Presentations Flashcards
What position does a SLAP lesion occur in?
12:00 position
What causes SLAP lesion?
acute trauma or repetitive motion
What are the associated pathologies of a SLAP lesion?
Bankart lesion
Rotator cuff lesion
Type I SLAP Lesion:
Fraying of the superior labrum
No detachment at the biceps tendon insertion
Type II SLAP lesion:
Detachment of the superior labrum and biceps tendon
Type III SLAP lesion
Bucket handle tear of superior labrum
Intact biceps
Type IV SLAP lesion
Bucket handle tear of superior labrum
Tearing of the biceps tendon
What is GIRD due to?
contracture of posterior, inferior portion of the joint capsule
What phase does a SLAP lesion occur?
late cocking phase or during deceleration
Signs and Symptoms of SLAP lesion:
decreased strength
decreased ROM (including IR)
popping and catching
pain inside shoulder
What are the tests for a SLAP lesion?
Biceps load Test II Passive Compresion Test Anterior Slide Test Supine Flexion Resistance Test (Type II Slap lesion) O'Brien's test
What are the treatments for a SLAP lesion?
rest
NSAID
rehab
What is carpal tunnel syndrome?
entrapment of the median nerve while passing the wrist
What are the signs and symptoms of carpal tunnel?
- Paresthesias (numbness, tingling, burning) involving the median nerve distribution (first 3 digits and median half of 4th digit)
- Increasing pain in the hand with repetitive use
- Deep aching pain in the wrist
- intermittent and worse at night
- wasting of thenar and first two lumbricals
What does the rupture of the distal tendon of the biceps cause?
flexion and supination losses
pain in the elbow
can be partial or complete tear
What is the MOI of biceps rupture?
a single, unanticipated extension force that is placed on the elbow when it is in the flexed position
Where does a biceps rupture occur?
distal end where it inserts into radial tuberosity
What are the two main causes of bicep tendon tears?
- injury (force of 40 kg or more against resistance from an elbow in about 90 degrees of flexion
- overuse (fraying over time)
What are risk factors for tendon tear?
age heavy overhead activities shoulder overuse smoking corticosteriod medications
ADLs usually require:
30-130 of flexion (100 degrees total)
During flexion at humero-ulnar joint:
concave surface of trochlear notch of ulna rolls and slides anteriorly on the convex trochlea
Flexion and extension at humero-radial joint:
fovea of radius rolling and sliding across rounded capitulum
Average amount of pronation rotation
75 degrees
Average amount of supination rotation
85 degrees
Clinical features of bicep tendon tear:
pop at elbow when tendon ruptures
pain is severe at first, but subsides after 1-2 weeks
swelling at elbow
bruising in elbow and forearm
pain and weakness of elbow flexion and forearm supination
Cervical Disc Herniation:
linked to a variety of neuropathic problems and often times resulting in severe pain, resulting in decrease quality of life
What are neuropathic complicxations?
neck and arm pain accompanied by changes in motor, sensory and reflex changes
Primary motion of C1 (atlas)
flexion and extension
Primary motion of C2 (axis)
rotation
What are the 4 parts of the vertebral artery?
pre-transverse VA
cervical Va
suboccipital VA
intracranial VA
Cranial motion in sagittal plane:
flexion and extension
protraction and retraction
Cranial motion in the horizontal plane:
axial rotation
Cranial motion in the frontal plane:
lateral flexion
Stable cervical spine injury:
compression fracture
traumatic disk herniation
unilateral facet dislocations
Unstable cervical spine injury
fracture-dislocations
bilateral facet dislocations
MOI of cervical spinal injury
aging and degeneration
traumatic injury
acute disk injury
Signs and symptoms of cervical spine injury
ipsilateral pain in the neck radiating pain down the arm and fingers numbness or tingling neck flexion and arm abduction decreased sensation to pain, touch or vibration cervical radiculopathy cervical myelopathy
Why is the AC joint susceptible to dislocation?
because of the sloped nature of the articulation and the high probability of receiving a large shearing force
What is the MOI for AC joint separation?
Blunt trauma
Force applied directly over the superolateral border of the shoulder usually during a fall with the humerus adducted
What are the primary movements of AC joint?
upward and downward rotation
What are the secondary movements of the AC joint?
external and internal rotation
anterior and posterior tilting
What are the signs and symptoms of AC joint separation?
pain, regional swelling, and bruising decreased ROM Scapular weakness hypermobile clavicle elevated clavicle
Where is a proximal stress fracture?
the greater trochanter, femoral neck or in the femoral head
Most often the greater trochanter
What are risk factors for hip fractures?
cardiovascular disease heart failure smoking tall stature stroke dementia
MOI for stress fractures?
overuse
repetitive microtrauma
repetitive high loading which lead to weakened bone trabeculae
Femoral on pelvic arthrokinematics:
convex on concave
opposite slide and roll
Pelvic on femoral arthrokinematics:
concave on convex: roll and slide in same direction
Angle of inclination:
angle between the shaft of the femur and the femoral neck
Which individuals are at a higher risk to develop stress fractures at femoral neck?
coxa vara individuals
What is a high risk stress fracture?
proximal femur is considered high risk if it is on the superolateral side of the femur
tension side
What is a low risk stress fracture?
A stress fracture on the inferomedial side of the femur is considered low risk.
compression side
What is medial apophysitis?
little leaguer’s elbow
a growth plate injury on the medial or inner aspect of the elbow
What have the highest rate of injury incidence?
late cocking and acceleration phases of throwing
When does maximum valgus strain occur?
around 90 degrees
What are the signs and symptoms of medial apophysitis?
slightly swollen warm and tender bump of the inner elbow
elbow pain with use of elbow, wrist and forearm muscles
pain that gets worse when bending the wrist against force
What increases the risk of medial apophysitis?
throwing sports conditioning routines that are too intense overweight poor strength and flexibility rapid skeletal growth
