Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3(S) - T & O > Shoulder + Humeral Fractures > Flashcards

Shoulder + Humeral Fractures Flashcards

1
Q

What is the most common shoulder dislocation?

A

Anterior (95%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does a shoulder dislocation present?

A

Loss of normal shoulder contour
Squaring of shoulder
Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What imaging views do you get to assess a shoulder dislocation?

A

X-ray AP, lateral and scapula Y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the best radiological image to assess whether a shoulder is anterioly or posteriorly dislocated?

A

Scapula Y view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What nerve is most at risk in a shoulder dislocation?

How is it assessed?

A

Axillary nerve

Regimental badge. Region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What usually causes posterior shoulder dislocations?

A

Seizures
Electrocutions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does a posterior shoulder dislocation appear on x-ray?

What does the limb look like on examination?

A

Light bulb sign

Internally rotated upper limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you manage a shoulder dislocation?

A

Analgesia
Reduce shoulder
Immobilise in a sling
Physio

Take post reduction imaging and re assess neurovascular status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some techniques of shoulder relocation?

A

Kochers
Hippocratic manouvre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some complications of shoulder dislocations and relocations?

A

Bony bankart lesions
Hillsacks lesions

Recurrent dislocations
Axillary nerve palsy
Rotator cuff injury
Adhesive capsulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a bankart lesion?
Bony and non bony

A

Bony = Fracture of anteroinferior glenoid

Usually following shoulder relocation

Non bony = avulsion/damage to anterior glenoid labrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a Hillsachs lesion?

A

H for humeral head

Posterolateral fracture of Humeral Head due to Impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is considered an acute rotator cuff injury?

A

Less than 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is considered a chronic rotator cuff injury?

A

More than 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 4 rotator cuff muscles?

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the function of each of the rotator cuff muscles?

A

Supraspinatus = abduction
Infraspinatus = external rotation
Teres minor = external rotation and Adduction
Subscapularis = internal rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What test assess the function of Supraspinatus?

A

Empty can test

(Painful arc test for impingement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What test assess the function of infraspinatus and teres minor?

A

Arms flexed at 90 degrees with elbow tucked at side and externally rotate against examiner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What test assess the subscapaularis muscle?

A

Hands behind back and patient pushes against examiners hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the pathophysiology of chronic rotator cuff tears?

A

Long term progressive micro tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the risk factors for rotator cuff injuries?

A

Repetitive over the head movements
Old
Trauma
Obesity
Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do rotator cuff tears present on examination?

A

Unable to abduct past 90 degrees
Tenderness over greater tuberosity
Sometimes Supraspinatus and Infraspinatus atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What imaging is done if a rotator cuff injury is suspected?

A

Urgent plain radiograph to exclude bony involvement

Then US to confirm presence and size of tear

MRI also can be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When are rotator cuffs managed conservatively?

A

If present within 2 weeks of injury

Not limited by pain or loss of function

Significant co-morbidity

25
Q

What is the conservative managemtn of rotator cuff tears?

A

Analgesia
Physio
Activity modification

26
Q

When are rotator cuff tears managed surgically?

A

Present after 2 weeks since injury occured

Too painful
Tear to large
Conservative failed

Can be arthroscopic or open repair

27
Q

What is adhesive capsulitis?

A

When the Glenohumeral joint capsule becomes adherent to the humeral head causing a frozen shoulder

28
Q

What causes adhesive capsulitis?

A

Primary = idiopathic

Secondary = rotator cuff tendinopathy, subacromial impingement, biceps tendinopathy, previous. Surgery or trauma

29
Q

What is the most common presentation of adhesive capsulitis?

A

Woman 40-70

Deep constant shoulder pain
Reduced ROM
Deltoid atrophy
Loss of arm swing

30
Q

What are the 3 stages of adhesive capsulitis?

A

Freezing
Frozen
Thawing

31
Q

What is the timeline for the 3 stages of adhesive capsulitis?

A

Freezing (2-9months)
Frozen (4-12months)
Thawing (12-24months)

32
Q

What is the presentation at each stage of adhesive capsulitis?

A

Freezing (constant increasing pain with decreasing movement)
Frozen (extremely painful cant move)
Thawing (pain relieving and movement increasing)

33
Q

What imaging can be used for adhesive capsulitis?

A

X-ray to rule out ACJ involvement or atypical fracture presentations

MRI is good however imaging is not actually required since its a clinical diagnosis

34
Q

What imaging can be used for adhesive capsulitis?

A

X-ray to rule out ACJ involvement or atypical fracture presentations

MRI is good however imaging is not actually required since its a clinical diagnosis

35
Q

What diseases is adhesive capsulitis common with so what can you measure when investigating?

A

Diabetes (HbA1c)

Autoimmune thyroid disease (TSH)

36
Q

What is the managemtn for adhesive capsulitis?

A

Physio during thawing phase
Analgesia

Intra-articular corticosteroid injections

Surgical =manuipulation under anaesthesia

37
Q

What is the subacromial space?

A

Space between coracoacromial arch/ligament, humeral head and greater tuberosity of the humerus

38
Q

What causes subacromial impingement syndrome?

A

Repetitive shoulder movements leading to micro traumas to the rotator cuff tendons

Bursitis
Degenerative tendiopathy
Muscular weakness leading humerus to shift medially

39
Q

Who does subacromial impingement syndrome occur most commonly in?

A

Active individuals
Manual professions

40
Q

How does a subacromial impingement present?

A

Progressive pain ini anterior superior shoulder

Pain exacerbated by abduction

41
Q

What test can be used to check for subacromial impingement?

A

Hawkins test

42
Q

How do you manage subacromial impingement syndrome?

A

Analgesia, physio, NSAIDS, corticosteroid joint injections

Surgery

43
Q

When is subacromial impingement syndrome managed surgically?

What can be done?

A

If persists 6months after conservative management tried

Direct repair of Muscularis tears
Remove subacromial bursa
Remove section of acromion

44
Q

How does an ACJ dislocation present?

A

Pain over the AC joint

Can have skin tenting

45
Q

What test is positive in ACJ dislocation?

A

Scarf test

46
Q

What is the scarf test?

A

Hand on opposite shoulder and you push the elbow back

47
Q

How is ACJ dislocation managed?

A

Briefly immobilise

Want to mobilise again ASAP

ORIF for skin tenting or. Failed conservative management

48
Q

What are the risk factors of humeral shaft fractures?

A

Osteoporosis
Increasing age female
Previous fractures

49
Q

What nerve is at risk in a humeral shaft fracture?

A

Radial nerve

50
Q

How can you assess radial nerve damage with humeral shaft fractures?

A

Finger extension against resistance

Dorsum 1st web space

51
Q

How do you manage a humeral shaft fracture?

A

Reduce fracture
Brace

Surgical: ORIF (with plate)
Or IM nail

52
Q

What age group are supracondylar humeral fractures most common in?

A

Young children

53
Q

What is the method of injury that usually leads to a supracondylar fracture?

A

FOOSH with extended elbow

54
Q

What nerves and artery are at risk with a supracondylar humeral fracture?

A

Anterior interosseous nerve of median nerve (most common)

Radial and ulnar nerve

Brachial artery

55
Q

How does a patient with a supracondylar fracture present?

A

Pain
Deformity
Bruising
Swelling
Nerve palsy.

56
Q

What imaging is required to assess a supracondylar fracture?

A

Plain radiograph AP and lateral

CT may be required if comminuted or Intra articular fractures suspected

57
Q

What sign is often seen on plain radiograph of supracondylar fractures?

A

Posterior fat pad sign

58
Q

Why does the anterior interosseous nerve get damaged in a supracondylar humerus fracture despite itts branch being given off more distal?

A

The AIN fibres are arranged posteriorly within the the median nerve

59
Q

How are supracondylar fractures managed?

A

Immediate closed reduction if NV status compromised

Closed reduction and K wire fixation

Above elbow cast

Y3(S) - T & O (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions