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MSK Year 3 > Shoulder and Elbow Problems > Flashcards

Shoulder and Elbow Problems Flashcards

Upper Limb Fractures Shoulder Dislocations Frozen Shoulder Rotator Cuff Injury Arthritis Golfer and Tennis Elbow

1
Q

Which shoulder/elbow injuries are common in teenagers?

A

Fractures

Instability

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2
Q

Which shoulder/elbow injuries are common around age 30-40s?

A

Rotator Cuff

Capsulitis

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3
Q

Which shoulder/elbow injuries are common in 50s and 60s?

A

Impingement

Acromioclavicular joint

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4
Q

Which shoulder/elbow injuries are common in 70s?

A

Degenerative rotator cuff and joints

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5
Q

Cause of upper limb fractures in the young

A

High enery impact

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6
Q

Causes of upper limb fractures in elderly

A

Osteoporotic injury

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7
Q

What is the incidence of the 3 types of shoulder dislocation>

A

Anterior - 90%
Posterior - 9%
Inferior - 1%

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8
Q

What can cause posterior shoulder dislocation?

A

Electrocution

Seizures

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9
Q

What is a common risk to those who have dislocated their shoulder under 20 years of age?

A

Recurrent instability

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10
Q

What is a bankart tear/lesion and what risk does it have?

A

Tear in the labrum

Increases risk of further dislocation in younger patients

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11
Q

Treatment for shoulder dislocation

A

Manipulation
Immobilisation
Physiotherapy
Surgery

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12
Q

A painful arc on abduction of the shoulder suggests which shoulder pathology?

A

Subacromial impingement

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13
Q

According to Bigliani 1991 subacromial impingement is pain and dysfunction caused by which 2 changes?

A

Decreased volume in the subacromial space

Increased content

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14
Q

What can cause a decrease in volume in the subacromial space?

A

Extra bone - irritates the tendon –> pain

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15
Q

What can lead to an increase of content in the subacromial space resulting in a painful arc?

A

Swollen bursa

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16
Q

What is the treatment for subacromial impingement?

A

Steroid injection
Physiotherapy - rehab of rotator cuff
Arthroscopic subacromial decompression

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17
Q

Frozen shoulder is a condition also known as…?

A

Adhesive Capsulitis

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18
Q

Signs and symptoms of frozen shoulder

A

Pain - constant, affects sleep
Can bend to 90 degrees passively
External rotation less than 50% of normal unaffected side

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19
Q

Name 3 differentials for shoulder pain

A

Infection
Calcific tendonitis
Frozen shoulder

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20
Q

Treatment for early presentation of frozen shoulder

A

Hydrodilatation
Saline
Steroid injection

21
Q

Further management of frozen shoulder- late presentation

A

Surgery
Physio
Steroid injection

22
Q

Acute treatment for rotator cuff injury

23
Q

Treatment for chronic degenerative rotator cuff injury

A

Surgery if symptomatic

24
Q

What type of surgery is used for treating rotator cuff injury?

A

Superior Capsular Reconstruction

25
Q

How is the capsule reconstructed in a superior capsular reconstruction surgery?

A

Cadaveric skin graft on glenoid and humeral head

26
Q

Which tendon is irreparable in surgery for rotator cuff injury?

A

Supraspinatus tendon

27
Q

3 causes of shoulder arthritis

A

Osteoarthritis
Inflammatory arthritis
Post-trauma arthritis

28
Q

Treatment of shoulder arthritis

A

Humeral head replaced

29
Q

What is paramount before initiating treatment (humeral head replacement) for shoulder arthritis?

A

Integrity of the rotator cuff - will wear out replacement joint if unstable

30
Q

How may surgery to treat arthritis in the shoulder be reversed?

A

Shoulder replacement - maximise deltoid function

31
Q

Which elbow injuries are common in younger patients?

A

Fractures and dislocations

32
Q

Which elbow injuries are common in middle aged patients?

A

Tendinopathies

33
Q

What is the main cause of elbow injuries in elderly patients?

A

Degenerative

34
Q

Sign of cubital tunnel syndrome

A

Pain and paraesthesia in ulnar region

35
Q

Management of cubital tunnel syndrome

A

Decompress ulnar nerve

36
Q

Why would occupation be an important part of history in cubital tunnel syndrome?

A

Positional ulnar nerve compression- constantly flexed elbow?

37
Q

Site of pain in golfers elbow

A

Pain on inside of forearm

38
Q

Site of pain - tennis elbow

A

Pain on outside of forearm

39
Q

Management of golfers/tennis elbow

A

Steroid injection

Avoid surgery

40
Q

What type of blood is steroid injection derived from?

A

Horse blood

41
Q

Where is steroid injection directed?

A

Site around painful tendon

42
Q

Role of platelets and GF in management of golfers/tennis elbow?

A

Healing response in deep part of degenerative tendon

First line treatment

43
Q

Subscapularis inserts into…

A

Lesser tuberosity of humerus

44
Q

Name given to socket

45
Q

Coracoid process - which muscles attach

A

Coracobrachialis

46
Q

What articulates at the capitellum?

A

Radius with humerus

47
Q

What articulates at trochlea?

48
Q

3 pathologies of rotator cuff

A

Tendinitis
Bursitis
Rotator Cuff tear - supraspinatus most common and in tendinitis also

49
Q

Painful arc typical to supraspinatus tendinitis

A

60 to 120 degrees

MSK Year 3 (8 decks)

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