Slides

Question 1

Lateral/anterior shoulder pain with overhead activities or exhibiting a painful arc? 3

Answer 1

• Subacromial impingement
• Tendinitis
• Bursitis

Question 2

Instability, apprehension, and pain with action, especially with shoulder abducted and externally rotated? 2

Answer 2

• Shoulder instability

- Possible labral tear if clicking

Question 3

Patient falls on shoulder followed by AC joint pain?

Answer 3

AC joint Sprain

Question 4

Decreased ROM with pain during resistance? 2

Answer 4

• Rotator cuff

- Bicep tendon involvement

Question 5

Pain and weakness with muscle loading, night pain age>60?

Answer 5

Rotator Cuff (active range is restricted)

Question 6

Poorly located shoulder pain, occasionally extending into elbow, pain aggravated by movement, loss of movement age>45, females more affected. Passive and Active ROM will be restricted?

Answer 6

• Adhesive Capsulitis

Question 7

What would the most harmful diagnosis be?
SLAP?
Rotator cuff tear?
Bicep tendonitis?

Answer 7

40%

20%

40%

Question 8

External Rotation Lag Sign, tests what muscle?

Answer 8

Infraspinatus

Question 9

Hornblower’s Sign tests what muscle?

Answer 9

Teres minor

Question 10

Belly press test, tests what muscle?

Answer 10

subscapularis

Question 11

Positive External rotation lag sign?

Answer 11

arm moves back (infraspinatus tear)

Question 12

Positive Hornblower’s sign?

Answer 12

the patient is unable to externally rotate the arm from this position (teres minor tear)

Question 13

Positive Belly Press test?

Answer 13

Examiner should not be able to pull arm away (subscapularis)

Question 14

Type I slap lesion?

Answer 14

11% of SLAP lesions, fraying of and degeneration of superior labrum. Usually occurs in middle aged adults.

Question 15

Type II slap lesion?

Answer 15

41%, most common-same findings as type I with biceps anchor detachment (fraying of and degeneration of superior labrum)

Question 16

Type III slap lesion?

Answer 16

33% more of a bucket handle tear of labrum, intact bicep tendon

Question 17

Type IV slap lesion?

Answer 17

15% involve same features as type III with extension of tear into the biceps tendon (a bucket handle tear of labrum, intact bicep tendon)

Question 18

Pain over lateral elbow during gripping?

Answer 18

– Possible lateral epicondylitis

- possible radial tunnel

Question 19

Pain over medial elbow during wrist flexion and pronation?

Answer 19

– Possible medial epicondylitis

Question 20

Numbness and tingling in ulnar nerve distribution distal to elbow?

Answer 20

– Possible cubital tunnel syndrome

Question 21

Pain in anterior aspect of elbow and forearm that is exacerbated by wrist flexion combined with elbow flexion and forearm pronation?

Answer 21

– Possible pronator syndrome

Question 22

Pain during movement with sensations of catching or instability?

Answer 22

– Possible rotary instability

Question 23

Posterior elbow pain during hyperextension?

Answer 23

– Possible valgus extension overload syndrome (clicking during pronation and supination)

Question 24

Positive Elbow flexion test?

Answer 24

Tingling or parasthesia along ulnar nerve distribution in the forearm and hand will suggest cubital tunnel syndrome

Question 25

Elbow flexion test stresses what nerve?

Answer 25

Ulnar nerve

Question 26

How can the ulnar nerve become stresses? 3

Answer 26

• hypertrophy of MCL
• MCL tear causing swelling leading to numbness
• medial epicondylitis

Question 27

What devices can you use when testing lateral/medial epicondylitis?

Answer 27

• Kaplans test grip strength machine

- Put strap on and reduced pain and increased strength

Question 28

Pain over radial styloid process with gripping?

Answer 28

– Possible de Quervain’s syndrome

Question 29

Insidious onset of numbness and tingling in 1st 3 fingers; may be worse at night?

Answer 29

– Possible carpal tunnel syndrome

Question 30

Paresthesias over dorsal aspect of ulnar border of hand and fingers 4,5?

Answer 30

Ulnar nerve compression at canal of Guyon

Question 31

Inability to extend metacarpophalangeal of IP joints?

Answer 31

– Possible Dupuytren’s contracture, possible trigger finger

Question 32

Falling on hand with wrist hyperextended, complains of pain with loading the wrist?

Answer 32

– Possible scaphoid fracture, possible carpal instability

Question 33

Froment’s Test:
With ulnar nerve palsy, the patient will experience difficulty maintaining a hold and will compensate by flexing which muscle?

Answer 33

flexor pollicis longus

Question 34

Pinch Grip Test:
With anterior interroseous nerve palsy, the patient will experience difficulty maintaining a pinch and will compensate by pressing the pads of the fingers to maintain grip pressure using what muscle innervated by the ulnar nerve?

Answer 34

adductor pollicis

Question 35

With Finkelstein’s test, pain indicates tenosynovitis (inflammation b/t the shealth and tendon) of what 2 muscle tendons?

Answer 35

• extensor pollicis brevis

- abductor pollicis longus

Question 36

Tensynovitis of extensor pollicis brevis, and abductor pollicis longus has what other 4 names?

Answer 36

– de Quervain’s

• hoffman’s disease
• gamer’s thumb
• washerwomans sprain.

Question 37

Thickening of the sheath of the flexor tendons at the A1 pulley?

Answer 37

Trigger Finger

Question 38

Extension of MCP and DIP, flexion of the PIP?

Answer 38

Boutonniere deformity

Question 39

Flexion of the MCP and DIP, hyperextension of the PIP?

Answer 39

Swan Neck Deformity

Question 40

Rupture of extensor digitorum tendon at the insertion on distal phalanx?

Answer 40

Mallet Finger

Question 41

Avulsion of flexor profundus, forced hyperextension, loss of DIP flexion?

Answer 41

Jersey Finger

Question 42

Autonomic nervous system preparing for fight-or-flight with this test?

Answer 42

Mannkopf’s test - press on area of pain and pulse rate should increase