Shoulder problems

Question 1

Posterior shoulder dislocations are by far the most common (T/F)

Answer 1

False

-95% are anterior dislocations

Question 2

What is a Bankart lesion? How does it arise?

Answer 2

Injury of the glenoid labrum due to anterior shoulder dislocation

Question 3

What is impingement syndrome?

Answer 3

Pain originating from sub-acromial space, due to catching or rubbing of the rotator cuff tendon on the bone.

Question 4

What are the intrinsic causes of impingement syndrome?

Answer 4

Osteophytes on the acromion

Injury or overuse of shoulder

Acromion structure (hooked or curved)

Bursitis

Question 5

What movements and tests are used in Impingement syndrome diagnosis?

Answer 5

Painful arc
Jobe’s test (empty can - supraspinatus)
Hawkins-Kennedy test (impingement)

Question 6

What are the X-ray signs of impingement syndrome?

Answer 6

Calcification ‘dots’ on the head of humerus

Question 7

Other than analgaesia, what pharmacological treatment can be given for impingement syndrome?

Answer 7

Subacromial space injections

Question 8

What surgery can be used in impingement syndrome?

Answer 8

Subacromial decompression surgery

Question 9

What is the main age range affected by the impingement syndrome?

Answer 9

30-40 year olds

Question 10

Cuff tear is mostly present in ___-___ year olds

Answer 10

50-60

cuff tear = grey hair

Question 11

What is noted on examination in patients with cuff tears?

What tests may be carried out?

Answer 11

Weakness

Passive range of movement is much greater than active movement

Muscle wasting

Tests:

• Jobe’s / empty can test (supraspinatus tear)
• External rotation of arm (infraspinatus/ teres minor)

Question 12

Who is most affected by the frozen shoulder?

Answer 12

Women 40-50

Question 13

What is the pathology of the frozen shoulder?

Answer 13

contracture and thickening of the glenohumeral ligament

Question 14

What are the possible frozen shoulder treatments?

Answer 14

Steroid injections
Athroscopic capsular release
manipulation under anaesthesia

Question 15

What muscle takes over from the rotator cuff muscles for the lever movement in the reverse polarity shoulder replacement?

Answer 15

deltoid

Question 16

What are the risk factors for development of Carpal Tunnel Syndrome?

Answer 16

female, pregnancy, hormonal fluctuations
hypothyroidism
diabetes
obesity
Rheumatoid Arthritis

Question 17

What is the presentation of carpal tunnel syndrome?

Answer 17

pins and needles
numbness
pain
clumsiness
change in shape of the hand
-wasting of thenar eminence 

Weak abductor pollicus brevis

Question 18

How is severe carpal tunnel syndorme treated?

Answer 18

Carpal tunnel decompression

-cut trasverse carpal ligament

Question 19

What are the common causes of cubital tunnel syndrome?

Answer 19

post traumatic
direct pressure by cysts and tumours
arthritis

Question 20

What nerve is affected in the cubital tunnel syndrome?

Answer 20

Ulnar nerve

Question 21

What nerve is affected in Carpal tunnel syndrome?

Answer 21

Median nerve

Question 22

What is the surgery performed for Cubital tunnel syndrome?

Answer 22

Cubital tunnel release

Question 23

Frozen shoulder only causes pain on abduction (T/F).

What movements are limited in particular?

Answer 23

False
-causes constant pain

External rotation
Abduction

Question 24

Acromioclavicular joint damage presents with diffuse pain radiating down the shoulder (T/F)

Answer 24

Flase

-patient pinpoints the pain to the location of the joint

Question 25

The main stabilisers of the clavicle are the ____________ ligaments

Answer 25

coracoclavicular ligaments