shoulder pain Flashcards

1
Q

What is the function of supraspinatus?

A
  1. posterior scapula

2. abducts the humerus

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2
Q

What is the function of infraspinatus?

A

externally rotates the humerus

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3
Q

What is the function of Teres minor?

A

externally rotates the humerus

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4
Q

What is the function of subscapularis?

A

internally rotates the humerus

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5
Q

which muscles are innervated by the subscapular nerve?

A
  1. supraspinatus
  2. infraspinatus
  3. subscapularis
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6
Q

what is the innervation of Teres Minor?

A

axillary nerve

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7
Q

What is painful arc/shoulder impingement syndrome?

A

supraspinatus tendon becomes painfully impinged within the subacromial space

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8
Q

what is supraspinatus tendonitis?

A
  1. acute inflammation of the supraspinatus muscle causes an area of swelling
  2. during abduction, this swelling becomes painfully squashed under the acromion.
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9
Q

What is calcifying tendonitis?

A
  1. same presentation as supraspinatus tendonitis
  2. 20 - 40 years
  3. calcification is seen on x ray within the tendon
  4. Injection steriods helps relieve the calcification
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10
Q

what is subacromial bursitis?

A

subacromial bursa can become impinged as a result of inflammatory arthropathy

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11
Q

What are the clinical features of shoulder impingement?

A
  1. Pain on abduction (especially 60 - 120)
  2. nocturnal pain / worse of affected side
  3. loss of movement / weakness
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12
Q

what is the supraspinatus integrity test?

A

Empty can test

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13
Q

what is the integrity test for infraspinatus and teres minor?

A

resisted external rotation

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14
Q

what is the integrity test for subscapularis?

A

lift off test

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15
Q

what is the mechanism of a rotator cuff injury?

A
  1. degeneration or arthritis

2. young overhead throwers

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16
Q

what is most commonly damaged in rotator cuff injury?

A

supraspinatus tendon is most commonly damaged

17
Q

What are the methods of conservatively managing shoulder main?

A
  1. NSAIDs

2. Shoulder exercises / Physio

18
Q

what are the surgical management options of shoulder pain?

A
  1. open surgery

2. subacromial decompression or rotator cuff repair

19
Q

What is ‘Frozen shoulder’ / Adhesive capulitis?

A
  1. common idiopathic condition characterised by painful restriction of shoulder movement
20
Q

what is the clinical progression of adhesive capsulitis?

A
  1. overall 6 months to recover from onset
  2. reactive inflammation (pain) is followed by adhesions forming (stiffness remains)
  3. recovery phase - gradual return of shoulder movement
21
Q

what are the clinical features of adhesive capsulitis?

A
  1. restriction of active and passive movements in all directions
  2. external rotation typically more painful but all other movements are restricted
  3. normal shoulder x - ray
22
Q

Management of adhesive capsulitis

A
  1. Analgesis / NSAIDs
  2. Steroid injections and physiotherapy - effective in reducing pain and disability assoc with frozen shoulder
  3. If no improvement
    - manipulation under anaesthesia