Other Flashcards
What is rotator cuff tear?
Rotator cuff tears are common in elderly people and may occur following minor trauma or as a result of long standing impingement. Tears greater than 2cm should generally be repaired surgically.
What is Parsonage-Turner syndrome?
This is a peripheral neuropathy that may complicate viral illnesses and usually resolves spontaneously and causes rapid onset, severe shoulder and arm pain.
Musculocutaneous nerve (roots, motor supply, sensory supply, mechanism of injury)
- C5-C7
- elbow flexion (biceps brachii) and supination
- lateral forearm
- isolated injury rare (part of brachial plexus injury)
Axillary nerve (roots, motor supply, sensory supply, mechanism of injury)
- C5-C6
- shoulder abduction (deltoid muscle)
- inferior region of deltoid
- injury due to humeral neck fracture/dislocation
- results in flattened deltoid
Radial nerve (roots, motor supply, sensory supply, mechanism of injury)
- C5-C8
- extension (forearm, wrist, fingers, thumb)
- small area between dorsal aspect of 1st and 2nd metacarpals
- humeral shaft fracture
- palsy results in wrist drop
Median nerve (roots, motor supply, sensory supply, mechanism of injury)
- C6, C8, T1
- LOAF muscles (lateral 2 lumbricals, opponens pollicis, abductor pollicis brevis, flexor pollicis brevis)
- wrist: paralysis of thenar muscles, opponens pollicis
- elbow: loss of pronation of forearm and weak wrist flexion
- palmar aspect of lateral 31/2 fingers
- wrist lesion - carpal tunnel syndrome
Ulnar nerve (roots, motor supply, sensory supply, mechanism of injury)
- C8-T1
- intrinsic hand muscles except LOAF
- wrist flexion
- medial 1 1/2 fingers
- medial epicondyle fracture
- damage may result in claw hand
Long thoracic nerve (roots, motor supply, sensory supply, mechanism of injury)
- C5-C7
- serratus anterior
- often during sport e.g. blow to the ribs
- complication of mastectomy
- damage results in winged scapula
Most common site osteomyelitis in children?
metaphysis
What are anterior shoulder dislocations associated with?
- FOOSH
- unilateral shoulder deformity
What are posterior shoulder dislocations associated with?
- electric shocks
- seizures
- stuck in internally rotated position
Analgesic to give to CKD patients for back pain?
codeine
Foot drop after total hip replacement?
sciatic nerve
Undergoes a low anterior resection with legs in the Lloyd-Davies position. Post operatively he complains of foot drop.
Peroneal nerve
Features of acromioclavicular joint dislocation:
secondary to direct injury to the superior aspect of the acromion. Loss of shoulder contour and prominent clavicle are key features.
Features of glenohumeral joint dislocation:
A Hill-Sachs lesion is when the cartilage surface of the humerus is in contact with the rim of the glenoid. About 50% of anterior glenohumeral dislocations are associated with this lesion.
Features of supraspinatus tear:
- pain to 90 degrees on abduction
- most common of rotator cuff tears. It occurs as a result of degeneration and is rare in younger adults.
What are the rotator cuff muscles?
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
What does the supraspinatus do?
- abducts arm before deltoid
- most commonly injured
What does the infraspinatus do?
rotates arm laterally
What does teres minor do?
adducts and rotates arm laterally
What does subscapularis do?
adducts and rotates arm medially
The spectrum of disease with rotator cuff shoulder problems?
- subacromial impingement
- calcific tendonitis
- rotator cuff tears
- rotator cuff arthropathy
What signs are present with rotator cuff injury?
- painful arc of abduction
- subacromial impingement: between 60 and 120 degrees
- rotator cuff tears: first 60 degrees
- tenderness anterior acromion
