UE Clinical Flashcards
Go completely out of anatomic alignment
Dislocate
Go back to anatomic alignment
Reduce
Go partially out of anatomic alignment
Subluxate
Rotator Cuff: Elevation
Supraspinatus, (Deltoid)
RC: Internal Rotation
Subscapularis
RC: External Rotation
Teres minor, infraspinatus
Most common RC pathologies (3)
Age-related degenerative tears, tendon degenerative process, idiopathic?
Less common RC pathologies (2)
Young athletes/laborers, acute injury related
Body healing in general
most often - will heal seld
shaft can accept some malalignment
ligaments can reattach to bones
Children heal especially well
____________ injuries must be made perfectly straight (or else____)
Articular surfaces - joint pain and permanent damage
Indicators of poor healing of rotator cuff pathology
Large, long-standing
Try PT
SC dislocation
High energy trauma (secondary injuries also likely)
AC dislocation
Mid to high energy
Often treated w/out surgery
“Shoulder separation” w/ coracoclavicular
Scapulothoracic dislocation
HIGH energy
Neurologic/vascular injuries and secondary injuries likely
Glenohumeral dislocation
Frequent “Shoulder” dislocation
Anterior vs. Posterior glenohumeral dislocation
describe position of humeral head w/ glenoid face of scapula
Anterior - most common, imbalance or over pull
Posterior - rare (lose body control - electrocution, seizure)
Humerus shaft tolerates _______
angulation or rotation deformity (vs. articular surfaces which do not)
Humerus fracture at ________, worry about nerve injury at ________ (4)
neck - axillary
radial - midshaft
medial & ulnar - distally (epicondyles)
Lateral epicondyle pain
tennis elbow
extensor tendons
Medial epicondyle pain
golfer’s elbow
flexor-pronator origin
Nursemaid’s elbow
dislocation of radial head/humerus
traction/pulling injury (slip out from anular ligament)
Adult dislocations
Simple - low energy, timely reduction –> okay, R/U move away from humerus as a unit
Fracture + dislocation - high energy, require surgical repair
Maybe long term problems (pain, stiffness, instability)
Changes in bones shape in ______ not tolerated
Forearm (d/t need for mobility in rotation)
Most common fracture of forearm
Distal radius
Most common fracture of the wrist
Scaphoid
Ulnar nerve damage
Sensation
Fine motor control of intrinsic muslces (ulnar sided lumbricals, dorsal interossei, palmar interossei)
Muscle loss annoying
Pathology can occur at wrist or elbow
Radial nerve injury
Proximal - wrist drop and thumb can’t extend
If after elbow but before branch to posterior interosseous - finger extension, lack of thumb extension (most distal), no change in sensation
Dorsal/palmar interossei + lumbricals –> extend fingers at ______ but flex at ______
DIP, PIP extend
Flex at MC
