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ortho/rheumatology > upper extremity > Flashcards

upper extremity Flashcards

1
Q

dupuytren contracture

affects what

causes what

tx

A

palmar aponeurosis, ring and little, middle fingers

causing painful nodules, pitting, and contractures

surgical release for metacarpal phalangeal joint greater than 30 degrees and for proximal phalangeal contractures of any degree, or nerve compression

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2
Q

rotator cuff syndrome characteristics

A

eccentric loading; common cause is impingement of supraspinatus tendon as it passes beneath the subacromial arch

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3
Q

sx of rotator cuff syndrome

A

dull pain

exacerbated by abduction of arm

pain interferes with sleep

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4
Q

common method of shoulder dislocations

A

fall on outstretched arm in abduction and extension.

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5
Q

PE shows loss of shoulder contour with elbow pointing outward

A

anterior should dislocation

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6
Q

hill sachs lesion

A

humoral head deformities noted in recurrent dislocations

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7
Q

bankart lesion

A

tear of the glenoid labrum picked up on MRI

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8
Q

diagnostic imaging for shoulder

A

AP view as well as a transthoracic “Y” view.

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9
Q

tx for shoulder dislocations

A

reduction, do films, check NV status, velpaeus sling. PT after 3 wks for people under 40 y/o and after 1 wk for pts older then 40

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10
Q

common shoulder problem with pts with DM

A

adhesive capsulitis

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11
Q

adhesive capsulitis comes from what? characteristics? DX and tx

A

inflammatory process that may follow injury. pain and restricted glenohumeral movement. arthrography may show decreased volume of joint capsule and capsular contraction. tx is NSAIDS, PROM.

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12
Q

why is proximal portion displaced superiorly in a fracture clavicle

A

attachment of sternocleidomastoid muscle

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13
Q

AC separation involves what and occurs how

A

tearing of the AC and/or coracoclavicular ligaments; caused by a fall on or impact to the tip of the shoulder

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14
Q

AC separation PE, Xray, Tx

A

PE: apparent step off the the AC joint. AP xray both shoulders, maybe do stress/weighted films. tx; sling or sx

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15
Q

what is carpel tunnel syndrome

A

compression of median nerve under the transverse carpel ligament

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16
Q

thenar atrophy can be a sign of what

A

carpel tunnel syndrome late in the disease

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17
Q

tennis elbow aka…

A

lateral epicondylitis

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18
Q

golfers elbow aka

A

medial epicondylitits

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19
Q

lateral epicondylitis, pt age, involves what structure

A

30s, tendinous insertion of extensor carpi radialis brevis

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20
Q

lateral epicondylitis PE,, tx

A

pain with lifting(when arm is pronated). duplicate pain with elbow in extension and forearm pronated, extend fingers against resistance. tx: counterbalance braces, PT, OT, maybe NSAIDS, sx, inj

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21
Q

medial epicondylitis affects what structures and how to reproduce the pain

A

flexor/pronator group; resisted pronation or flexion of wrist

22
Q

organism in olecranon bursitis

A

staph aureus. NSAIDS and warm compresses

23
Q

what is nursemaids elbow

A

longitudinal traction and the radial head slips anteriorly out of the annular ligament

24
Q

what is de Quervain’s disease and who does it occur in

A

stenosing tenosynovitis involving the abductor pollicis longus and extensor pollicis brevis; woman >30y/o and DM

25
Q

deQuervains PE and tx

A

pain at base of thumb, +Finklestein’s test; NSAID, thumb spica splint, PT/OT, inj, sx decompression

26
Q

common shoulder dislocation

A

anterior 95%

27
Q

shoulder pain can be referred pain caused by

A

cervical spondylosis

28
Q

Supraspinatus

Infraspinatus

Teres minor

Subscapularis

A

Supraspinatus – abducts the arm (This is the most commonly injured muscle)

Infraspinatus – externally rotates the arm

Teres minor – externally rotates the arm

Subscapularis – internally rotates the arm

29
Q

carpel tunnel syndrome parathesias spares what finger

A

pinky

30
Q

anterior shoulder dislocation presentation

A

pt hold arm in slight abduction and ER

elbow pointing outward

31
Q

post shoulder dislocation position

A

pt hold arm in adduction and IR

32
Q

shoulder dislocation risk for what

A

axillary nerve injury

33
Q

velpeau sling for what

A

shoulder dislocation

and humeral head fx

34
Q

subacromial decompression for what

A

rotator cuff

35
Q

secondary to osteonecrosis, trauma, septic arthritis, endocrine, neuropathic d/o

A

can cause OA of humeral head

36
Q

humerus fracture

from what

nerve?

may lead to what 2 things

A

from direct trauma

radial nerve palsy

may lead to wrist drop and loss of thumb EXTENSION

37
Q

humerus fx tx

A

coaptation sling/splint

then

hanging arm cast

38
Q

humeral head fx

etio and age

pain where

signs?

presentation

A

old pts with osteoporosis

pain at greater tuberosity

ecchymosis 24-48 hrs later

hold extremity against chest wall

39
Q

humeral head fx

dx

tx

A

AP, lateral, y views

“neer classification”

ORIF, CRIF, pendulum, velpeau sling

40
Q

clavicle fx

age

3% of what

A

kids

live births due to trauma

41
Q

humeral head fx look for injuries to what

A

brachial plexus and axillary artery

42
Q

supracondylar humerus fx

mechanism

symptoms

A

fall on outstretched hand with hyperextension of elbow

pain and MINIMAL swelling

43
Q

watch for what with supracondylar humeral fx

A

varus and valgus deformity from arrest of medial and lateral growth plate

check for brachial artery injury

volkman

44
Q

supracondylar humeral fx

tx

A

kids: CRIF with post splint
adults: ORIF

45
Q

clavicle fx presentation and tx

A

arm supported by other arm

kids: figure 8 sling 4-6 weeks
adults: sling 6 weeks

46
Q

clavicle fx description

A

proximal portion displaced superiorly due to attachment of sternocleidomastoid muscle

47
Q

night stick fx

definition and tx

A

ULNAR shaft from direct trauma often from self defense with blunt object

tx

ORIF if bad displacement

48
Q

monteggia fracture

description

mechanism

tx

A

DIAPHYSEAL fx of radius with dislocation of distal radio/ulnar joint

from direct blow to radius

ORIF radius and casting fx forearm in supination to reduce radioular joint

49
Q

colles fx

description

ages

mechanism

A

distal radius

elderly and kids

fall on outstretched hand, leading to dorsally displaced dorsally angulated fx

SILVER FORK DEFORMITY

50
Q

SILVER FORK DEFORMITY TX

A

CRIF then long arm cast,

ORIF if fx is intra-articular

51
Q

boxers fx

A

metacarpal neck of 4th or 5th finger

look for puncture wound

25-30 degrees angulation: ulnar splint, maybe pinning

52
Q

gamekeeper’s thumb

A

UCL sprain/tear

instability and weak pinch

partial rupture: immobilize, thumb spica cast

complete: surgical repair

ortho/rheumatology (13 decks)

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