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Rachel Flash cards > Shoulder MSK > Flashcards

Shoulder MSK Flashcards

1
Q

Deltoid

A

C5,6, Posterior cord, Axillary nerve

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2
Q

Pec Major

A

C5,6,7,8,T1, Medial and lateral pectoral nerves

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3
Q

Biceps Brachii

A

C5,6, Lateral cord, Musculocutaneous nerve

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4
Q

Coracobrachialis

A

C5,6, Lateral cord, Musculocutaneous nerve

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5
Q

Latissimus Dorsi

A

C6,7,8, Posterior cord, thoracodorsal nerve

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6
Q

Teres Major

A

C5,6, Posterior cord, lower subscapular nerve; does whatever the lats do

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7
Q

Triceps

A

C6, 7,8, Posterior cord, Radial Nerve

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8
Q

Pectoralis Major

A

C5,6,7,8,T1, medial and lateral pectoral nerves

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9
Q

Shoulder flexion

A

Anterior deltoid, pectoralis major, Biceps, Coracobrachialis

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10
Q

Shoulder extension

A

Posterior deltoid, latissimus dorsi, teres major, triceps, pectoralis major

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11
Q

Shoulder abduction

A

middle deltoid, supraspinatus

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12
Q

Supraspinatus

A

C5,6, upper trunk, suprascapular nerve

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13
Q

Infraspinatus

A

C5,6, upper trunk, suprascapular nerve

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14
Q

Shoulder adduction

A

pectoralis major,

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15
Q

Inferior GH ligament

A

primary anterior ligament stabilizer above 90 degrees; prevents antero-inferior dislocations of humerus

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16
Q

Loose ligaments of shoulder , hyper mobile people what type of strengthening

A

isometric , not much movement of humeral head

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17
Q

triceps attachement

A

infraglenoid tuberosity

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18
Q

biceps long and short head attachments

A

long head- supraglenoid tuberosity

short head- coracoid process

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19
Q

shoulder internal rotation

A

subscapularis, teres major, lats

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20
Q

shoulder extension

A

rear deltoid, lats, teres major, triceps

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21
Q

Traumatic shoulder dislocation— TUBS

A

traumatic, unidirectional, bankhard, surgery

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22
Q

Atrauamtic shoulder dislocation- AMBRI

A

atraumatic, multidirectional, bilateral, rehab, if surg requred inferior capsular shift

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23
Q

Flex arm to 90 deg and internally rotate, then adduct arm across body, while pushing humerus posteriorly

A

jerk test- pt will jerk away if possible

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24
Q

flex arm upward and apply posterior inferior force (dont have to adduct or internally rotate)

A

Kim test

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25
Q

O brien

A

labral tear, supinating feels better than palm down against resistance

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26
Q

Posterior cutaneous nerve of thigh nerve roots

A

(S1-S3) part of sacral plexus.

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27
Q

Innervation of levator scapulae

A

Dorsal scapular

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28
Q

Function of piriformis

A

The piriformis muscle abducts, externally rotates, and extends the hip

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29
Q

Biceps femoris long head action

A

adducts hip

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30
Q

which carpal bone crosses both proximal and distal carpal rows

A

The scaphoid bone is the only carpal bone that crosses both carpal rows.

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31
Q

Function of iliofemoral ligament

A

The iliofemoral ligament is the strongest ligament of the body and limits extension, abduction, and external rotation of the hip.

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32
Q

Floor, roof, medial and lateral walls of Guyon’s canal

What structures traverse through Guyon’s canal ?

A

The floor- transverse carpal ligament
the roof is the volar carpal ligament
medial and lateral walls are formed by the pisiform and hook of hamate.

The canal houses both the ulnar nerve and the ulnar artery. Fractures or masses (eg, ganglion cyst) can compress the nerve or artery at this location.

33
Q

The Lisfranc ligament connects what structures?

A

the base of the medial cuneiform to the base of the second metatarsal. It is injured or disrupted in a Lisfranc fracture.

34
Q

Function of Peroneus tertius

A

dorsiflexes and everts the foot.

35
Q

Function of Peroneus brevis

A

everts and plantar flexes the foot.

36
Q

Function of tib anterior

A

ankle dorsiflexor and invertor.

37
Q

Synovial joint types

A 
Ball-and-socket joints (eg, hip joint [multiaxial], provide the most ROM. 
The saddle joint is a biaxial joint that provides the second most ROM. 
Hinge (elbow-uniaxial)
Pivot (atlanto-axial joint-uniaxial)
Condyloid joints (metacarpophalangeal joints-biaxial)
Plane joints (acromioclavicular).
38
Q

Function of semitendinosis

A

Internal rotation of hip

39
Q

Obturator internus, Quad fem, Superior gemellus, glut max are all

A

External rotators of hip

40
Q

Normal ROM of ankle

A

Normal ROM for the ankle is 50° of plantar flexion and 20° of dorsiflexion.

41
Q

dorsal interroseous muscle function

A

abduct the digits and MCP flexion.

42
Q

ACL function

A

It draws the femoral condyles anteriorly during flexion

Prevents hyperextension of the knee and backward sliding of the femur

Internal rotation of the femur tightens it, and external rotation loosens it

43
Q

Prevents hyperextension of the knee and backward sliding of the femur

A

ACL

44
Q

Internal rotation of the femur tightens it, and external rotation loosens it

A

ACL

45
Q

It draws the femoral condyles anteriorly during flexion

A

ACL

46
Q

The main flexor of the forearm

A

is the brachialis muscle (originates at the lower half of the anterior humerus and inserts at the ulnar tuberosity)

47
Q

4 compartments of lower leg

A

The deep posterior, superficial posterior, lateral, and anterior compartment makes up the four compartments of the lower leg.

No medial compartment

48
Q

Borders of carpal tunnel

A

The roof of the carpal tunnel is formed by the transverse carpal ligament; the floor is formed by the central carpal bones. The medial wall is formed by the hamate and the pisiform bones. The lateral wall is formed by the trapezius and scaphoid bones.

49
Q

Which ligament can be mistaken for a tear of the posterior horn of the lateral meniscus on MRI?

A

Arcuate popliteal ligament complex

50
Q

Arm and forearm articulations

A

The radial head articulates with the capitellum and the ulna articulates with the trochlea.

51
Q

Dorsal compartments of hand

A 
I-extensor pollicis brevis, abductor pollicis longus;
II-ECRB, ECRL
III-EPL
IV-ED, EI
V- EDM
VI- ECU
52
Q

Tensor fasciae lata
Gluteus medius
Gracilis
are all

A

External rotators of the hip

53
Q

AC ligament sprained, CC intact

AC joint intact without clavicular displacement

A

Type 1 AC joint separation, rehab

54
Q

Complete tear AC
CC ligament sprained
AC joint disrupted with slight widening and mildly elevated

A

Type II, rehab

55
Q

Complete tear AC
Ruptured CC
Clavicle elevated above superior border of the acromion

A

Type III, +/- surgery

56
Q

Complete rupture AC
Complete Rupture CC
Clavicle displaced POSTERIORLY and superiorly

A

Type IV, Surgery

57
Q

Complete rupture AC
Complete rupture CC
CC distance more than 100% of opposite side with severe shoulder droop on exam

A

Type V, surgery

58
Q

Complete rupture AC, Complete rupture CC, distal clavicle inferior to coracoid

A

Type VI, rare, surgery

59
Q

Jerk test (opposite of apprehension)

A

posterior GH instability, place arm in 90 deg flexion and max internal rotation with elbow flexed 90 degrees, adduct the arm across the body in the horizontal plane while pushing the humerus in a posterior direction.The patient will jerk awy when arm nears midline to prevent sublux.

60
Q

shoulder fusion position

A

50 deg abduction 30 deg forward flexion 50 deg internal rotation

61
Q

ROM to go first with adhesive capsulitis

A

external rotation and abduction

62
Q

Most common area of humerus fx

A

surgical neck

63
Q

in fracture at surgical neck what muscle is the principal abductor

A

supraspinatus (causes abduction of the proximal fragment of the humerus)

64
Q

surgical neck fx axillary nerve may be injured, affecting which muscles and sensation distribution?

A

deltoid, teres minor, sensation of lateral arm/shoulder

65
Q

AVN from humeral neck fractures secondary to interruption of the

A

humeral circumflex artery

66
Q

little leagers shoulder

A

stress fx of epiphyseal growth plate in the proximal humerus

67
Q

Proximal humerus fractures classification and treatment

A

Proximal humerus fractures are classified using the 4-part classification system.

In 1-part fractures, the humerus remains as one whole part (intact), with no elements displaced off the humerus. These are treated with a sling.

In 2-part fractures, one of the 4 “parts” (greater and lesser tuberosities, humeral head, humeral shaft) is displaced from the other 3, thus leaving 2 “parts” of bone existing in the proximal arm: the displaced fragment and the still intact other 3 parts.

In 3-part fractures, 2 of these parts are broken off

In 4-part fractures, all 4 of these parts are separated from one another. 2-4 part fractures require surgery,

68
Q

Roos test

A

abduct and externally rotate their shoulders to 90 degrees and then begin opening and closing their hands over a 3-minute period….neurogenic thoracic outlet syndrome, lower brachial plexopathy

69
Q

Hill Sach’s lesion treatment

A

referral to ortho

A true glenohumeral dislocation with an associated Hill Sachs lesion is an indication of instability of the shoulder joint. Absolute indications for an early orthopaedic consultation include a humeral head articular surface osseous defect of greater than 25%, greater than 50% rotator cuff tear, glenoid osseous defect greater than 25%, humeral head articular surface osseous defect greater than 25%, proximal humerus fracture requiring surgery, irreducible dislocation, interposed tissue or nonconcentric reduction, failed trial of rehabilitation, inability to tolerate shoulder restrictions, or inability to perform sport-specific drills without instability.

70
Q

Absolute indications for an early orthopaedic consultation i

A

humeral head articular surface osseous defect of greater than 25%, greater than 50% rotator cuff tear, glenoid osseous defect greater than 25%, humeral head articular surface osseous defect greater than 25%, proximal humerus fracture requiring surgery, irreducible dislocation, interposed tissue or nonconcentric reduction, failed trial of rehabilitation, inability to tolerate shoulder restrictions, or inability to perform sport-specific drills without instability.

71
Q

SLAP vs anterior-inferior labrum tear

A

question 109 in certification q bank

This patient presents with an anterior-inferior labrum tear related to chronic unidirectional anterior shoulder instability following a prior traumatic event (dislocation). This type of instability is common after a traumatic event as opposed to multidirectional instability, which is associated with congenital laxity or chronic repetitive microtrauma. Anatomically, unidirectional anterior instability involves disruption in the anterior-inferior glenohumeral joint capsule and anterior-inferior labrum with or without associated bony injury to the glenoid rim (Bankhart lesion) and humeral head (Hill-Sachs deformity). Superior labral anterior to posterior (SLAP) lesions may occur, but that possibility is less likely in this patient, because of his history and a negative O’Brien compression test.

72
Q

Muscles that
tilts the glenoid cavity inferiorly:

tilt the cavity superiorly:

A

The levator scapula and rhomboids

Serratus anterior and trapezius

73
Q

Three important spaces of the shoulder that are bordered by the triceps include
quadrangular space
triangular space
triangular interval

A

The axillary nerve passes through the quadrangular space. The scapular circumflex artery passes through the triangular space. The radial nerve and profunda brachii artery pass through the triangular interval.

74
Q

quadrangular space borders

A

teres minor superiorly,
the long head of the triceps medially,
the teres major inferiorly,
and the surgical neck of the humerus laterally

axillary nerve passes through

75
Q

triangular space borders

A

inferior: teres major
lateral: long head of triceps
superior: lower border of teres minor

scapular circumflex artery passes through

76
Q

Triangular Interval Borders

A

superior: teres major
lateral: lateral head of the triceps or the humerus
medial: long head of the triceps

Contents profunda brachii artery and
radial nerve

77
Q

GH to scapulothoracic

Superior glenohumeral, middle glenohumeral and inferior glenohumeral ligament

A

120 deg/ 60 deg

2:1 ratio

78
Q

Rehab after shoulder athrodesis

Rehab after dislocated shoulder
The return of ROM should be gradual at about 10 degrees per week, which would put the return of ROM at 6-8 weeks.

A

Rehab for shoulder arthrodesis is slow, avoiding AROM until 8-12 weeks or more.

shoulder arthrodesis is 30 degrees abduction, 30 degrees flexion, 30 degrees internal rotation.

79
Q

clavicle fx common

A

middle 1/3

For Group 1, non-displaced fractures, ROM exercises can begin at 2-4 weeks.

Rachel Flash cards (24 decks)

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