
  • MC in males
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8
Q

Clavicle fractures: What clinical manifestations can be seen?

A

pain w/ ROM
deformity
+/- “tenting” of skin
may hold arm against chest

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9
Q

What are complications of clavicle fractures?

A

pneumo or hemothorax
coracoclavicular ligament disruption
brachial plexus injury

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10
Q

How do you manage clavicle fractures?

A

Mid 1/3 –> arm sling x 4-6 wks in adults, figure of 8 sling for kids

Proximal 1/3 –> ortho consult

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11
Q

AC joint dislocation: What is the MOI?

A

direct blow to adducted shoulder

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12
Q

AC joint dislocation: what clinical manifestations are seen?

A

pain w/ lifting arm

+/- deformity

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13
Q

How do you manage AC joint dislocations?

A

Brief sling immobilization, ice, analgesia, ortho fu

Type III might need surgery!

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14
Q

What are the classes of AC joint dislocation?

A

I: normal cxr, ligamental sprain
II: slight widening (AC ligament ruptured)
III: significant widening (rupture of both AC & CC ligaments)
IV: class III + displacement of clavicle into trapezius
V: class IV + disruption of clavicle attachments

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15
Q

Anterior GH shoulder dislocation: What is the MOI?

A

blow to abducted, externally rotated arm that is extended

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16
Q

What are the clinical manifestations seen in anterior GH dislocations?

A

arm abducted, externally rotated

“squared off shoulder”

17
Q

What type of GH dislocation is MC?

A

Anterior

18
Q

How do you diagnose an anterior GH dislocation?

A

Axillary & “Y” view
Hill-Sachs lesion: Groove on humeral head
Bankart lesion: glenoid inferior rim fx

19
Q

Posterior GH dislocation: What is the MOI?

A

forced adduction, internal rotation

20
Q

What are posterior GH dislocations MC a/w?

A

Seizures, electric shock

21
Q

What must you rule out in anterior GH dislocations?

A

Axillary nerve damage (pinprick sensation over deltoid)

22
Q

How do you treat GH dislocations?

A

Reduction

23
Q

What is the MCC of shoulder pain if > 40yo?

A

Rotator cuff tear

24
Q

Rotator cuff injuries: What is the MOI?

A

chronic erosion (overhead movements)
+/- trauma
Common in athletes or laborers

25
Q

What muscles make up the rotator cuff? Which is most commonly injured?

A

SITS

  • supraspinatous (most commonly injured)
  • infraspinatous
  • teres minor
  • subscapularis
26
Q

Rotator cuff injuries: clinical manifestations

A

anterior deltoid pain w/ decreased ROM esp w/ overhead activities, external rotation or abduction

27
Q

What is commonly seen in rotator cuff tears?

A

weakness, atrophy, & continuous pain

28
Q

Rotator cuff injuries: PE

A
  • passive ROM > active ROM
  • supraspinatus test = “empty can” test
  • impingement tests: of subscapular nerve/supraspinatous - 1. Hawkins (sharp anterior shoulder pain w/ internal rotation), 2. Drop arm test (inability to raise arm above shoulder level), 3. Neer test (arm fully pronated w/ pain during forward flexion)
29
Q

What test may help distinguish tendinopathy from rotator cuff tears?

A

subacromial lidocaine test

  • normal strength w/ pain relief = tendinopathy
  • persistent weakness = tear
30
Q

How do you treat tendinitis vs rotator cuff tear?

A

Tendinitis: shoulder pendulum/wall climbing exercises, NSAIDs, ice

Tear: rehab, NSAIDs, steroids, surgery

Elective 2 EOR (1 decks)

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