Sports UE Flashcards

1
Q

What is normal HH and glenoid version?

A

HH 30deg RV
G 5deg RV

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2
Q

Which ligaments provide AP vs sup-inf stability at the AC joint?

A

AC = AP (horizontal stability)
- Superior thickest

CC = sup inf (vertical stability)
1. Trapezoid = lateral
2. Conoid = medial

AC tend to rupture before CC

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3
Q

What is a sublabral foramen and Buford complex?

A

Sublabral foramen = labrum not firmly attached to glenoid ant sup (12%)
Buford complex = absent ant sup labrum with thick MGHL

Normal variants that can be confused with SLAP. Don’t fix, will lose ER

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4
Q

GHL - what do they do
SGHL
MGHL
IGHL - ant and post

A

SGHL - arm at side
MGHL - arm 45deg
aIGHL - arm 90deg, ant translation
pIGHL - arm 45-90deg, post translation

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5
Q

What 4 structures are contained in the rotator interval?

A

Capsule
SGHL
CH lig
LH biceps

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6
Q

Name nerve innervation + 4 rotator cuff muscles

A

Supra - suprascap, C5/6 - Jobe
Infra - “ “ - ER lag
Teres - axillary, C5/6 - Hornblowers
SS - upper/lower SS, C5/6 - lift off

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7
Q

What is the rotator cable/cresent?

A

Thickening of CH lig
A thicker part of the rotator cuff that run from behind biceps to the infra (perpendicular to the lateral tendon insertion)
Acts as a suspension bridge - talk about lateral cuff tears not being functionally significant because of cable being intact
Anterior SS tears that involve the interval may disrupt the cable, theoretical higher risk of progression/FI

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8
Q

What BV runs in the bicipital groove - what is it a branch of?

A

Ax art -> AHCA -> arcuate art

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9
Q

What is the difference between the following:
ALPSA
GLAD
HAGL

A

ALPSA - labrum + periosteum go medial down anterior glenoid neck
GLAD - glenoid cartilage goes with the labrum, may need microfracture at time of repair
HAGL - capsule off humerus, some people repair

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10
Q

What is the track equation?

A

Track = 0.83D - d
D : glenoid diameter
d : glenoid defect

If HS > track = off track

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11
Q

What is the comma sign tissue?

A

Avulsed SGHL in a SS tear

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12
Q

What are Walch A-C?

A

A: HH Centered
A1 - minor wear
A2 - deep central erosion

B: HH posterior sublux
B1 - posterior wear
B2 - biconcave
B3 - neoglenoid takes over the entire glenoid

C: glenoid RV >25deg aka dysplastic

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13
Q

Hamada classification

A

Normal AHI 8-10mm

H1 = AHI >6mm (normal-ish)
H2 = AHI <5
H3 = “ “ + acetabularization
H4 = GH joint narrowing
H5 = HH collapse

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14
Q

Position for glenohumeral fusion

A

20 abd
30 FF
40 IR

Fuse HH high so fuses to glenoid and undersurface acromion

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15
Q

Risks of medialized vs lateralized rTSA

A

Medialized: notching, loss shoulder contour
Lateralized: acromial stress, stress at bone implant interface

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16
Q

What structures are at risk during late cocking and deceleration in the shoulder?

A

Late cocking = internal impingement (SLAP, partial articular RC tears)
Deceleration = cuff

17
Q

What is a Bennett lesion?

A

Posterior glenoid exostosis - think result of internal impingement
Non op -> excision

18
Q

Name 4 parts of LCL and 3 parts UCL

A

LCL
1. RCL
2. Annular
3. Accessory
4. LUCL

MCL
1. Ant bundle - 0-90deg
2. Post bundle - >90deg
3. Transverse bundle

19
Q

What are the major medial and lateral elbow scope portals / structures at risk

A

Medial - think ULNAR n
- Ant med = viewing

Lateral - think RADIAL n (PIN)
- Ant lat
- Mid lat
- Post lat

Otherwise, direct posterior goes through triceps

20
Q

What phase of throwing most stresses UCL?

A

Late cocking

21
Q

What are 2 physical exam maneuvers to differential ant vs post band UCL

A

Ant: valgus stress test
Post: milking maneuver

22
Q

What are the late signs of UCL insuff

A

Post med ostephytes
Recognize because this is an adaptation. If you remove these without reconstruction UCL, bad news!

23
Q

What are the percentage loss supination vs flexion for distal biceps

A

40% loss supination strength / 85% supination endurance
20% loss flexion strength

24
Q

What is Speed vs Yergason test for biceps

A

Speed: resisted flexion in supination
Yergason: resisted supination

25
Any difference in outcomes for scope suprapec vs open subpec biceps tenodesis
Nope
26
What are the 3 types of acromion?
1 flat 2 curved 3 hooked Best seen on scap Y
27
What are the 3 ossification centers of acromion? Most common location for os acromiale?
A->P: pre, meso, meta Most common at meso/meta junction Often bilateral so look for both sides
28
What ligament is the "essential lesion" for adhesive capsulitis?
CH lig
29
Which athlete is the gimme for distal clavicle osteolysis? Treat
Weight lifters Nonop 1st Distal clavicle resection -> preserve sup + post capsule for stability, don't resect >1cm
30
What is the most common SC injury
PHYSEAL 1st to ossify, last to fuse (around 20yo)
31
Which head of the pec is involved in rupture
Sternal Both insert at the same spot, question is where originate (sternum vs clavicle)
32
Sx quadrilateral space syndrome
Weak deltoid + teres minor bc compression post br ax n Dx with arteriogram bc can also see post hum circum art compression
33
Medial scapular winging - Nerve / muscle Surgery if fail non op
Inf border of the scapula is medial (vs sup) Serratus ant / long thoracic nerve is OUT Overpower of the trap Rehab -> split pec major transfer
34
Lateral scapular winging - Nerve / muscle Surgery if fail non op
Inf border lateral Trap weak / spinal accessory nerve (CN 11) Non-op -> Eden Lange trsf = move levator and rhomboids lateral
35
Best next test if see charcot joint
C spine imaging - syringomyelia
36
Swollen arms - 2 ddx
Thoracic outlet Ax/subclavian art aneurysm/thrombosis