Ortho - Upper Limb

Question 1

what are the muscles of the rotator cuff? what are there functions?

Answer 1

supraspinatus - abduction
infra - external rotation
teres minor
subscap - internal rotation

Question 2

how does acute calcific tendonitis present? Tx?

Answer 2

acute onset shoulder pain 
self limiting (pain management/steroid injections)

Question 3

why does painful arc occur?

Answer 3

supraspinatus tendon compressed in subacromial space on abduction

Question 4

Tx for painful arc?

Answer 4

NSAIDs
analgesia
physio
steroid injections

Question 5

features of frozen shoulder?

Answer 5

pain for 2-9mnths
stiff 4-12mnths
loss of ER

Question 6

most common type of shoulder dislocation?

Answer 6

anterior

Question 7

what is a bankart lesion? when does this occur?

Answer 7

detachment of anterior glenoid labrum and capulse

anterior shoulder dislocation

Question 8

what nerve can be damaged in shoulder dislocation? sign?

Answer 8

axillary

regimental badge patch
deltoid and teres minor

Question 9

Ix for shoulder dislocation? findings?

Answer 9

XRAY (lightbulb sign)

anterior + posterior drawer test

Question 10

Tx for shoulder dislocation?

Answer 10

reduce
sling
bankart repair if recurrent

Question 11

what fracture is associated with shoulder dislocation? Tx?

Answer 11

greater humeral tuberosity

ORIF

Question 12

what nerve is affected in carpal tunnel? what does it supply?

Answer 12

median

sensation to thumb and 2 1/2 fingers
lateral lumbricals

Question 13

risk factors for carpal tunnel?

Answer 13

pregnancy
DM
CKD
hypothyroid
female

bilateral = RA

Question 14

features of carpal tunnel?

Answer 14

numb
weak
pain worse at night
muscle wasting of thenar eminence

Question 15

what are tinnel’s and phalen’s?

Answer 15

tinnel’s - percus M nerve

phalen’s - upside down prayer

Question 16

Tx for carpal tunnel?

Answer 16

splint

surgery

Question 17

what nerve is affected in cubital tunnel? where is it compressed? what does it supply?

Answer 17

ulnar
medial epicondyle

flexor muscles
hand muscles
medial 1 1/2 fingers

Question 18

examination findings for cubital tunnel?

Answer 18

tinnel’s (at medial epicondyle)

froment’s - reduced grip strength of the thumb

Question 19

what causes lateral epicondylitis?

Answer 19

repeated wrist extension

Question 20

what causes medial epicondylitis

Answer 20

repeated wrist flexion

Question 21

Tx for lateral/medial epicondylitis?

Answer 21

rest
NSAIDs
physio

Question 22

OA features in the hand?

Answer 22

heberden’s (DIP)
bouchard’s (PIP)
squaring at thumb base

Question 23

RA features in the hand?

Answer 23

spares DIP
Swan neck (hyperextended PIP)
boutonniere’s (hyperextended DIP)
ulnar deviation