Shoulder Pathology

Question 1

Glenohumeral joint structure

Answer 1

Ball and socket. Relies heavily on muscles and ligature for stability.

Question 2

Primary ligament of the acromioclavicular joint

Answer 2

Coracoclavicular ligament

Question 3

Sternoclavicular ligaments

Answer 3

Anterior and posterior scternoclavicular ligaments, interclavicular ligature

Question 4

Frozen shoulder

Answer 4

The shoulder joint capsule thickens and tightens around the shoulder, restricting motion. Also called adhesive capsulitis.

Question 5

Onset of frozen shoulder

Answer 5

Can be sudden or gradual, usually around 45-60 years old.

Question 6

Which movements are particularly restricted in frozen shoulder?

Answer 6

Abduction and external rotation

Question 7

Stages of frozen shoulder

Answer 7

Freezing, frozen and thawing

Question 8

Freezing stage of frozen shoulder

Answer 8

Painful and restricted ROM, lasts 6-12 weeks

Question 9

Frozen stage of frozen shoulder

Answer 9

Less painful, but more stiff. Lasts 4-6 months

Question 10

Thawing stage of frozen should

Answer 10

Motion gradually improves over a period of as much as a year.

Question 11

Main bursa of the shoulder

Answer 11

Subacromial, subscapular, subcoracoid, subdeltoid

Question 12

Subacromial bursitis

Answer 12

Internal rotation irritates the bursa. This is felt at the lesser tuberosity.

Question 13

Subcoracoid bursitis

Answer 13

Irritated by lifting weight overhead.

Question 14

Supraspinatus tendinitis

Answer 14

Fairly common due to impingement and relatively poor oxygenation.

Question 15

Infraspinatus tendinitis

Answer 15

Irritated by sustained abduction, external rotation and overhead activities.

Question 16

Bicipital tendinitis

Answer 16

Due to repetitive trauma from overhead flexion and rotation.

Question 17

Biceps brachii injury

Answer 17

The long head is more susceptible to damage.

Question 18

Signs and symptoms of biceps injury

Answer 18

Pain in the upper arm, popping sound at time of injury, bruising, weakness in flexion and supination, bulged biceps.

Question 19

Impingement syndrome

Answer 19

Compromised space between the coracoacromial arch and the proximal humerus.

Question 20

Sprain

Answer 20

Injury to a ligament

Question 21

Strain

Answer 21

Injury to a muscle or tendon

Question 22

What causes sprains?

Answer 22

Overstretching a ligament

Question 23

What causes strains?

Answer 23

Excessive force being applied to a muscle.

Question 24

Acromioclavicular sprains

Answer 24

Commonly called a separated shoulder. Due to an injury that causes displacement of the acromion from the clavicle.

Question 25

Why is the glenohumeral joint more susceptible to dislocation?

Answer 25

The head of the humerus and the glenoid fossa don’t fit well together.

Question 26

Elbow pathologies

Answer 26

epicondylitis, tendinitis, dislocations, bursitis, sprains and strains.

Question 27

Elbow dislocation

Answer 27

The ulna and radius move out of place in relation to the humerus. Second most common type of dislocation.

Question 28

Lateral epicondylitis

Answer 28

Pain in the lateral aspect of the elbow. Also called tennis elbow.

Question 29

What causes lateral epicondylitis?

Answer 29

A tear in extensor muscles. Common in gripping activities.

Question 30

Signs and symptoms of lateral epicondylitis

Answer 30

Gradual or intermittent mild ache with the most tender point being at the anterior portion of the epicondyle.

Question 31

Medial epicondylitis

Answer 31

Caused by a strain to the wrist flexors. Called Golfer’s elbow.

Question 32

Olecranon bursitis

Answer 32

Pain and swelling in the elbow. May be due to a fall on the elbow or be idiopathic.

Question 33

De Quervain’s tenovaginitis

Answer 33

Two tendons which share a sheath rub against one another. Causes pain at the distal, lateral forearm and a positive Finkelstein’s test

Question 34

Skier’s/Game keeper thumb

Answer 34

Injury to the collateral ligament of the MCP joint. Can lead to adhesions and decreased flexion. Usually caused by forceful hyperextension or abduction of the thumb.

Question 35

Mallet fingers

Answer 35

The result of a rupture or avulsion of the extensor tendon where it inserts into the distal phalanx of the fingers.

Question 36

Jammed fingers

Answer 36

A sprain to the joint of the finger. Causes a painful and inflamed joint.

Question 37

Jersey fingers

Answer 37

A tear of one or more flexor tendons in a finger at the distal phalanx. Causes, pain, swelling, bruising and an inability to bend the joint.

Question 38

Bennett fracture

Answer 38

Fracture to the base of the thumb. From forced abduction, usually punching or falling.

Question 39

Rupture of extensor pollicis longus

Answer 39

Often found with fracture of the distal radius, synovitis or rheumatoid arthritis. Causes pain in wrist and inability to straighten thumb.

Question 40

Volkman’s Ischemic Contracture

Answer 40

Contracture of the hand following muscular death and replacement by fibrous tissue. Caused by trauma that prevents blood flow for at least 6 hours.

Question 41

Congenital Pseudoarthrosis

Answer 41

Movement of a bone at the location of fracture due to inadequate healing. Common in clavicle, radius and ulna.

Question 42

Dupuyten’s contractrue

Answer 42

Contracture ot the palmar aponeurosis.

Question 43

Causes of Dupuyten’s contracture

Answer 43

Painless proliferation of fibroblasts from inflammatory fibrosis. This transforms the contractile tissue into non-contractile tissue.

Question 44

Risk factors in Dupuyten’s contracture

Answer 44

Alcoholism, diabetes, liver disorders, epilepsy, men over 30 and women over 45.

Question 44

Signs and symptoms of Dupuyten’s contracture

Answer 44

Small node on the palm and then progresses to the flexor side of the fingers.