sport injuries Flashcards
- shoulder injuries:
the 4 rotator cuff muscles are
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
( check structure )
the rotator cuff tears are injuries in —
1- origins is — :
Supraspinatus –> —
Infraspinatus–> —
Teres Minor –>—
Subscapularis –>—
2- inerstion in —
- greater tubroristy:
- lesser tuborsity:
3- innervation:
—- nerve: supraspinatus, infraspinatus
—- nerve: subscapularis
—– nerve: teres minor
- shoulder
- scapula
- supraspinous fossa
- infraspinous fossa
- lateral border of scapula
- sub scapular fossa
- humorous
- great: supraspinatus, infraspinatus, teres minor
- lesser: subscapularis
- subrascapular nerve
- sub scapular
- axially
the functions fir the rotator cuff tears are —- Supraspinatus = —
Infraspinatus = —
Teres Minor = —-
Subscapularis = —-
clinical relevance: above actions are used to elicit pain in torn rotator cuff muscles
- stabilisation
- abduction
- external rotation
- external rotation
- internal rotation
how does the cuff tears tears:
1-Chronic degenerative tears: Usually older patients!
2-Chronic impingement
3-Avulsion: eg; Shoulder dislocation, falls
the pain in rotator cuff tears are located in — regions and usually — but can be – if the tear is traumatic , the — is a poor indicator of conservative management
- weakness causes:
- deltoid region
- insidious
- acute
- night pain
- loss of rom
we can investigate rotator cuff tears by:
1- —–
May show calcified tendons
Cause of impingement eg: hooked acromion
2- —-
Gold Standard
3- —-
Pros: Inexpensive and readily available
Con: User dependent limited ability to identify other pathologies
x ray
mri
ultrasound
rotator cuff tears management:
1- non-operative by:
2- operative by:
1- Physical therapy, analgesia, steroid injections First line for most tears
- operative as:
Partial tears = Decompression: subacromial debridement
Full thickness = Rotator Cuff Repair
shoulder location are — articulates with the —
1- static stabilisers as:
2- dynamic stabilisers as:
- humeral head articulates w glenoid
- glenoid labrum and glenohumeral ligament
- rotator cuff muscles and biceps brachialotis tendon ( long head )
the mehcniams of injury of shoulder dislocation is —
and 95% of shoulder dislocations are —
- trauma as contact sport or falls n elderly
- anterior dislocation
shoulder dislocation
1- symptoms:
2- signs:
1-
Pain
Deformity
Immobility
Feelings of instability
2-
Abducted & externally rotated arm position
Squaring of shoulder
Axillary nerve injury: Loss of sensation over regimental badge area
+- Positive rotator cuff provocative tests
shoulder dislocations investigation is —
management by:
x ray:
Incongruence of humeral head, glenoid anatomy
Humeral head anterior and medial displacement
1- non opérative for acute dislocation as closed reduction and sling
2-operative for recurrent dislocations for shoulder stabilisation ( bankart repair/latarjet )
anterior cruciate ligament responsible for — injury
the origin is from :
insertion :
function :
- soft tissue
- femur : lateral femoral condyle
- tibia: anteriorly between intercondylar eminences
- prevents anterior translation of tibia relative to the femur
how can you hurt ur anterior cruciate:
Valgus Force:
-Twisting while foot is planted firmly on the ground
-Lateral force applied to a planted leg
*Unhappy Triad = ACL, MCL, and Meniscus injury
symptoms and signs of anterior cruciate:
investigation by:
1-symptoms :
-Pain with difficulty weightbearing
-Swelling
-May report hearing a “pop”
2- signs:
Effusion
Quadriceps avoidance gait
Positive Lachman/Anterior Drawer Test
x ray : more normal
mri: gold standard
anterior cruciate management:
1- non operative:
For patients with low demand
Increased risk of meniscal/cartilage damage
2- operative = ACL reconsutrcution
-For higher demand patients
-Uses tendon graft eg; hamstring or quadriceps to reconstruct ACL
ankle injuries :
- modified hinge joint includes:
—- is important ligament stabilising ankle joint
N.B includes:
tibia fibula and talus
syndesmosis
AITFL , PITFL location
mechanism of distal fibula fracture is —–
presentation of:
- twisting ankle injury
- pain swelling inability to weighttbear
can be done by x ray for AP lateral and mortise view
-ankle fibula fracture weber classification
-CEHCL SLIDE 28 SOSOSOOOO IMPORTANT
- we cna get:
1- isolated lateral malleolar
2- bimalleolar
3- trimalleolar
management of distal fibula fracture:
- nonoperative:
weber A and stable mortise - operative = ORIF as displaced fractures and unstable mortise
clavicle fractures:
1- mechanism of injury — and its injury in —
2- the — is pulled superiorly due to SCM
3- the — is pulled inferiorly due to the weight of the arm
- direct impact to right shoulder
- upper limb
- medial fragment
- lateral fragment
investigation of clavicle fracture:
- xray usually suffienct
- ct: may be useful for preoperative planning nd medial clavicle fractures
clavicle fractures clinical presentation:
- symptoms:
- signs:
- management:
1-
Pain: Acute onset
“Popping” or “Cracking” sound
2-
Tender swelling +- deformity
Check for skin tenting/open fractures
Neurovascular injury: Brachial plexus/subclavian vessels
- nonoperative:
-Majority of clavicle fractures
Sling or figure of 8 strap used
15% risk of non-union
-Who needs operative management
Open fractures/skin tenting
Vascular injuries
-Operation = Open reduction internal fixation
scaphoid fracture is the – bone in — row
- blood supply:
1- —- : —- is the major blood supply
2- minor supply from —
- largest
- proximal carpal row
- retrograde flow
- radial artery : dorsal carpal branch
- superficial palmar branch
scaphoid mechanism of injury is typically —-
clinical presentation includes:
– pain which worse on motion and +/- swelling
- signs include :
- FOOSH
- wrist pain
- tenderness over the anatomical snuff box
scaphoid investigation by:
management by:
1-X-Ray hand
25% of fractures aren’t visible initially
X-rays should be repeated at 14-21 days if there is clinical suspicion
2-MRI/Bone Scan
Can be used to evaluate for occult fractures
3-CT
- Used to determine fracture characteristics
Non-operative = Immobilisation
Cast immobilization
Used for majority of scaphoid fractures
Operative management
Indications; Proximal pole fractures, significantly displaced/deformed fractures
