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Clin Med 1 - Exam 5 > Shoulder > Flashcards

Shoulder Flashcards

1
Q

Physical exam signs of bicep tendon tear

A
  • Popeye sign: bulge in lower arm at rest
  • Tenderness in bicipital groove
  • Luddington test: patient contracts both biceps, provider palpates for lack of contraction
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2
Q

Physical exam signs of rotator cuff tendinopathy

A
  • Subacromial tenderness
  • Decreased active ROM (passive ROM ok)
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3
Q

What condition is associated with gradual onset superior/lateral shoulder pain, especially while laying on the affected side as well as pain with overhead/arm-length activities with no history of a traumatic event

A

Rotator cuff tendinopathy

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4
Q

SLAP lesion treatment

A

Surgical debridement
- injury more common in younger athletes, do need surgery to get back

(Non-surgical usually unsuccessful)

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5
Q

Most common risk factor for frozen shoulder (adhesive capsulitis)

A

Diabetes

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6
Q

Nerve most likely to be compromised in a humeral shaft fracture and how to assess for it

A

Radial nerve
- check ability to extend wrist or fingers
- check sensation over dorsum of hand

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7
Q

Two primary groups who get proximal humerus fractures

A

Young and the elderly

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8
Q

Joints to assess for injury after diagnosing a humeral fracture

A

Shoulder and elbow

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9
Q

Name of fracture of posterior humeral head, associated with shoulder instability

A

Hill-Sachs

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10
Q

Rotator cuff muscle most commonly affected by tendinopathy

A

Supraspinatus

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11
Q

Humeral shaft fracture treatment

A

Most are non-surgical

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12
Q

Two tests for bicep tendinopathy and SLAP lesion

A
  • Speed’s test
  • Yergason’s test
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13
Q

Bicep tendon ruptures are more common in this gender and age

A

Men aged 40-60

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14
Q

Describe thoracic outlet syndrome

A
  • Nerves and vessels impinged by scalenes against first rib
  • Brachial plexus, axillary artery, and subclavian vein pass through there
  • Can be from whiplash injury or extra muscles
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15
Q

Thoracic outlet syndrome treatment

A
  • PT
  • Weight loss
  • Decompression
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16
Q

Most common types of shoulder instability

A
  • Anterior (injury)
  • MDI (condition)
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17
Q

Name of lesion seen on shoulder x-rays as a bony defect at edge of glenoid rim, associated with shoulder instability

A

Bankart lesion

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18
Q

A patient with a history of shoulder trauma/throwing presents with a feeling of the shoulder “slipping out” when arm is abducted and externally rotated (apprehension test). What do they likely have?

A

Anterior shoulder instability

(MDI not associated with trauma)

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19
Q

Symptoms of SLAP lesions

A
  • Pain with overhead activities (most common)
  • Popping, clicking, catching in shoulder
20
Q

What is a SLAP lesion?

A

Labral tear

SLAP = Superior Labrum Anterior to Posterior

Biceps long head originates from the glenoid labrum

21
Q

Diagnosis of thoracic outlet syndrome

A

Diagnosis of exclusion

22
Q

Best imaging method for rotator cuff tendinopathy after x-ray has excluded osteoarthritis

A

MRI

23
Q

Most common ages for frozen shoulder (adhesive capsulitis)

A

40 to 60

24
Q

Treatment of shoulder instability

A

Acute dislocation
- Reduction asap
Repeat dislocations
- Surgery
MDI
- PT
- Avoid positions of known instability

25
Q

How to differentiate between rotator cuff tendinopathy and frozen shoulder (adhesive capsulitis)

A

Range of motion

Rotator cuff: decreased AROM
Frozen shoulder: decreased AROM and PROM

26
Q

How to differentiate anterior shoulder instability from frozen shoulder (adhesive capsulitis)

A

Onset

  • Anterior shoulder instability: acute
  • Frozen shoulder: gradual
27
Q

Treatment of frozen shoulder (adhesive capsulitis)

A

Conservative treatments best
- NSAIDs only work early on
- PT
- Injections

(no surgery)

28
Q

Which condition is associated with intense scarring, thickening, and contraction of shoulder ligaments leading to loss of active and passive ROM

A

Frozen shoulder (adhesive capsulitis)

29
Q

Symptoms of a bicep tendon rupture

A
  • Sudden pain in anterior shoulder
  • May hear/feel a snap
  • Ball of muscle down by elbow (popeye sign)
30
Q

Treatment of choice for most patients with a bicep tendon rupture

A

Non-surgical best for most patients
- PT for strength and ROM
- Steroid injections

Surgical repair for younger athletes, or laborers who needs strength (old people can live with it and more common in older men)

31
Q

SLAP lesion best imaging method

A

MRI

32
Q

How to differentiate between rotator cuff/shoulder osteoarthritis and SLAP lesions

A

Age

  • SLAP lesions <35
  • Rotator cuff/osteoarthritis >35
33
Q

Three phases of frozen shoulder (adhesive capsulitis)

A

Freezing phase
- 4 to 20 months
- pain at deltoid insertion, night pain
- decreased ROM, especially external rotation
Frozen phase
- 4 to 12 months
- more stiffness, less pain
Thawing phase
- 5 to 24 months
- gets better on its own, can recur

34
Q

Most common symptoms in thoracic outlet syndrome

A

Neurogenic symptoms in arm
- Pain, dysesthesia, weakness, numbness

(nerves easily irritated, take a long time to calm down)

35
Q

Which area of the clavicle is most commonly fractured?

A

Middle third (diaphysis)

36
Q

Are bicep tendon ruptures more commonly in the long or short head?

A

97% in the long head

(rubs in bicipital groove of humerus over time)

37
Q

Four muscles of the rotator cuff

A
  • Supraspinatus
  • Infraspinatus
  • Teres Minor
  • Subscapularis
38
Q

How to differentiate clavicular fracture from AC joint separation?

A
  • X-ray
  • Maybe crepitus in fracture
39
Q

A patient has superior shoulder pain after falling on their lateral shoulder. There is pain to palpation over the AC joint and they have decreased ROM. What condition might they have?

A

AC Joint separation (separated shoulder)

(may need x-ray to differ from clavicular fracture)

40
Q

Imaging methods for bicep tendon ruptures

A
  • MRI
  • Ultrasound good if complete tear
41
Q

Clavicle fracture treatment

A

Non-surgical
- Figure of 8 brace
- PT for ROM
- Will heal but look deformed
Surgical
- for more active patients
- or open fractures/n/v damage

42
Q

Are rotator cuff injuries more common in patients under or over the age of 40?

A

Over 40

43
Q

Are rotator cuff tears more commonly due to acute injury or degeneration?

A

More commonly degeneration from chronic impingement

44
Q

Best treatments for rotator cuff tendinopathy

A
  • Avoidance of aggravating activities
  • PT
45
Q

Why can we only give a limited total number of glucocorticoid injections to any patient with joint pain?

A

Cortisone destroys collagen in the body and will degrade the joint

Clin Med 1 - Exam 5 (13 decks)

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