Shoulder Flashcards
Where is the most common site of clavicular fractures?
Middle 3rd of clavicle
What happens to arm position in a mid-clavicular fracture?
Medial segment elevated (sternocleiodomastoid muscle) Shoulder drops (trapezius muscle unable to hold lateral segment up) Arm pulled medially (pect major)
What nerves can be damaged in a mid-clavicular fracture?
Suprascapular
Subraclavicular (C3&4)
What is a rotator cuff tear?
Tear to one or more of the tendons of the 4 rotator cuff muscles of the shoulder
Impairs; abducting, internally and externally rotating the humerus
What causes rotator cuff tears?
Mainly chronic - extended use with other factors
Degenerative micro-trauma model
Age related
What is the most common presentation of rotator cuff muscle tears?
Anterolateral shoulder pain radiating down the arm
Weakness of shoulder abduction and movement above horizontal plane
What is impingement syndrome?
When supraspinatus tendon impinges on the catacombs-acromial arch leading to irritation and inflammation.
Worsened when shoulder is flexed or abducted resulting in a in weakness and reduced range of motion
What causes impingement syndrome?
Anything that narrows the space
Thickening of carococromial ligament
Inflammation of supraspinous tendon
Subcritical osteophytes
What is the painful arc?
Caused by impingement syndrome of supraspinatus tendon
During abduction of shoulder between 60 and 120 degrees
What is calcified supraspinatus tendinopathy?
Macroscopic deposits of hydroxyapatite in the tendon (mainly supraspinatus)
How does supraspinatus tendinopathy present?
Chronic pain aggravated by abducting or flexing arm above shoulder
Mechanical symptoms; snapping/ catching
How does calcific tendopathy develop?
Local hypoxia
Tenocytes to chondrocytes that lay down cartilage
Ca deposits formed
Ectopic bone formation
What is the most common joint of OA in the shoulder?
Acromioclavicular
What is another name for adhesive capsulitis?
Frozen shoulder
What is adhesive capsulitis?
Capsule of glenohumeral joint becomes inflamed and stiff greatly restricting movement and causing chronic pain
What type of pain is present with adhesive capsulitis?
Constant that is worse at night, with movement and cold weather
What are risk factors of adhesive capsulitis?
Female
Diabetes mellitus
Trauma to shoulder
Connective tissue disorders
What is the most common direction for a shoulder dislocation?
Anterior
Dislocates anterioinferioly (due to weak inferior aspect) Pulled anteriorly due to ligament disruption and muscle pull
How do anterior shoulder dislocations occour?
Arm abducted and externally rotated and arm forced posteriorly
Direct blown to posterior
What is a Bankart lesion/ labra tear?
When the force of the humeral head popping out of the socket causes part of the glenoid labrum to be torn off
What is a Hill-Sachs lesion?
Indentation fracture in the posterolateral humeral head
Caused by the humeral head dislocating anteriorly and the posterior aspect becoming jammed on anterior lip of glenoid fossa
What position is the arm held in with an anterior shoulder dislocation?
External rotation
Abduction
What position is the arm in with a posterior shoulder dislocation?
Internally rotated
Adducted
Prominent caracoid process
What mechanisms cause posterior shoulder dislocations?
Violent muscle contractions (epilepsy/ lightening strike)
Blow to anterior shoulder
Arm flexed across body and pushed posteriorly
