Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MSK > shoulder pathologies and upper limb nerve entrapments > Flashcards

shoulder pathologies and upper limb nerve entrapments Flashcards

1
Q

who is normally affected by shoulder instability?

A

teenage to 30s

  • young
  • sporty
  • mostly traumatic !

also commonly seen in older people with rotator cuff tears

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

what type of shoulder instability are there?

A

posterior and anterior dislocation

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

what is more common; an anterior or posterior dislocation?

A

anterior dislocation (95%) is more common compared to posterior dislocation (5%)

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

when does anterior dislocation typically occur?

A

during sports and it is usually traumatic

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

when does a posterior dislocation typically occur?

A

-epileptic fit or electrocution

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

what is the treatment for acute shoulder instability?

A

reduction in emergency department:

  • Kocher method
  • Hippocratic method
  • Stimson method

2-3 weeks sling

  • Analgesia
  • Gradual early mobilisation
  • Physiotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does shoulder instability look like?

A

abnormal shoulder contour

in chronic there is often muscle wasting

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

what does shoulder instability feel like on examination?

A

tenderness

muscle spasm

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

what tests should be done for someone with shoulder instability?

A
  • rotator cuff strength
  • apprehension test
  • relocation
  • general laxity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what investigations are done for shoulder instability?

A
  • general exam
  • XRAY :AP shoulder and garth views
  • MRI arthrogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are some injuries associated with shoulder instability?

A

Labral lesion (Bankart)
Fracture humeral head (Hill Sachs)
Fracture of glenoid (Bony Bankart)
Rotator cuff tear (older patients >40)

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

what is the instability rehab plan?

A

6 week sling
8-10 weeks no driving
12 weeks no heavy lifting

can return to non contact sport in 12 weeks

can return to contact sport in 6 months

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

how long should patient not drive after shoulder instability?

A

8-10 weeks

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

how long should a patient wait before heavy lifting after shoulder instability?

A

12 weeks

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

when can a patient return to sport after shoulder instability?

A

non contact= 12 weeks

contact= 6 months

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

what patients with shoulder instability need surgical repair?

A

those with a labral tear (Bankart)

most patients

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

what is impingement syndrome?

A

pain originating from the sub-acromial space

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

what does impingement syndrome suggest <30?

A
  • rotator cuff tendonitis

- subacromial bursitis

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

what does impingement syndrome in 30-40s suggest?

A
  • Calcific tendonitis

- Early tendinosis

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

what does impingement syndrome in 40-50s suggest?

A
  • Tendinosis

- partial tears rotator cuff

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

what does impingement syndrome suggest in 50-60s?

A

cuff tear

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

what does impingement syndrome in 70s suggest?

A

-cuff arthropathy

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

what are specialty tests for impingements?

A
  • Hawkins

- Jobe’s

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

what investigations are done if there is impingement?

A

XRAY- AP shoulder and garth views or outlet view

USS

MRI- if patient has difficulty moving shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the treatment for impingement?
- rest (avoid doing exercises that hurt) - oral pain relief - physio - cortico steroid injections in subacromial space (x2 at most) at least 6 months non operative treatment -decompression surgery
26
what is the impingement rehab after decompression surgery?
sling 1-2 weeks early PT and ROM exercises RC strengthening usually takes about 6 months to work
27
what is impingement linked with on examination?
- painful arc | - positive impingement test
28
who is impingement usually seen in?
30-40
29
who are cuff tears usually seen in?
50-60 grey hair=cuff tear
30
how do cuff tears normally present?
- pain | - weakness mainly in overhead activity
31
what specialty tests should be done for someone with suspected cuff tears?
- supraspinatus - Gerber's lift off - Horn blowers
32
what investigations are done for someone with suspected cuff tear?
XRAY USS- if range of movement allows it MRI - if stiff
33
what is the treatment for cuff tear?
- rest - analgesia - sling Acute: - urgent investigation - early physio - early reassessment - early intervention - arthroscopic or open repair of RC
34
what is the cuff repair rehab?
- sling 6 weeks - no driving 8-10 weeks - 12 weeks no heavy lifting - prolonged physiotherapy recovery can take 6-9 months
35
what % of repaired cuff rotators re tear in the next year?
20-40%
36
what is frozen shoulder?
- primary idiopathic problem | - shoulder is painful and stiff for months sometimes years
37
what age group is usually affected by frozen shoulder?
40-50s
38
what sex is usually affected by frozen shoulder?
more common in females
39
what other diseases does frozen shoulder have an association with?
diabetes, lipid and endocrine disease and Dupuytren's
40
what is the pathophysiology of frozen shoulder?
- contracture and thickening of coraco- humeral ligament which tightens the rotator (which sits in between the supraspanous and subscapularous) and the axillary fold - decreases joint volume and makes the shoulder tighter
41
frozen shoulder is an adhesive process. TRUE or FALSE
FALSE!! :00
42
how does frozen shoulder usually present?
- pain at rest - pain at night - anterior pain - stiffness - global restriction in ROM - external rotation <50% of normal
43
what are the possible diagnoses if there is a lack of external rotation in the shoulder?
- locked posterior dislocation - glenohumeral arthritis - frozen shoulder
44
what does frozen shoulder look like on radiograph?
normal
45
what is the treatment for frozen shoulder?
Non operative: - gentle movements - analgesia - physio - glenohumeral steroid injections - fluoroscopic distention Operative: - manipulation under anaesthetic - arthroscopic capsular release
46
what is the rehab for frozen shoulder after surgery?
- sling for short period - pain control - AGGRESSIVE physioooooooo
47
what age group is glenohumeral osteoarthritis usually found in?
>60s
48
how does glenohumeral arthritis usually present?
- gradual onset - pain at night - stiffness - intermittent exacerbation - functional difficulties - asymmetry - muscle wasting - limited external rotation - global restriction in movement - pain throughout ROM
49
what would an Xray of someone with glenohumeral osteoarthritis look like?
- joint space narrowing - subchondral sclerosis - subchondral cysts - osteophyte formation
50
what is the treatment for glenohumeral osteoarthritis?
non operative: - analgesia - physiooooo - GH steroid injection operative: - shoulder replacement (arthroplasty) - resurfacing - total shoulder arthroplasty - reverse polarity shoulder arthroplasty
51
what is the post arthroplasty rehab?
``` -sling 6 weeks 8-10 weeks NO DRIVING! -physiooooo -no heavy lifting for 12 weeks -pain relief ```
52
what is the median nerve neuropathy?
carpal tunnel syndrome
52
what is the median nerve neuropathy?
carpal tunnel syndrome
53
what is the ulnar nerve neuropathy?
cubital tunnel syndrome
54
who is usually affected by carpal tunnel syndrome?
``` >30s female pregnant hypothyroidism diabetes obesity RA ```
55
why do patients feel pins and needles if they have carpal tunnel syndrome?
due to the relative reduction in blood supply to the median nerve
56
what would an intrinsic cause of reduction in blood supply to median nerve be? (carpal tunnel)
diabetes
57
what would an extrinsic cause of reduction in blood supply to median nerve (carpal tunnel syndrome) be?
pressure put on the nerve due to swelling e.g. synovitis
58
what hand muscles does the median nerve innervate?
LOAF!! Lateral two lumbricals Opponens Pollicis Abductor Pollicis brevis Flexor pollicis brevis
59
what are some carpal tunnel signs?
- thenar atrophy - altered sensation thumb, index, half of middle - weakness of abductor pollicis brevis
60
what special tests would be conducted on someone with suspected carpal tunnel?
Durkan's test- compression Tinnel's test- tapping Phalen's test- volar flexion
61
treatment for mild/moderate carpal tunnel syndrome?
- splintage - physio - steroid injection
62
treatment for severe carpal tunnel syndrome?
-carpal tunnel decompression
63
what is the rehab for carpal tunnel decompression surgery?
- 2 days to reduce dressing - 5 days to keep dry - 10 days for sutures - 6 weeks return pincher grip - 12 week grip strength
64
who is more commonly affected by cubital tunnel syndrome?
>30s | males
65
what can cause cubital tunnel syndrome?
- post traumatic causes - direct causes (cysts, tumours) - arthritis
66
what muscles does the ulnar nerve innervate in the hand?
All other muscles in hand (all muscle but LOAF): - ulnar two lumbricals - all hypothenar muscles - deep head FPB - adductor pollicis
67
how does cubital tunnel syndrome present?
Early: - pins and needles - pain - clumsiness Late: - numbness - weakness
68
what are the signs for cubital tunnel?
- hypothenar and interosseous atrophy - clawing of ring and small finger - altered sensation - weakness And dig minimi - weakness of grasp and pinch - Wartenbergs sign (abducted small finger)
68
what are the signs for cubital tunnel?
- hypothenar and interosseous atrophy - clawing of ring and small finger - altered sensation - weakness And dig minimi - weakness of grasp and pinch - Wartenbergs sign (abducted small finger)
69
what special tests are done for cubital tunnel tests?
- Tinnels test (tapping) - Modified Phalen's test (elbow flexion test) - Froments test (thumb flexion during key grip)
70
what are investigations for cubital tunnel?-
- clinical examination | - nerve conduction studies (NCS) and electromyogram (EMG)
71
what is treatment for cubital tunnel?
mild/moderate: - elbow splintage - physiotherapy - NSAID Severe: -ulnar nerve decompression
72
what is the rehab plan after cubital tunnel decompression surgery ?
- 2 days reduce dressing - 5 days keep dry - 10 days for sutures
73
what are the three stages of frozen shoulder?
FREEZING STAGE- any movement of shoulder causes pain, and shoulder's range of movement starts to become limited. FROZEN STAGE- pain may get slightly better at this stage. However, shoulder becomes more stiff and increasingly difficult to use. THAWING STAGE- range of motion in shoulder begins to improve

MSK (64 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions