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Clin Med II MSK > Upper Extremity > Flashcards

Upper Extremity Flashcards

1
Q

Most common shoulder dislocation

A

Anterior

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2
Q

Causes of posterior shoulder dislocation

A

Sz, electrocution (rare)

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3
Q

Deformity in anterior shoulder dislocation

A

Prominent acromion

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4
Q

What xray view to get for posterior shoulder dislocation?

A

Axillary lateral view

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5
Q

Complications of shoulder dislocation

A
  • Labral tear (cartilage surrounding glenoid)

- Axillary nerve injury

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6
Q

What is disrupted in AC joint sprain?

A
  • AC ligaments

- Coracoclavicular ligaments

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7
Q

How are AC joint sprains graded? How to determine grade? Which are operative?

A
  • 1-6 (1 is least severe displacement)
  • Need xray to grade
  • 1-3: non-operative
  • 3-6: operative
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8
Q

Most common cause of AC joint pain

A

AC joint arthrosis

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9
Q

Cause of shoulder impingement syndrome

A

Overuse (AKA swimmer’s shoulder)

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10
Q

When is pain usually present in shoulder impingement syndrome? And with which motions?

A
  • Night

- Reaching overhead/backwards, lifting

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11
Q

Muscles of rotator cuff

A
  • Supraspinatus
  • Subscapularis
  • Infraspinatus
  • Teres minor
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12
Q

Most commonly torn muscle of rotator cuff

A

Supraspinatus

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13
Q

Diagnostic modality for rotator cuff tear

A

MRI

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14
Q

Tests for rotator cuff inflam or impingement

A
  • Hawkin’s test: pain abducting shoulder or flexing elbow

- Neer’s test: pain w/ forward arm flexion

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15
Q

How to tell bt impingement and rotator cuff tear

A

Rotator cuff tear: there is a pop/rip

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16
Q

Frozen Shoulder AKA…

A

Adhesive capsulitis

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17
Q

Pathophys of frozen shoulder

A

Inflam, loss of motion from thickening of glenohumeral capsule

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18
Q

3 phases of frozen shoulder

A
  • Inflammatory: significant pain
  • Frozen: limited pain, but significant motion loss
  • Thawing: gradual return of motion, permanent deficits
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19
Q

Does frozen shoulder have loss of ACTIVE or PASSIVE movement?

A

BOTH

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20
Q

Treatment for frozen shoulder

A 
Decrease inflam (NSAIDS, steroids), improve motion (PT)
- May take 2-3 yrs to resolve
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21
Q

Complications of shoulder fracture

A
  • Adhesive capsulitis

- Rotator cuff tear

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22
Q

Most common location to break your clavicle

A

Middle 1/3

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23
Q

How does a broken clavicle present?

A

Deformity w/ point tenderness and ecchymosis

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24
Q

What is the most common fracture in women >50?

A

Proximal humerus fx

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25
What is the most common site of radial nerve injury?
Proximal humerus fx
26
What do you worry about in kids w/ proximal humerus fx?
- Compartment syndrome | - Brachial artery
27
What splint do you put on a proximal humerus fx?
Sugar tong splint
28
What is the layman's term for lateral epicondylitis?
Tennis elbow
29
What is the layman's term for medial epicondylitis?
Golfer's elbow
30
What is the layman's term for olecranon bursitis?
Scholar's elbow
31
Is lateral epicondylitis an inflammatory condition?
No, it is actually TENDINOSIS
32
Lateral vs. Medial epicondylitis: pain w/ resisted flexion or extension, supination or pronation?
Lateral=extension & supination | Medial=flexion & pronation
33
Abrupt goose egg swelling over olecranon
Olecranon bursitis
34
Which nerve is entrapped (and where) in cubital tunnel syndrome?
Ulnar nerve at the medial elbow
35
Sx of cubital tunnel syndrome
Numbness and tingling in 4th and 5th digits
36
Cause of nursemaid's elbow
Traction of elbow in extension (pulled up by arm)
37
How will a kid w/ nursemaid's elbow hold their arm?
Flexed and pronated
38
What 3 things to ALWAYS check in trauma situation to assess neurovascular status? Always recheck these 3 things after doing what?
Pulses, sensory, motor Reducing a fx or dislocation
39
Most common elbow fx in kids
Supracondylar fx
40
What sign will you see on xray of supracondylar fx?
Fat pad sign--dark area on either side of bone
41
Which 2 nerves and artery are you concerned about in a supracondylar fx?
Median and radial nerve | Brachial artery
42
Which is more common: distal or proximal humerus fx?
Proximal
43
What sign will you see on xray of distal humerus fx?
Posterior fat pad or "sail" sign
44
Monteggia fx
Fx of proximal ulna AND radial head dislocation | Can also have radial head fx
45
Galeazzi fx
Fx of distal radial shaft AND dislocation of distal radio-ulnar joint
46
Most common carpal bone fx
Scaphoid fx
47
Where is there tenderness in a scaphoid fx?
Anatomical snuffbox
48
Which 2 tendons make up the anatomical snuffbox?
Tensor pollicus longus | Extensor pollicus brevis
49
Complication of scaphoid fx
Avascular necrosis
50
What are the 2 types of distal radial fractures?
Colles and Smith
51
What is the most common upper extremity fracture?
Distal radial fx
52
Which is more common: Colles or Smith fx?
Colles
53
Colles fx...AKA? - Mechanism of injury - What does it look like?
- "Dinner fork" deformity - Fall on extended wrist - Dorsal angulation--bone sticking up on dorsal side
54
Smith fx...AKA? - Mechanism of injury - What does it look like?
- "Garden spade deformity" - Fall on flexed wrist - Ventral angulation--bone sticking up on palm side
55
How to diagnose distal radial fractures (which view?)
Lateral xray
56
What can develop over time after Smith fx?
Carpal tunnel
57
Tx for: Colles? Smith?
Colles: sugar tong splint/cast Smith: Ortho for reduction/surgery or cast and PT
58
De Quervian's Tenosynovitis involves which 2 tendons?
Extensor pollicus brevis | Abductor pollicus longus
59
Most common compression neuropathy in upper extremity
Carpal Tunnel Syndrome
60
Borders of the carpal tunnel
- Flexor retinaculum/ transverse carpal ligament (palmar) - Scaphoid and trapezium (radial) - Hamate and triquetrum (ulnar) - Carpal bones (dorsal)
61
Dupuytren's contracture contracts in which direction?
AKA claw hand | Flexion contractures
62
Most common fingers affected by Dupuytren's contracture
4th and 5th
63
Bacterial causes of infection in hand (2)
Strep or staph
64
Paronychia - Cause of acute - Cause of chronic
Inf next to fingernail - Acute=bacterial - Chronic=fungal
65
Felon
Abscess in tip of finger
66
Herpes Whitlow
Herpes inf of fingernail
67
Most common dislocations of hand (2)
DIP and PIP
68
Boxer's fx
5th metacarpal
69
Ulnar collateral ligament injury is caused by what forced motion
Forced abduction of thumb
70
Tx for ulnar collateral ligament injury (partial vs. complete)
Partial=spica cast | Complete=surgery
71
Mallet finger is what type of injury and caused by what motion
Tear at DIP joint (bent at DIP, cannot straighten) | Caused by blow to tip of extended finger forcing flexion at DIP
72
Boutonniere deformity is caused by what motion
Force against tip of partially extended digit | Causes flexion at PIP, extension at DIP
73
Bennett's fx
Fx at base of thumb + dislocation
74
Rolando's fx
Comminuted Bennett's fx
75
Tx for Bennett's and Rolando's fx
UNSTABLE --> ORIF

Clin Med II MSK (7 decks)

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