Screening for Shoulder and Upper Extremity

Question 1

What are three different kind of infections that could present as shoulder pain?

Answer 1

1. septic arthritis
2. Osteomyelitis
3. Mononucleosis

Question 2

What joints are septic arthritis common in the shoulder region?

Answer 2

AC and SC jt

Question 3

What is PMH with SA?

Answer 3

iv drug use (illegal or medical), diabetes, trauma, surgery or animal bite

Question 4

What is most common form of OM?

Answer 4

staph aureus

Question 5

What organs are affected most by mono?

Answer 5

lungs, liver, spleen (LUQ pain)

sx: sore throat, fever, HA, fatigue

Question 6

What gynecologic problems could present as shoulder pain?

Answer 6

Ectopic pregnancy which is a medical emergency

lower ab, pelvis or shoulder pain with bleeding or spotting

Question 7

What areas refer pain to the left shoulder?

Answer 7

pancreas, spleen (Kher’s sign)

Question 8

What areas refer to right shoulder?

Answer 8

peptic ulcer, cholecystitis, MI, liver

Question 9

What areas can refer pain to either shoulder?

Answer 9

kidney, lung, gyno, MI

Question 10

What are 5 big DD of the shoulder?

Answer 10

MI, ligamentous instability, central cord, pancoast tumor, brachial plexus

Question 11

What major area near shoulder area is affected by ligamentous instability?

Answer 11

alar and transverse ligament

Question 12

What are causes of lig. instability?

Answer 12

trauma, RA, AS, oral contraceptive use, down syndrome pts

Question 13

What are signs and sx of central cord syndrome?

Answer 13

incontinence, balance and gait issues due to LE tone, UE can have numbness and atrophy

Question 14

What is number one cause of a pan coast tumor?

Answer 14

over 50 and SMOKING

starts as nagging pain and then is a constant burning

Question 15

What are sx of brachial plexus injury?

Answer 15

numbness, pain at rest, tenderness of mm that is innervated by damaged nerves, motor and sensory patterns that follow peripheral pattern

Question 16

What nerve damage can present as MS?

Answer 16

spinal accessory, axillary, long thoracic, suprascapular

Question 17

What will pt present with if damage to spinal accessory nerve?

Answer 17

unable to shrug shoulders, weak ABD, dropping of shoulder, no scap stabilization

Question 18

What will pt present with if damage to axillary nerve?

Answer 18

weak abd and flexion, sensory loss at deltoid insertion

Question 19

What will pt present with if damage to long thoracic nerve?

Answer 19

SA weakness, loss of scap humero rhythm

usually from recent trauma or unexpected chest surgery

Question 20

What will pt present with if damage to suprascaoular nerve?

Answer 20

looks like a RC injury but will never get better, weakness of ABD and ER, deep poor localized pain

Question 21

What muscles are most commonly affected by a long flexor tendon rupture?

Answer 21

pronator teres, FCR, palmaris longus, FCU

Question 22

What will a grade 1-3 tendon rupture present with?

Answer 22

1. will likey never see bc it will only last a couple of days
2. tender, pain, hematoma, pain with motion or stretch
3. loss of motion, palpable defect, no power of movement

Question 23

How can someone get a space infection of the hand?

Answer 23

recent puncture, cut, scrape, resulting in swelling, pain, tenderness, and warmth

Question 24

How can you differentiate between an MS injury of hand or infection?

Answer 24

pt will likely have a fever, chills malaise and weakness

Question 25

Which diseases are likely to cause Raynaud’s?

Answer 25

RA, occlusive lung disease, smoking and BB use

Question 26

What is important to remember about Raynauds pts?

Answer 26

can’t use ice as a modality with them

Question 27

What are best ways to treat CRPS?

Answer 27

calm down sympathetic nervous system and aggressively treat swelling and mobility

Question 28

What are primary risk factors to fractures?

Answer 28

trauma, osteoporosis, steroid use( autoimmune pts and lung pts), DM

Question 29

What types of fx are common with FOOSH?

Answer 29

radial head, colles, scaphoid, lunate

Question 30

What motions are impaired with a radial head fracture?

Answer 30

can’t supinate or pronate and may have elbow pain

Question 31

What motion will increase pain in a colles fracture?

Answer 31

wrist extension

Question 32

What are sx of scaphoid fx?

Answer 32

anatomical snuff box pain, trouble griping, not making any gains in PT

Question 33

What is gold standard for catching a scaphoid fx?

Answer 33

MRI,

X ray will likely miss it