Orthopedic Conditions Flashcards
Most common cause of shoulder injury is?
FOOSH
Osteoporosis ration for Women to men is
2:1
Shoulder injuries for the Younger Population is typically due to ____ and typically have _____
a high-velocity injury
greater displacement
Name 3 locations of Shoulder Fractures
- Humeral Head
- Proximal/Humeral Neck
- Humeral Shaft
Fractur of the Humeral Shaft can lead to
- Risk for radial Nerve injury
- Leading to radial Nerve palsy
- Decreased ability to extend elbow, wrist, and fingers
Frozen shoulder is also called _____
adhesive capsulitis
Avascular necrosis –
disrupted flow of blood leads to degeneration of bone. The blood to the humeral head is supplied by the anterior circumflex artery
The blood to the humeral head is supplied by the?
anterior circumflex artery
Myositis ossificans- Muscle calcifies and starts to more resemble ______
connective tissue
CRPS is caused by
over-reaction of the sympathetic nervous system
Elbow fractures can cause _____ injury
Peripheral Nerve Injury
Volkmann’s Ischemia
edema develops within the connective tissue of the elbow. This puts a lot of pressure on nerves and blood vessels. This is life threatening.
Rotator Cuff Muscles of the shoulder provide stability to the __ joint with movement
GH
Function of the supraspinatus
Initiator of abduction (Most susceptible to injury due to location-usually from repetitive motions)
Function of infrapsinatus
external rotator
Function of teres minor
External rotation
Function of the subscapularis
Internal Rotation
Shoulder impingement syndrome is caused by compression of the structures found in the ____
subacromial space
What are the structures in the subacromial space?
Supraspinatus tendon, subacromial bursa, long head of biceps, joint capsule
Can you have tendonitis without Impingement?
Yes
Chief complaint with RTC and Biceps tendonitis will be?
Pain with movements above 90 degrees of flexion
Bursitis is Inflammation of the
subacromial bursa
Bursitis typically coexists with
shoulder impingement
Calcific Tendonitis Most commonly occurs where?
Supraspinatus & Infraspinatus
What is the most common torn RTC Tendon?
Supraspinatus
Minor RTC Tear size – • Medium Tear –
• Large Tear –
• Massive Tear –
less than 1 cm
Medium RTC Tear size
1cm – 3 cm
Large RTC Tear size
3 cm to 5 cm
Massive RTC Tear size
Greater than 5 cm
Symptoms of RTC tear –
- Pain over the top of the shoulder
- Radiating pain down lateral upper arm
- Weakness and difficulty/pain lifting arm overhead (flexion) and out to side (abduction)
- Difficulty and pain with lifting
- Usually audible popping
- Positive DROP ARM test for Supraspinatus T.
A ___ test for surpaspinatus T is a sign of a RTC tear
DROP ARM
Proximally, biceps Tendon Tears are usually on which head of the biceps?
LONG HEAD
Proximally, bicep tendon tears are due to?
overstretching arm overhead, lifting something heavy, overuse and fraying of the tendon
Distal bicep tendon tears are usually due to?
Elbow forcibly bent with a heavy load, mostly with heavy lifting
What are the three phases of adhesive capsulitis?
- Freezing –Losing ROM, becoming painful
- Frozen – Maximal loss of motion, most painful, difficult to use the shoulder, impaired sleep, can be a long lasting phase.
- Thawing – Starting to regain ROM, sleeping better, things are starting to heal.
TUBS acronym stands for
Traumatic Unilateral lesion with Bankart lesion (anterior glenoid labrum) and usually requiring surgery
AMBRI acronym stands for
Atraumatic, Multidirectional, frequently Bilateral, responds to Rehabilitation and rarely requires an Inferior capsular
Traumatic instability is usually caused by a?
significant injury
95% of traumatic instability is
Anterior
5% of traumatic instability is
Posterior
Risk factors for laxity
- Age - the younger the patient the greater the likelihood of the joint becoming unstable
- The severity of the first dislocation
- Limited or no Immobilization of the joint after the first dislocation
- Detachment of the anterior glenoid labrum (Bankart lesion) increases the rate of recurrence
- Defect on the posterolateral surface of the humeral head (Hill- Sachs lesion) which increases the instability
After a TSA (Total Shoulder Arthoplasty,) which motions should be avoided?
Abduction and ER
Common causes of hip fractures
Common cause is a fall, MVA, or a sudden rotational force
Which room of the house is the most common for falls to occur?
Bathroom
Can a physiological fracture occur?
YES
Most common hip fracture is a?
intertrochanteric Fracture
Intertrochanteric fractures are more common in adults over __ years of age and more common in ___
50; women.
Hip Fractures account for ___ of all fractures in people over the age of __
90%; 70
With femoral Head Fractures, there is an Increased risk of?
avascular necrosis
What two vessels provide vascular Supply to the Femur
Artery of ligamentum teres (supplies capsule) and deep femoral arteries supply the femoral head.
Anterior Hip replacement movement precautions are
no external rotation, no extension. May not have hip precautions
Posterior Hip replacement movement precautions are
no internal rotation, no flexion above 90 degrees, no adduction.
Resurfacing of the hip is also called
Birmingham hip
Weight bearing precautions for cemented hip replacements
Dependent on Physician but usually can WBTT (Weight-bearing to tolerance). Usually good for elderly, less active people and people with osteoporosis
Weight-bearing precautions for Non-Cemented Hip replacements
Porous stem to allow natural bone to grow and attach to the prosthesis will be NWB for up to 2-3 months
Indications are that __ hips last longer than ____
non-cemented
cemented
Non-Weight Bearing - (NWB) % of body weight and ambulatory device-
0% Walker or crutches
Touchdown Weight Bearing (TTWB) % of body weight and ambulatory device
- 10-15% - Walker or crutches
Partial Weight Bearing (PWB) % of body weight and ambulatory device
¬- 30% - Walker or crutches
50% Weight Bearing % of body weight and ambulatory device
- 50%- Cane
Full Weight Bearing (FWB) % of body weight and ambulatory device
75-100% - Cane or no device
In a partial Knee replacement, the ___ or ____ compartment of the knee is replaced
Medial or Lateral
Indications for knee replacement are?
painful joints that restrict motion or restrict functional performance
