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Phase 3b AE > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

What can cause spinal cord compression?

A

Bone displacement
Bone collapse
Disc prolapse
Local tumour or abcess

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2
Q

What is the pattern of distribution of root pain?

A

Lower motor neurone signs occur at the level of the lesion.
Upper motor neurone signs and sensory changes below the lesion (spastic weakness, brisk reflexes, upgoing planters and loss of co-ordination, joint position, vibration, temperature and pain)

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3
Q

Which tracts lesions affect which sensations on which side of the body?

A

Dorsal column - light touch, proprioception, vibration - same side as the insult
Spinothalamic - pain and temperature - opposite side 2-3 dermatomes lower than the insult

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4
Q

What does a sharp or dull shoulder pain indicate?

A

Sharp - capsulitis

Dull - osteroarthrosis

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5
Q

What does pain on movement in the shoulder indicate?

A

Trauma
Impingement
If young, dislocation

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6
Q

What are the two types of recurrent shoulder dislocation?

A

Atraumatic

Traumatic

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7
Q

What is an atraumatic recurrent shoulder dislocation?

A 
Atraumatic - no history of trauma, general joint laxity
BRAA
Bilateral
Rehabilitation (treatment)
Atraumatic
All directions (dislocation direction)
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8
Q

What is a traumatic recurrent shoulder dislocation?

A 
Usually anterior and secondary to trauma (may be mild)
BUST
Bankard lesion
Unidirectional
Surgical treatment
Traumatic
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9
Q

What is a Bankard lesion?

A

The capsule is attached to the neck of the scapula but detached from the glenoid labrum

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10
Q

What may cause a rotator cuff tear?

A

Degeneration

Less commonly a sudden jolt

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11
Q

What are the symptoms of a complete and partial rotator cuff tear?

A

Complete - limit shoulder abduction to 45-60 degrees
Partial - Painful arc syndrome
There should be full range of passive movement.
Pain is felt at the shoulder tip and upper arm, tenderness at the acromion

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12
Q

How would you investigate a rotator cuff tear?

A

US, MRI or arthrography reveals communication between joint capsule and subacromial bursa

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13
Q

How would you treat a rotator cuff tear?

A

Tendon repair may be successful, particularly if done early

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14
Q

What is painful arc syndrome?

A

Pain on abduction between 45 and 160 degrees.

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15
Q

What are the causes of pain on abduction?

A

Supraspinatus tendinitis
Calcifying tendinitis
Acromioclavicular joint osteoarthritis

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16
Q

What is the typical age for supraspinatus tendinitis?

A

35-60

17
Q

How would you treat supraspinatus tendinitis?

A

Active shoulder movement with physio
NSAIDs, naproxen 250mg/8h PO after food
Subacromial bursa steroid injection

18
Q

What is the typical age for calcifying tendinitis?

A

25-55

19
Q

What is calcifying tendinitis?

A

There is acute inflammation on supraspinatus. Pain is maximal during the period of resorption.

20
Q

How would you treat calcifying tendinitis?

A

Physio
NSAIDs
Steroid injection

21
Q

How would you treat acromioclavicular joint osteoarthritis?

A

Steroid injection often helps

Excision of the lateral end of the clavical may be needed

22
Q

How would tendinitis of the long head of the bicep present?

A

Pain is felt in the anterior shoulder and is characteristically worse on forced contraction of the biceps

23
Q

How would you treat tendinitis of the long head of the bicep?

A

NSAIDs

Hydrocortisone injection to the tendon may give relief but risks rupture

24
Q

How would rupture of the long head of biceps present?

A

Discomfort occurs after ‘something has gone’ when lifting or pulling. A ‘ball’ appears in the muscle on elbow flexion

25
Q

How would frozen shoulder (adhesive capsulitis) present?

A

May follow modest injury in older people.
Pain may be severe and worse at night (unable to lie on one side).
Active and passive ROM reduced, decreased abduction and sometimes external rotation.

26
Q

How would you treat frozen shoulder (adhesive capsulitis)?

A 
NSAIDs
Intra-articular steroid injections
Physio
Manipulation
Resolution may take years

Phase 3b AE (4 decks)

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