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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
Q

What is the most common site of radial nerve injury?

A

Proximal humerus fx

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26
Q

What do you worry about in kids w/ proximal humerus fx?

A
  • Compartment syndrome

- Brachial artery

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27
Q

What splint do you put on a proximal humerus fx?

A

Sugar tong splint

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28
Q

What is the layman’s term for lateral epicondylitis?

A

Tennis elbow

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29
Q

What is the layman’s term for medial epicondylitis?

A

Golfer’s elbow

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30
Q

What is the layman’s term for olecranon bursitis?

A

Scholar’s elbow

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31
Q

Is lateral epicondylitis an inflammatory condition?

A

No, it is actually TENDINOSIS

32
Q

Lateral vs. Medial epicondylitis: pain w/ resisted flexion or extension, supination or pronation?

A

Lateral=extension & supination

Medial=flexion & pronation

33
Q

Abrupt goose egg swelling over olecranon

A

Olecranon bursitis

34
Q

Which nerve is entrapped (and where) in cubital tunnel syndrome?

A

Ulnar nerve at the medial elbow

35
Q

Sx of cubital tunnel syndrome

A

Numbness and tingling in 4th and 5th digits

36
Q

Cause of nursemaid’s elbow

A

Traction of elbow in extension (pulled up by arm)

37
Q

How will a kid w/ nursemaid’s elbow hold their arm?

A

Flexed and pronated

38
Q

What 3 things to ALWAYS check in trauma situation to assess neurovascular status?

Always recheck these 3 things after doing what?

A

Pulses, sensory, motor

Reducing a fx or dislocation

39
Q

Most common elbow fx in kids

A

Supracondylar fx

40
Q

What sign will you see on xray of supracondylar fx?

A

Fat pad sign–dark area on either side of bone

41
Q

Which 2 nerves and artery are you concerned about in a supracondylar fx?

A

Median and radial nerve

Brachial artery

42
Q

Which is more common: distal or proximal humerus fx?

A

Proximal

43
Q

What sign will you see on xray of distal humerus fx?

A

Posterior fat pad or “sail” sign

44
Q

Monteggia fx

A

Fx of proximal ulna AND radial head dislocation

Can also have radial head fx

45
Q

Galeazzi fx

A

Fx of distal radial shaft AND dislocation of distal radio-ulnar joint

46
Q

Most common carpal bone fx

A

Scaphoid fx

47
Q

Where is there tenderness in a scaphoid fx?

A

Anatomical snuffbox

48
Q

Which 2 tendons make up the anatomical snuffbox?

A

Tensor pollicus longus

Extensor pollicus brevis

49
Q

Complication of scaphoid fx

A

Avascular necrosis

50
Q

What are the 2 types of distal radial fractures?

A

Colles and Smith

51
Q

What is the most common upper extremity fracture?

A

Distal radial fx

52
Q

Which is more common: Colles or Smith fx?

A

Colles

53
Q

Colles fx…AKA?

  • Mechanism of injury
  • What does it look like?
A
  • “Dinner fork” deformity
  • Fall on extended wrist
  • Dorsal angulation–bone sticking up on dorsal side
54
Q

Smith fx…AKA?

  • Mechanism of injury
  • What does it look like?
A
  • “Garden spade deformity”
  • Fall on flexed wrist
  • Ventral angulation–bone sticking up on palm side
55
Q

How to diagnose distal radial fractures (which view?)

A

Lateral xray

56
Q

What can develop over time after Smith fx?

A

Carpal tunnel

57
Q

Tx for:
Colles?
Smith?

A

Colles: sugar tong splint/cast
Smith: Ortho for reduction/surgery or cast and PT

58
Q

De Quervian’s Tenosynovitis involves which 2 tendons?

A

Extensor pollicus brevis

Abductor pollicus longus

59
Q

Most common compression neuropathy in upper extremity

A

Carpal Tunnel Syndrome

60
Q

Borders of the carpal tunnel

A
  • Flexor retinaculum/ transverse carpal ligament (palmar)
  • Scaphoid and trapezium (radial)
  • Hamate and triquetrum (ulnar)
  • Carpal bones (dorsal)
61
Q

Dupuytren’s contracture contracts in which direction?

A

AKA claw hand

Flexion contractures

62
Q

Most common fingers affected by Dupuytren’s contracture

A

4th and 5th

63
Q

Bacterial causes of infection in hand (2)

A

Strep or staph

64
Q

Paronychia

  • Cause of acute
  • Cause of chronic
A

Inf next to fingernail

  • Acute=bacterial
  • Chronic=fungal
65
Q

Felon

A

Abscess in tip of finger

66
Q

Herpes Whitlow

A

Herpes inf of fingernail

67
Q

Most common dislocations of hand (2)

A

DIP and PIP

68
Q

Boxer’s fx

A

5th metacarpal

69
Q

Ulnar collateral ligament injury is caused by what forced motion

A

Forced abduction of thumb

70
Q

Tx for ulnar collateral ligament injury (partial vs. complete)

A

Partial=spica cast

Complete=surgery

71
Q

Mallet finger is what type of injury and caused by what motion

A

Tear at DIP joint (bent at DIP, cannot straighten)

Caused by blow to tip of extended finger forcing flexion at DIP

72
Q

Boutonniere deformity is caused by what motion

A

Force against tip of partially extended digit

Causes flexion at PIP, extension at DIP

73
Q

Bennett’s fx

A

Fx at base of thumb + dislocation

74
Q

Rolando’s fx

A

Comminuted Bennett’s fx

75
Q

Tx for Bennett’s and Rolando’s fx

A

UNSTABLE –> ORIF

Clin Med II MSK (7 decks)

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