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Clin Med 1 > Shoulder Injuries > Flashcards

Shoulder Injuries Flashcards

0
Q

inflammation associated with repetitive trauma during every day shoulder movement.
Risk factor: repetitive overhead activity

A

tendonitis

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1
Q

chronic degeneration of the muscles w/ age

pain despite lack of inflammation

A

tendonosis

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2
Q

pain that comes on gradually, deep ache in the lateral shoulder that radiates to the deltoid- point tenderness. Painful ROM, improves w/ analgesics

A

tendonitis

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3
Q

what can be the result of tendonitis progression, impingement, & degeneration?

A

Chronic tear of the rotator cuff

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4
Q

Shoulder pain that is worse at night. Worsening pain with gradual weakness. Weakness does not improve with analgesics. Decreased ROM, especially abduction

A

Chronic rotator cuff tear

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5
Q

what is the specialized exam for a chronic rotator cuff tear?

A

drop arm sign

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6
Q

acute shoulder pain w/ negative radiographs

A

acute tear

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7
Q

etiologies of acute tear (2)

A

trauma, pathology

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8
Q

What are the specialized exams for rotator cuff injuries? (6)

A

Apley’s scratch test, empty can test, lift off test, Hawkin’s test, Neer’s impingement sign

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9
Q

what is the most commonly involved muscle in rotator cuff injuries?

A

Supraspinatus

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10
Q

Treatment of a rotator cuff injury? (5)

A

ice anterolaterally, NSAIDs if appropriate
weighted pendulum stretching for 5 min to maintain ROM
restrict overhead motions
shoulder immobilizer for very short duration- PT afterwards
subacromial steroid injection- rest afterwards

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11
Q

stiffened glenohumeral joint

A

Frozen Shoulder/Adhesive Capsulitis

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12
Q

Chronic shoulder pain w/ decreased ROM, rigid immobility

A

Frozen shoulder/adhesive capsulitis

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13
Q

frozen shoulder tx (2)

A

intense PT to stretch the joint lining & restore ROM

some will require surgery to remove adhesions

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14
Q

shoulder pain w/ abduction, flexion, & internal rotation. Subacromial tenderness. Normal glenohumeral ROM, preserved strength

A

Shoulder impingement syndrome

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15
Q

shoulder impingement syndrome etiology

A

compression of the rotator cuff tendons & the subacromial bursa between the humeral head and lateral edge of acromion process

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16
Q

shoulder impingement syndrome complications? (3)

A

bursitis
rotator cuff tendonitis
degenerative changes

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17
Q

hallmark sign of shoulder impingement syndrome?

A

pain reproduced by the painful arc of flexion-internal rotation manuevers

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18
Q

tests for shoulder impingement syndrome? (3)

A

Neer’s, Hawkin’s impingement tests

MRI to r/o cuff tear

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19
Q

Shoulder impingement syndrome treatments (4)

A

ice, activity changes
NSAIDs
PT
possible corticosteroid injections

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20
Q

bump on the shoulder that is worse at bedtime, AC joint tenderness, pain increases w/ downward traction

A

Acromioclavicular Injury

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21
Q

injured in fall onto the tip of the shoulder w/ arm tucked into side

A

AC joint

22
Q

AC joint intact, capsular distension, ligament stretch (sprain)

A

Grade I AC Injury

23
Q

AC ligament is torn, coracoclavicular ligament intact. Unstable AC joint, decreased ROM

A

Grade II AC injury

24
Q

separation of superior and inferior AC ligaments & coracoclavicular ligaments. Clinical deformity, instability, pain, decreased ROM.

A

Grade III AC injury

25
Q

Acromioclavicular injury treatment (4)

A

Shoulder immobilizer for 3-4 weeks to allow ligaments to reattach
Ice, rest, NSAIDs
activity restrictions
corticosteroid injections if not improving after 2-4 weeks

26
Q

what is the usual clavicle fracture?

A

middle 1/3, displaces superiorly, & may be comminuted

27
Q

concern w/ distal clavicle fx?

A

brachial plexus involvement

28
Q

concern w/ proximal clavicle fx?

A

evaluate internal organs

29
Q

clavicle fx tx? (4)

A

conservative for nondisplaced or minimally displaced fxs in adults, nearly all peds
Sling/swatch, analgesics, muscle relaxers, sleeping upright

30
Q

clavicle fx healing?

A

most within 4-6 weeks, some 8-10 weeks

31
Q

clavicle fx ortho referral? (2)

A

displaced midclavicle fxs

all proximal and distal fxs

32
Q

inflammation, possible degeneration of bursa. Associated w/ repetitive movement or acute injury. May result from systemic disease

A

Subacromial bursitis

33
Q

inflammation, pain w/ ROM & rest, decreased ROM due to pain, localized tenderness to palpation

A

Subacromial bursitis

34
Q

subacromial bursitis treatment (3)

A

ice & NSAIDs
restriction of overuse
aspiration & corticosteroid injection

35
Q

inflammation of the long head of the biceps tendon as it passes through the bicipital groove, associated w/ repetitive lifting

A

Biceps tendonitis

36
Q

pain in the anterior shoulder w/ abduction and external rotation. Maximal point of tenderness along bicipital groove. Popping sensation, weakness

A

Biceps tendonitis

37
Q

specialized exams for biceps tendonitis? (2)

A

Yergason’s sign, Speed’s test

38
Q

Biceps tendonitis treatment? (4)

A

NSAIDs
rest
PT
Surgery for younger pts who are active

39
Q

shoulder instability, arm guarded, sulcus sign

A

glenohumeral subluxation/dislocation

40
Q

detachment of anterior inferior labrum from glenoid rim

A

Bankart lesion

41
Q

depression of the posterolateral humeral head when its impacted by anterior rim of glenoid

A

Hill Sachs lesion

42
Q

Apley scratch test? and what conditions it evaluates?

A

touch the opposite scapula to test shoulder ROM

frozen shoulder, rotator cuff

43
Q

Empty can test? and what conditions it evaluates?

A

resistance against forward flexion in hyperpronation (thumbs down), elbow extension, & abduction

rotator cuff: supraspinatus injury/tear

44
Q

lift off test? and what conditions it evaluates?

A

hand on back, shoulder internally rotated. Push against resistance

Rotator cuff: subscapularis injury

45
Q

Hawkin’s test? and what conditions it evaluates?

A

passive flexion to 90* & forceful internal rotation of the shoulder.
pain –> impingement –> rotator cuff concerns

rotator cuff, shoulder impingement syndrome

46
Q

Neer’s impingement sign? and what conditions it evaluates?

A

passive flexion w/ arm pronated & scapula stabilized. Empty can w/ assist to full ROM
pain –> subacromial impingement –> rotator cuff concerns

rotator cuff, shoulder impingement syndrome

47
Q

gradation of Neer’s test for shoulder impingement syndrome?

A

Pain at 90* = mild impingement
Pain at 60-70* = moderate impingement
Pain at 45* or below = severe impingement

48
Q

Cross over test? and what conditions it evaluates?

A

passive cross body adduction

AC injury

49
Q

Yergason test? and what conditions it evaluates?

A

elbow flex at 90* w/ forearm pronated. Supinate forearm & externally rotate humerus against resistance

Bicipital tendon assessment

50
Q

Speed’s test? and what conditions it evaluates?

A

arm extended in full supination w/ shoulder flexed. Elevate arm against resistance

bicipital tendon

51
Q

Apprehension & Relocation test? and what conditions it evaluates?

A

elbow flexed at 90, arm abducted at 90. Apply external rotation at the shoulder & note apprehension, pain

glenohumeral dislocation/subluxation

52
Q

Sulcus sign

A

arm in neutral, relaxed position. Provider will pull the arm downward, resulting in a depression or “sulcus” in the shoulder near the acromion.
Pt may show this voluntarily

glenohumeral instability

Clin Med 1 (18 decks)

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