Quiz 5 [CH 18 + 19] Flashcards
bones of the shoulder (3)
-clavicle
-scapula
-humerus
articulations of the shoulder (4)
-sternoclavicular joint
-acromioclavicular joint
-glenohumeral joint
-scapulothoracic joint
muscles of the shoulder
-rotator cuff (see next flashcard)
-deltoid
-trapezius
-rhomboids
-lats
-serratus anterior
rotator cuff muscles (4)
-supraspinatus
-infraspinatus
-teres minor
-subscapularis
ligaments of the shoulder (1)
acromioclavicular ligament
palpations of the shoulder
-scapula
-clavicle
-sternoclavicular joint
-acromioclavicular joint
-humerus
palpations of the scapula
-spine of scapula
-medial border
-lateral border
prevention of shoulder injuries
-for overhead athletes, emphasis should be placed on strengthening the rotator cuff muscles
-scapular stabilization strengthening exercises help provide a base for the highly mobile GH joint
-proper falling technique
what muscles are targeted by scapular stabilization strengthening exercises
-serratus anterior
-middle trap
-lower trap
____ is required for distal mobility
proximal stability
phases of correct throwing technique (5)
-wind up phase
-cocking phase
-acceleration phase
-deceleration phase
-follow-through phase
throwing- wind up phase
-preparation phase
-lead leg strides forward
-shoulder starts to abduct + externally rotate
throwing- cocking phase
-begins when hands separate
-ends with shoulder in maximal external rotation
throwing- acceleration phase
-lasts from maximal external rotation until the ball releases
throwing- deceleration phase
-lasts from ball release until max shoulder internal rotation
-shoulder external rotators contract eccentrically to decelerate the humerus
throwing- follow-through phase
-lasts from maximum shoulder internal rotation until the end of motion, when there is a balanced position
assessing the shoulder complex- history
-what happened to cause the pain?
-where is the pain located?
-is there a feeling of weakness or a sense of fatigue?
-what shoulder movements or positions seem to aggravate or relieve the pain?
assessing the shoulder complex- observation
-anterior, lateral, + posterior
-obvious deformity?
-one shoulder higher?
-shoulders rounded?
-scapular movement
assessing the shoulder complex- palpation
-point tenderness
-abnormal swelling/lumps
-muscle spasm/guarding + trigger points
-palpate anteriorly + posteriorly
clavical fx- cause
-fall on an outstretched arm
-fall on the tip of the shoulder
-direct impact
clavicle fx- signs
-injured clavicle appears lower on the affected side
-palpation may reveal swelling, point tenderness, + mild deformity
clavicle fx- care
-immediately immobilize; continue for 6-8 weeks
-surgery may be required
humerus fx- cause
-direct blow
-falling on an outstretched hand
-dislocation
-car accident
humerus fx- signs
-pain
-inability to move the arm
-swelling
humerus fx- care
-x-ray needed to confirm diagnosis
-immediate application of splint + sling
-immediate referral
sternoclavicular joint sprain- cause
-uncommon in sport
-indirect force transmitted through the humerus
-direct impact to the clavicle
sternoclavicular joint sprain- signs
-depends on grade of injury
-pain
-swelling
-inability to abduct shoulder through full ROM
sternoclavicular joint sprain- care
-immobilization maintained for 3-5 weeks
-high reoccurrence rate
acromioclavicular joint sprain- cause
-fall on an outstretched arm
-direct impact to the tip of the shoulder
acromioclavicular joint sprain- signs
-discomfort
-obvious deformity
-point tenderness
-loss of ROM
acromioclavicular joint sprain- care
-POLICE
-immobilization
-referral for further imaging
glenohumeral dislocations- cause
-forced abduction with external rotation
-landing on an outstretched arm
glenohumeral dislocations- signs
-obvious deformity
-moderate to severe pain + disability
glenohumeral dislocations- care
-immediate immobilization using a sling
-shoulder must be reduced
-further imaging for potential fx
shoulder impingement syndrome- cause
-repetitive compression of shoulder structures (biceps tendon, supraspinatus, etc.)
-throwing, swimming, serving a tennis ball, spiking a volleyball, etc.
-anatomy
shoulder impingement syndrome- signs
-diffuse pain around the acromion
-painful arc in the ROM between 70-120 degrees of abduction
-tightness in the joint capsule
shoulder impingement syndrome- care
-POLICE
-rotator cuff strengthening
-stretching posterior capsule
rotator cuff strain- cause
-most often involves the supraspinatus muscle
-overhead throwing
rotator cuff strain- signs
-pain with muscle contraction
-tenderness on palpation
-loss of strength
rotator cuff strain- care
-POLICE
-progressive strengthening exercises
-reduce activity
subacromial bursitis- cause
-direct impact
-shoulder impingement
subacromial bursitis- signs
-pain with moving shoulder
-swelling
-tenderness during palpation
subacromial bursitis- care
-cryotherapy
-anti-inflammatory medication
biceps tenosynovitis- cause
-repeated stretching of bicep tendon
biceps tenosynovitis- signs
-tenderness in the anterior upper arm
-pain during overhead activities
biceps tenosynovitis- care
-POLICE
-anti-inflammatory medications
labral tears- cause
-GH dislocation
-fall on an oustretched hand
-throwing motion
are labral tears acute or chronic
can be both
labral tears- signs
-“deep” pain
-constant aching
labral tears- care
-NSAIDs
-activity modification
-therapy
-possible surgery
bones of the elbow joint (3)
-radius
-ulna
-humerus
articulations of the elbow joint
-humeroulnar joint
-humeroradial joint
-radioulnar joint
ligaments of the elbow joint
-annular ligament
-radial collateral ligament
-ulnar collateral ligament
muscles of the elbow joint (4)
-biceps brachii
-brachialis
-brachioradialis
-triceps
assessing elbow injuries- history
-is this a new injury or is this a chronic problem?
-was there direct trauma?
-is there any tingling or numbness radiating down the forearm?
assessing elbow injuries- observation
-increased carrying angle
-decreased ROM
-obvious deformity
-swelling
assessing elbow injuries- palpation
palpate the bony aspects including:
-epicondyles
-olecranon
-proximal radius + ulna
special test for elbow
valgus stress test (UCL)
olecranon bursitis- cause
-direct blow
-falling on the tip of the elbow
olecranon bursitis- signs
-pain
-swelling
-point tenderness
olecranon bursitis- care
-ice + compression
-padding to the area
elbow sprains- cause
-hyperextension
-forces that bend or twist the lower arm outward (valgus force)
-most common sprain = UCL
most common elbow sprain
UCL
elbow sprains- signs
-pain
-inability to throw
-point tenderness over ligament
elbow sprains- care
-ice + compression
-sling at 90 degrees of flexion
-unstable or complete tairs need Tommy John Surgery (UCL repair)
UCL repair surgery name
Tommy John Surgery
lateral epicondylitis- cause
-aka tennis elbow
-repetitive forceful extension of the wrist causing irritation to the tendons attachment of the extensor muscles at the lateral epicondyle
what diagnosis is “tennis elbow”
lateral epicondylitis
lateral epicondylitis- signs
-aching pain at lateral epicondyle
-tenderness + weakness
-pain on resisted extension of the wrist
lateral epicondylitis- care
-POLICE
-NSAIDs
-stretching
medial epicondylitis- cause
-aka golfer’s elbow
-overuse injury
what diagnosis is “golfer’s elbow”
medial epicondylitis
medial epicondylitis- signs
-pain with forced flexion
-point tenderness
-some cases swelling
medial epicondylitis- care
-rest
-ice
-counterforce brace applied just below the joint
elbow osteochondritis dissecans- cause
-unknown
-potential impairment of the blood supply can lead to separation of portions of articular catilage + bone creating loose bodies
elbow osteochondritis dissecans- signs
-locking of the elbow joint
-loss of ROM
elbow osteochondritis dissecans- care
surgical removal
ulnar nerve injuries- cause
-athletes with pronounced outward angle may develop a nerve friction problem
-impingement
ulnar nerve injuries- signs
-paresthesia to the 4th and 5th fingers
-weakness
-lack of grip strength
ulnar nerve injuries- care
-conservative management
-avoiding stress to elbow
elbow dislocations- cause
-falling on an outstretched arm with the elbow hyperextended
-severe twist while the elbow is flexed
elbow dislocations- signs
-obvious deformity
-olecranon process extends backward
-severe pain + disability
elbow dislocations- care
immobilizing splint + referral for reduction as soon as possible
elbow fractures- cause
-fall on outstretched hand
-direct blow
elbow fractures- signs
-obvious deformity
-swelling
elbow fractures- care
-ice + sling
-immediate referral
bones of the forearm (2)
-radius
-ulna
radius/ulna is on thumb side
radius
flexor muscles of forearm (2)
-flexor carpi ulnaris
-flexor carpi radialis
extensor muscles of forearm (2)
-extensor carpi ulnaris
-extensor carpi radialis
assessing the forearm- history
-what caused the injury?
-loss of function?
-what were the symptoms at the time of the injury?
-did symptoms occur later?
assessing the forearm- observation
-visually inspect entire forearm
-look for obvious deformities
assessing the forearm- palpation
palpated at injury site + areas distant
forearm strains- cause
overuse (repeated contractions)
forearm strains- signs
-dull aching pain in muscles
-pain throwing or with daily activities
forearm strains- care
-treat the symptoms
-cryotherapy
-increase strength
colles’ fracture- cause
-involves lower distal end of radius
-fall on outstretched hand with an extended wrist forcing the forearm backwards + upwards into hyperextension
colles’ fracture- signs
-visible deformity
-numbness/tinglingn
-pain
colles’ fractures- care
-splint the injury
-check pulse
-sling + refer for x-ray
proximal radial head fracture- cause
FOOSH
proximal radial head fracture- care
-non-op = immobilization followed by ROM exercises
-op = ORIF surgery
proximal radial head fracture- signs
-pain + tenderness along the lateral aspect of the elbow
-limited ROM, especially in pronation + supination
bones of wrist/hand/fingers (3)
-carpals
-metacarpals
-phalanges
carpal bones (8)
-scaphoid
-lunate
-triquetrum
-pisiform
-trapezium
-trapezoid
-capitate
-hamate
assessing the wrist/hand/fingers- history
-what increases or decreases the pain?
-any feelings of weakness?
-what therapy or medications, if any, have been given?
assessing the wrist/hand/fingers- observation
arm + hand symmetry
assessing the wrist/hand/fingers- palpation
-bones of wrist palpated for any pain + deformity
-MCP joint
-phalanges
wrist sprain- cause
-abnormal or forced movement of the wrist
-falling on hyperextended wrist
wrist sprain- signs
-pain
-swelling
-difficulty moving wrist
wrist sprain- care
-POLICE
-x-ray to rule out fracture
carpal tunnel syndrome- cause
-inflammation of the tendons + synovial sheath within the anterior aspect of the wrist
-repeated wrist flexion
carpal tunnel syndrome- signs
-numbness + tingling
-weakness
carpal tunnel syndrome- care
-rest + immobilization
-if condition continues-> corticosteroid injection or surgery
scaphoid fracture- cause
-most frequently fractured carpal bone
-fall on an oustretched hand
scaphoid fracture- signs
-snuffbox tenderness
-swelling + pain
scaphoid fracture- care
-referred for x-ray
-cast immobilization for 6 weeks
where does snuffbox tenderness occur
bottom of thumb
hamate fracture- signs
-wrist pain
-weakness + tenderness
-possible tingling + numbness
hamate fracture- cause
commonly occurs from contact when holding sports equipment such as a baseball bat
hamate fracture- care
casting +/or padding
wrist ganglion- cause
-usually appears slowly after repeated forced hyperextension of the wrist
-most often appears on the back of the wrist
wrist ganglion- signs
-pain at lump site
-pain with wrist extension
wrist ganglion- care
combination of aspiration + chemical cauterization
boxer’s fracture
fx of 5th metacarpal
boxer’s fracture- cause
direct axial force by punching a wall or another person
boxer’s fracture- signs
-palpable defect in shaft of 5th metacarpal
-knuckle appears depressed or sunken
boxer’s fracture- care
-referred for x-ray
-immobilization for 3-4 weeks
mallet finger- cause
-baseball or basketball finger
-blow to the tip of the finger
mallet finger- signs
-inability to fully extend finger
-pain at distal interphalangeal joint
-point tenderness
mallet finger- care
-POLICE
-x-ray to rule out fracture
-splint
boutonniere deformity- cause
-rupture of the extensor tendon over the middle phalanx
-forces DIP into extension + PIP into flexion
boutonniere deformity- signs
-inability to extend PIP joint (textbook may be incorrect)
-swelling
-pain
boutonniere deformity- care
splinting PIP into extension
jersey finger- cause
-rupture of the flexor digitorum profundus from its insertion into the distal phalanx
-most often occurs at the ring finger when the athlete tries to grab the jersey of an opponent
jersey finger- signs
-the DIP cannot be flexed
-finger stuck in extension
jersey finger- care
tendon must be surgically repaired
gamekeeper’s thumb- cause
-sprain of UCL ligament of the thumb
-forceful abduction of the proximal phalanx
gamekeeper’s thumb- signs
-pain over UCL
-tenderness + swelling over the medial aspect of the thumb
gamekeeper’s thumb- care
-x-ray to rule out fracture
-splinting of the thumb for at least a 3-week period
dislocation of the phalanges- cause
blow to the finger by a ball
dislocation of the phalanges- signs
-obvious deformity
-pain + swelling
dislocation of the phalanges- care
-reduction of the finger
-x-ray to rule out fracture
-splinted for 3 weeks in 30 degrees of flexion
-when returning to play, athlete should be buddy taped
