shoulder pathology Flashcards

1
Q

what attaches to the greater tubercle of the humerus

A

the SIT muscles

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2
Q

role of supraspinatus

A

abduct 0-15

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3
Q

role of infraspinatus and teres minor

A

externally rotate

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4
Q

role of subscapularis

A

internally rotate

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5
Q

what is subacromial impingement

A

compression of (normally supraspinatus) under the coracoacromial arch

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6
Q

what can cause subacromial impingement

A

osteophytes, bursitis (may be caused by overuse of the tendon by repetitive overhead action), calcific tendonitis

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7
Q

examination findings of subacromial impingement

A

painful arc and positive hawkins test

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8
Q

diagnosis of subacromial impingement

A

normally clinical but can do an MRI to confirm

3 tests which test for it:
1) empty can test
2) Hawkins test
3) painful arc test

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9
Q

MX of subacromial impingement

A

1) conservative - NSAID, ice, rest, physio 2) steroid injections 3) surgery

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10
Q

complications of subacromial impingement

A

adhesive capsulitis and rotator cuff tears

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11
Q

will strength be effected in subacromial impingement

A

no

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12
Q

a rotator cuff tear can be what

A

acute or chronic

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13
Q

RF for rotator cuff tear

A

age, trauma, repetitive overhead use

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14
Q

Ex findings of a rotator cuff tear

A

tenderness over the lateral aspect of the shoulder, muscle wasting, reduced ROM and power

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15
Q

IX for rotator cuff tear

A

Xray to rule out fracture, US to confirm tear and MRI for details of tear

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16
Q

Mx of rotator cuff tear

A

conservative or surgical

17
Q

main complication of any shoulder pathology

A

adhesive capsulitis

18
Q

RF for adhesive capsulitis

A

diabetes, thyroid, female, adhesive capsulitis in other shoulder

19
Q

PC in adhesive capsulitis

A

generalised deep and constant pain, joint stiffness and reduced ROM

20
Q

Ex findings in adhesive capsulitis

A

reduced ROM in active and passive, tenderness on palpation, movement worse in external rotation and flexion

21
Q

Ix for adhesive capsulitis

A

clinical diagnosis but can do MRI to confirm and do HbA1c

22
Q

surgical options for adhesive capsulitis

A

MUA and arthrographic distension (where water is put into the joint to break down the adhesions)

23
Q

how long might adhesive capsulitis last

24
Q

what kind of shoulder dislocation causes a lightbulb sign

25
why is shoulder dislocation most common
shallow glenoid fossa
26
MOA of anterior shoulder dislocation
FOOSH
27
MOA of posterior shoulder dislocation
electrocution
28
how does someone with an anterior inferior shoulder dislocation present
pain, unwillingness to move, loss of shoulder contours, anterior bulge and arm in ABDUCT and EXT ROTATION
29
nerves to assess in shoulder dislocation
axillary and supra scapular (if abnormal recheck in one week)
30
IX for shoulder dislocation
AP and scapula Y and axillary
31
complications of shoulder dislocation
Hill sach and bankart lesion
32
MX of a shoulder dislocation
reduction (kocher or double traction) and immobilisation for 6 weeks in a broad arm sling. Early physio is important.
33
what displacement occurs in a clavicular fracture
medial displaces superiorly due to the pull of SCM an the lateral displaces inferiorly due to the weight of the arm
34
how are most clavicle fractures treated (even those with significant deformity)
conservatively due to the prominence of the metal work
35
non union is a big problem for clavicle fractures - where is this most likely to happen
if the fracture occurs in the distal third and if non union occurs there has to be an ORIF