Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Musculoskeletal 1 > Upper Extremity Injuries - Shoulder > Flashcards

Upper Extremity Injuries - Shoulder Flashcards

1
Q

What are the basic orthopedic treatments?

A
  • NSAIDs
  • Ice
  • Activity restriction, rest, immobilization (specific to each injury)
  • PT
  • OT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How can the extent of fractures be described?

A
  • complete

- incomplete: crack/hairline, buckle, greenstick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

descriptions of configurations of fractures

A
  • transverse: straight across
  • oblique: at an angle
  • spiral: wrapping around the bone
  • comminuted: into many pieces
  • segmental: more than one area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

displaced vs. non-displaced fracture

A

displaced can be angulated, translated, rotated, distracted, shortened, or overriding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is very important and one of the first things you not on a fracture?

A

open vs closed

*affects management of fracture and care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the classification scheme for pediatric fractures w/ open epiphyseal plates?

A
  • Salter-Harris

- Type 1-V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

define the classifications of the salter-harris scheme

A
  • 1: strait across
  • 2: above growth plate
  • 3: below the plate
  • 4: two or through the plate
  • 5: growth plate crushed together
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

95% of glenohumoral dislocations are what kind?

A

anterior in nature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the most common nerve injured during a shoulder dislocation?

A

axillary n.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

complications d/t injured axillary n

A
  • loss of sensation to deltoid

- loss of flexion of the wrist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the most common cause of a shoulder dislocation?

A

fall on abducted, externally rotated shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PE of shoulder dislocation

A
  • will appear slightly abducted and externally rotated
  • loss of rounded appearance at acromion
  • will resist movement d/t pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what films to get w/ a shoulder dislocation

A

-3 view XR of should w/ axillary view
or
-scapular “Y” view*** specific for shoulder dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

anatomically speaking, what forms the scapular Y?

A
  • body, spine, and coracoid process

- glenoid should fall in the center of the Y and be obscured by the humeral head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does the scapular Y appear in dislocations?

A

humeral head appears medial to the “y”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what injuries are associated w/ shoulder dislocations and define them

A
  • hill-sachs deformities: defect of humoral head caused by hitting the glenoid rim during dislocation
  • bankart lesions: labral tears w/ bony fragment avulsion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

tx of a shoulder dislocations

A
  • closed reduction through manipulation of humeral head
  • then post reduction XRs
  • sling/immobilization w/ PT/OT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when to operate shoulder dislocations

A

if they are recurrent or chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the reduction techniques for shoulder dislocations?

A
  • scapular manipulation
  • upright technique
  • Mitch, stimson, fares
  • traction/counter traction** the one he uses
  • what every you have to do to get it back in! (that’s what she said)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is an AC joint injury?

A
  • injury to the acromioclavicular joint involving the CC and AC ligaments
  • sprains range from type I - VI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what type of injury commonly causes AC joint injury?

A
  • fall or direct trauma to acromion

- a typical case presentation: QB gets hit and lands on his shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

PEs for AC joint injury

A
  • TTP of AC joint
  • crossbody adduction test
  • AC shear test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

crossbody adduction test

A
  • active: pt reaches hand across to shoulder
  • passive: examiner passively flexes shoulder to 90 degrees then horixontally adducts the shoulder as far as possible
  • resisted: examiner resists patient’s attempt to horizontally abduct shoulder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

AC shear test

A
  • interlock fingers w/ hand on distal clavical and spine of scapula
  • pain in AC joint when hands are squeezed together = positive test
  • he didn’t recommend this one
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

radiology for AC joint injury

A
  • get XR of shoulder

- text book: Zanca view allows AC joint to be seen w/o overlapping images - not really seen in practice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which classifications of AC join injuries are treated conservatively vs operatively

A
  • type I-III: conservatively w/ immobilization and PT

- type IV-VI: operative tx w/ repair of damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what patients most commonly present w/ proximal humerus fx

A

elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

common cause of proximal humerus fx

A
  • fall or trauma

- most are treated non-operatively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

PE of proximal humerus fx

A

-swelling, TTP, pain w/ ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

nerve commonly injured in proximal humerus fx

A

axillary n.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

radiology for proximal humerus fx

A
  • 2 view XR or humerus
  • or
  • 3 view XR of shoulder
32
Q

NEERS classification for proximal humerus fx

A
  • Based on the anatomical relationship of the 4 major segments of the proximal humerus; anatomical neck, surgical neck, greater tuberosity, and the lesser tuberosity
  • classified as one, two, three or four part
33
Q

define the different parts of the NEERS classification for proximal humerus fx

A
  • One-part: no fragments are displaced
  • Two-part: one displaced fragment
  • Three-part: Two displaced fragments, but humeral head remains in contact with the glenoid
  • Four-part: Three or more displaced fragments and dislocation of the articular surface from the glenoid.
34
Q

conservative tx vs. ORIF in proximal humerus fx

A
  • one part: can tx conservatively
  • two part and up: need ORIF
  • for acute management: immobilize w/ sling and pain control
35
Q

what is a possible complication of proximal humerus fx?

A

adhesive capsulitis (frozen shoulder)

36
Q

What nerve is most commonly injured in a mid-shaft humerus fx?

A

radial n. **

37
Q

possible complications when radial n. is injured?

A
  • decreased wrist, finger, and thumb extension

- sensory loss at dorsum of hand

38
Q

radiology for mid-shaft humerus fx

A

-2 view of humerus

39
Q

tx of mid-shaft humerus fx

A
  • initially: splint and/or immobilization w/ sling

- surgical tx w/ ORIF

40
Q

possible complications from mid-shaft humerus fx

A
  • radial n. palsy

- non-union

41
Q

an example of how to present a mid shaft humerus fx:

A

“I’ve got a closed fx of the mid shaft humerus that appears to be comminuted”
or
“i’ve got a closed comminuted mid shaft fx of the left humerus. no nerve palsy, pain is controlled, will you see her in your clinic in a few days?”

42
Q

supracondylar fx of the humerus

A
  • uncommon in adults

- more info in peds

43
Q

clavicle fx

  • typical in who?
  • MC site
A
  • typical in young children

- MC in middle third

44
Q

clavicle fx is commonly caused by what?

A

fall on shoulder

45
Q

PE of clavicle fx

A
  • pain/swelling to localized area

- possible hematoma formation

46
Q

what is a sign of significant displacement of the clavicle?

A

tenting of skin

47
Q

radiology in clavicle fx

A
  • XR of shoulder w/ widened view to include clavicle

- want to assess shoulder for additional injury

48
Q

indications for emergent ortho referral in clavicle fx

A
  • tenting of skin

- open fx

49
Q

location of clavicle fx in relation to tx

A
  • middle third: tx conservatively

- distal third: need ortho eval and possible surg

50
Q

rotator cuff is made up of the tendons of what muscles?

A

SITS

  • supraspinatus
  • infraspinatus
  • teres minor
  • subscapularis
51
Q

rotator cuff tendonitis

  • source of morbidity
  • types of activities
A
  • common in manual laborer and athletes

- over head activities: swimming, tennis, baseball/softball, weight lifting, etc

52
Q

PE of rotator cuff tendonitis

A
  • shoulder pain w/ overhead motions

- pain w/ ABduction > 90 degrees w/ internal rotation

53
Q

special tests for rotator cuff tendonitits

A
  • Neer
  • Hawking
  • Empty can
  • Lift off/ belly press test
  • note: can have pain in these tests from many shoulder problems - not just specific to rotator cuff
54
Q

neer’s test

A
  • place hand on pts scapula, other on forearm
  • pt fully internally rotates (thumb points down)
  • passively forward flex arm through full ROM
  • pain = impingement
55
Q

hawking test

aka hawkins-kennedy test

A
  • flex arm to 90 degrees
  • stabilize shoulder w/ one hand
  • forcibly internally rotate shoulder, thumb pointed down
  • pain = impingement
56
Q

tx for rotator cuff tendonitits

A
  • non-operative:
  • basic ortho care
  • steriod injections: don’t exceed 3-4 per year d/t risk of tendon necrosis
  • PT/OT: underused!!
57
Q

rotator cuff tear

A

-same tendons as rotator cuff tendonitis, just separated from the bone

58
Q

what radiologic modality to order to confirm rotator cuff tear?

A

MRI of shoulder

59
Q

tx of rotator cuff tear

A

surgery

60
Q

what is the labrum

A

cartilaginous tissue around the edge of the glenoid

61
Q

when do labrum tears often occur?

A
  • in shoulder dislocations

- overuse injury

62
Q

SLAP tear

A
  • superior labrum anterior and posterior

- common in pitchers

63
Q

what is the special test for a SLAP tear?

A

O’brien’s sign

64
Q

O’brien test

A
  • aka active compression test
  • pt. flexes GH joint to 90 degrees and horixontally adducted 15 degrees from sagittal plane
  • downward pressure is applied w/ humerus fully internally rotated and externally rotated
  • if pain w/ internal rotation but decreases w/ external rotation and there is clicking = SLAP
65
Q

special test for anterior labrum injury

A

apprehension test

66
Q

apprehension test

A

-as should is moved passively into max external rotation in abduction and foward pressure is applied to posterior aspect of humeral head, pt complains of pain or instability

67
Q

special test for posterior labrum injury

A

jerk test

68
Q

impingement syndrom

A
  • combo of shoulder sx that cause limited ROM and pain secondary to impingement
  • very very painful
69
Q

PE of impingement syndrome

A
  • positive Neers and Hawking’s sign

- pain w/ ROM above head and should ABduction > 90 degrees

70
Q

tx for impingement syndrome

A
  • conservative: 4-6 mo.

- if conservative fails: operative

71
Q

what is the MC form of impingement syndrome?

A

subacromial decompression

72
Q

adhesive capulitis

A
  • GRADUAL development of global limitation of active and PASSIVE ROM
  • literally cannot move shoulder
73
Q

what is a common presentation of adhesive capsulitits

A

-50-60 yo women w/ DM

74
Q

PE of adhesive capsulitis

A

-nagging pain at night and progressive global stiffness in the absence of other pathology

75
Q

tx of adhesive capsulitis

A
  • conservative
  • surgery not typically helpful
  • manipulation under anesthesia has been proven effective

Musculoskeletal 1 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions