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Orthopedics > Shoulder Pathology > Flashcards

Shoulder Pathology Flashcards

1
Q

2 kinds Labral lesions

A

1) SLAP

2) Bankart

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2
Q

Labral lesion Sx

A

1) dull/throbbing
2) difficulty sleeping on shoulder
3) loss of strength
4) **instability
5) popping/clicking/catching

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3
Q

What is the most common cause of Labral tears

A

*impact injury (not age)

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4
Q

What is a Labral lesion

A

Tearing of glenoid labrum

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5
Q

What is SLAP Labral lesion

A

“Superior labrum anterior posterior”

-injury to anterior/posterior attachment of bicep tendon

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6
Q

SLAP Labral lesion Sx

A

1) impingement/catching with overhead force/pushing

2) pain with movement (above head/throwing)

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7
Q

cause of SLAP Labral lesion

A

1) fall outstretched arm
2) forceful pulling arm (catching heavy object)
3) rapid/forceful movement above shoulder level

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8
Q

Risks for SLAP

A

1) overuse (weightlifting, throwing)
2) shoulder dislocation
3) MVA

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9
Q

On a clock where do SLAP lesion occur

A

10 and 2

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10
Q

On a clock where do Bankart lesion occur

A

3 and 6

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11
Q

What is a Bankart lesion

A

-anterior (inferior) glenoid labrum

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12
Q

2 kinds of Bankart lesions

A

1) soft- labrum

2) bony- anteroinferior glenoid rim bone

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13
Q

SX of Bankart lesion

A

1) pain worse with arm behind back

2) hill-Sachs lesion- posterolateral humeral head compression fracture= promotes future dislocation

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14
Q

Cause of Bankart lesion

A

Anterior shoulder dislocation

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15
Q

What other pathologies to differentiate for Labral lesions

A

1) ALPSA (anterior Labral posterior sleeve avulsion)
2) cuff fraying
3) rotator cuff tears
4) SLAP lesion
5) impingement

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16
Q

What is bursitis

A

Inflammation of the bursa

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17
Q

Etiology of bursitis

A

Inflammation-> increase synovial cells-> increase collagen/fluid production in bursa-> decrease lubrication outside bursa

18
Q

Cause of bursitis

A

1) repetitive trauma/friction (micro-trauma)
2) impact
3) rheumatoid arthritis
4) infection

19
Q

Sx of bursitis

A

Impingement syndrome

20
Q

What are other names for impingement syndrome

A

“Sub criminal impingement, painful arc syndrome, supraspinatus syndrome, swimmers shoulder, throwers shoulder”

21
Q

Etiology of impingement syndrome

A

Decreased sub acromial space= impingement (of supraspinatus tendon, subacromial bursa, long head bicep tendon)

22
Q

Cause of bursitis

A

1) intrinsic/primary- rotator cuff degeneration/weakness
- subacromial bursitis
2) extrinsic/secondary- subacromial bone spurs
- osteoarthiritic Spurs from AC joint
- variation of acromion shape
- thickening coracoacromial ligament
- poor posture (anteriorly)
- weak scapular stabilizers (rhomboids/traps)
- tight mm (pecs, serrated anterior)

23
Q

Predisposing factors for impingement syndrome

A

Overhead activities

24
Q

Sx of impingement syndrome

A

1) pain front/side shoulder
2) onset- sudden (trauma) OR gradual (micro trauma)
3) increase pain- overhead activity/lying on shoulder
4) decrease strength with pain
5) decreased ROM
6) painful arc movement- forward elevation (60-120)
7) crepitus

25
Q

Differential for impingement syn

A

1) rotator cuff tear (pain resolves, weakness persists)

2) supra scapular nerve entrapment

26
Q

Diagnosis for impingement syn

A

1) Hawkins-Kennedy test
2) painful arc sign
3) weakness in external rotation with arm at side

27
Q

What is adhesive capsulitis

A

“Frozen shoulder”

28
Q

Types of adhesive capsulitis

A

1) idiopathic
2) trauma
3) post surgery
4) vaccine related

29
Q

Etiology of adhesive capsulitis

A

Decrease synovial fluid-> thickening shoulder capsule-> adhesions within capsule/connective tissue

30
Q

Cause of adhesive capsulitis

A

Trauma with autoimmune component

31
Q

Risks for adhesive capsulitits

A

1) tonic seizures
2) diabete mellitus
3) stroke
4) LU Dz
5) connective tissue Dz
6) thyroid Dz
7) HT Dz

32
Q

Sx for adhesive capsulitis

A

1) constant pain
2) pain increases at night/cold
3) progressive loss AROM/PROM
4) provoked by certain movements (pain and cramping)

33
Q

Normal course of healing of adhesive capsulitis

A

1) stage 1 (freezing/painful)- 6week-9 month
- slow onset
- increase pain= decreased ROM (vice versa)
2) stage 2 (frozen/adhesive)- 4-9 month
- pain= slow improvement
- stiffness
3) stage 3 (thawing/recovery)- 5-26 months
- motion slowly returns to normal

34
Q

2 kinds of rotator cuff tears

A

1) partial (fraying)/ 1-2 degree

2) full thickness/ 3 degree

35
Q

What is included in 3 degree

A

1) small pinpoint tear
2) large buttons hole tear
3) majority of tendon, tendon still attached to humeral head
4) complete detachment of tendon from humeral head

36
Q

Etiology of rotator cuff tear

A

1) injury (acute)- varying amts of stress
- supraspinatus tendon/rotator interval
- severe pain radiates thru arm
- limited ROM- abduction
2) degeneration (chronic)
- extended use and poor biomechanics/mm imbalance

37
Q

Sx of rotator cuff tear

A

1) sporadic worsening of pain
2) debilitating mm atrpohy
3) pain during rest
4) crepitus
5) ROM (abduction/flexion)

38
Q

Risks for rotator cuff tear

A

1) repetitive stress
2) decrease blood (supraspinatus) ***CUPPING
3) impingement syndrome

39
Q

What is a rotator interval

A

Triangular space between suprascapularis/supraspinatus, coracohumeral/superior glenhumeral ligaments, long head bicep tendon, anterior joint capsule

40
Q

What is VOMIT

A

“Victims of medical imaging technology”

  • MRI studies
  • 20% partial rotator cuff tear
  • 15% full thickness tear
  • 50% rotator cuff tear of ppl over 60- no pain/injury
  • 40% pro baseball players- partial/full thickness, no pain, even after 5 years

Orthopedics (22 decks)

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