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NPTE Study: MSK > MSK Pathology 2 > Flashcards

MSK Pathology 2 Flashcards

1
Q

GH instability refers to

A

Excessive translation of the humeral head during active rotation

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2
Q

GH instability: subluxation

A

Joint laxity: allows for more than 50% of humeral head to passively translate over the glenoid rim without dislocation

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3
Q

GH instability: dislocation

A

Complete separation of the articular surfaces of the glenoid and humeral head

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4
Q

GH instability: approximately 85% of dislocations detach the

A

Glenoid labrum

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5
Q

GH instability: most common type

A

Anterior dislocation

  • stress on the anterior capsule, GH ligament, and RC
  • causes humerus to move anteriorly out of the glenoid fossa
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6
Q

GH instability: s/s subluxation

A
  • feeling shoulder “popping” out and back into place
  • pain
  • paresthesia
  • dead arm
  • positive apprehension test
  • capsular tenderness
  • swelling
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7
Q

GH instability: dislocation s/s

A
  • severe pain, paresthesias
  • limited ROM
  • weakness
  • visible shoulder fullness
  • arm supported by contralateral limb
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8
Q

GH instability: tx

A
  • initial immobilization with sling for 3-6 weeks
  • RICE and NSAIDs in early phase
  • after immobilization: ROM/isometric strengthening followed by progressive resistive exercises
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9
Q

GH instability: later tx should focus on these muscles

A

Internal/external rotators

Scapular muscles

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10
Q

Impingement syndrome: etiology

A

humeral head and RC attachments migrate proximally and become impinged on the undersurface of the acromion and coracoacromial ligament

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11
Q

Impingement syndrome: s/s

A
  • pain/discomfort deep in shoulder
  • pain with OH activities
  • painful arc of motion
  • positive impingement sign
  • top over greater tuberosity and bicipital groove
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12
Q

the most common rheumatic disease in children

A

Juvenile RA

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13
Q

JRA etiology

A

External source (virus, injection, trauma) triggers autoimmune response and JRA in children with genetic predisposition

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14
Q

Juvenile RA: most to least common types

A
  • oligoarticular (40-60%)
  • polyarticular (30-40%)
  • systemic (10-20%)
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15
Q

JRA s/s: systemic

A 
Acute onset
Fevers
Rash
Enlarged spleen, liver
Inflammation of lungs/heart
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16
Q

Juvenile RA: polyarticular s/s

A

Higher incidence in females
Significant rheumatoid factor
Arthritis in more than 4 joints with symmetrical involvement

17
Q

Juvenile RA: oligoarticular s/s

A

Affects less than 5 joints

Asymmetrical

18
Q

Juvenile RA: treatment

A
  • pharmacological mgmtfor pain and inflammation
  • PROM/AROM
  • positioning/splinting
  • strengthening/endurance/WB activities
  • postural training
  • pain mgmt: modalities
19
Q

Juvenile RA: surgical mgmt

A

May be indicated 2/2 pain, contractures, or irreversible joint destruction

20
Q

Lateral epicondylitis: irritation of these muscles

A

Common extensor muscles at origin on the lateral epicondyle

21
Q

Lateral epicondylitis: common sports

A

Throwing sports

22
Q

Lateral epicondylitis: etiology

A
  • Eccentric loading of wrist extensor muscles, usually ECRB
  • Results in microtrauma

*tennis: handle too small, strings with too much tension

Most common between 30-50 years old

23
Q

Lateral epicondylitis: s/s

A
  • pain immediately anterior or distal to lateral epicondyle

- worsens with repetition and resisted wrist extension

24
Q

Lateral epicondylitis: use of strap

A

Strap may be placed 2-3 inches distal to elbow jt to reduce muscular tension placed on the epicondyle

May diminish or eliminate symptoms

25
Q

Legg-Calve-Perthes disease: what is it?

A

Degeneration of the femoral head due to disturbance to blood supply (AVN)

26
Q

4 stages of Legg-Calve-Perthes disease:

A
  1. Condensation
  2. Fragmentation
  3. Re-ossification
  4. Remodeling

Disease is self-limiting

27
Q

Legg-Calve-Perthes disease: etiology

A
  • trauma
  • genetic predisposition
  • synovitis
  • vascular abnormalities
  • infection
28
Q

Legg-Calve-Perthes disease: s/s

A
  • pain
  • decreased ROM
  • antalgic gait
  • positive Trendelenburg sign
29
Q

Legg-Calve-Perthes disease: treatment focus

A
  • reduce pain
  • maintain position of the femoral head in proper position
  • improve ROM
30
Q

MCL sprain: also involves injury to these other structures

A
  • ACL

- medial meniscus

31
Q

MCL sprain: etiology

A

Contact or noncontact, fixed foot, tibial rotational injury associated with:

  • valgus force
  • tibial ER
32
Q

MCL sprain: surgical intervention

A

Rarely required because MCL is well vascularized

33
Q

Meniscus tear: which one is most commonly injured and why?

A

Medial most commonly injured due to its attachment to the joint capsule (less mobile)

34
Q

Meniscus tear: Those with this injury have a higher predisposition for subsequent meniscus tear

A

Deficient ACL

35
Q

Meniscus tear: etiology

A

Usually associated with fixed foot rotation in WB on a flexed knee (produces compression and rotation forces on the meniscus)

36
Q

Meniscus tear: s/s

A
  • joint line pain

- catching/locking sensation

37
Q

Meniscus tear: when are repairs performed?

A

Tears at outer edges of meniscus due to increased vascularity

NPTE Study: MSK (46 decks)

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