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MSK > upper limb > Flashcards

upper limb Flashcards

1
Q

what happens in rotator cuff impingement?

A

the tendons of the rotator cuff (mainly supraspinatous) are compressed in the tight subacromial space during movement

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2
Q

approximately, when in abduction does painful arc syndrome occur?

A

60-120 degrees

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3
Q

name some causes of rotator cuff impingement ?

A

hooked acromion rotator cuff tear
tendonitis subacromial bursitis
acromioclavicular OA

painting /overhead work
athelets-throwing, swimming

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4
Q

what is this?
shoulder pain (radiating to deltoid and upper arm)
tenderness on later edge of acromion
Hawkin’s _kennedy test positive

A

rotator cuff impingment

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5
Q

treatment for rotator cuff impingement?

A
  1. conservative- NSAIDS, analgesics, physio, steroid injection
  2. surgery- subacromial decompression to create for space for tendon to pass through
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6
Q

classic history of a sudden jerk in patient >40 with pain and weakness

A

rotator cuff tear

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7
Q

how do you confirm rotator cuff tears?

A

Ultrasound or MRI

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8
Q

treatment for rotator cuff tear?

A

non surgery-physio

surgery-subacromial decompression

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9
Q

what is adhesive capsulitis?

A

frozen shoulder

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10
Q

progressive pain and stiffness of shoulder in 40-60 year olds and loss of external rotation

A

frozen shoulder

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11
Q

how do you treat frozen shoulder/

A

physio and analgesics

steroids injections can help in the painful phase

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12
Q

what is acute calcific tendonitis?

A

acute onset of severe shoulder pain characterized by calcium deposition in supraspinatus tendon

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13
Q

where do you see calcific tendonitis?

A

proximal to greater tuberosity of humerus on XRAY

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14
Q

treatment for calcific tendonitis?

A

subacromial steroid injection and local anaesthetic gives great relief

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15
Q

what are the 2 types of shoulder instability?

A

traumatic

atraumatic

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16
Q

what is traumatic dislocation?

A

patients experience traumatic anterior shoulder dislocation.

most of these settle after reduction and physio

for recurrent dislocations, the Bankart repair can stabilize the shoulder

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17
Q

what is atraumatic dislocation?

A

patients tend to have generalised lax ligaments, dislocations can be multidirectional

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18
Q

what causes anterior shoulder pain with pain on resisted biceps contraction?

A

inflammation of long head of biceps (biceps tendonitis)

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19
Q

name things which can cause referred pain to the shoulder

A

neck
angina
diaphragmatic irritation-biliary colic, hepatic abscess

20
Q

lateral epicondylitis?

A

tennis elbow

21
Q

what causes tennis elbow

A

repetitive strain

lost of restricted extension of the wrist

22
Q

painful and tender over lateral epicondyle

A

tennis elbow

23
Q

treatment for tennis elbow?

A 
rest from activity
physio
NSAIDs
steroid injections
use of a brace
ultrasound therapy maybe
surgery in rare cases/for athletes
24
Q

medial epicondylitis

A

golfer elbow

25
Q

cause of golfer elbow

A

repetitive strain or degeneration of the common flexor origin

26
Q

which arthritis is more common in the elbow/

A

RA

27
Q

what is Dupuytren’s contracture?

A

connective tissue disorder where the palmar fascia undergoes hyperplasia

28
Q

normal fascia bands form nodules and cords progressing to contractures

A

Dupuytren’s contracture

29
Q

who is more affected by Dupuytren’s contracture?

A 
men
people with diabetes
people with liver cirrhosis
Peyronie's disease
Ledderhose disease
30
Q

pathology of Dupuytren’s contracture?

A

proliferation of myofibroblast cells and production of abnormal collegen

31
Q

what body part does Peyronie’s disease affect?

A

penis

32
Q

what body part does Ledderhose disease affect?

A

feet

33
Q

when do people with Dupuytren’s contracture get surgery?

A

when its affecting their function

34
Q

what is trigger finger?

A

tendonitis of a flexor tendon to a digit

35
Q

how to treat trigger finger?

A

steroid injection around tendon within the sheath

surgery offered inn recurrent cases

36
Q

Heberden’s nodes

A

bony thickenings from OA in distal interphalangeal joints

37
Q

Bouchard’s nodes

A

bony swellings from OA in proximal interphalangeral joints

38
Q

Boutonniere deformity
swan neck deformity
Z shaped thumb
ulnar deviation

volar MCPJ subluxation

A

RA in hands

39
Q

3 stages of RA in the hand?

A
  1. synovitis and tenosynovitis
  2. erosions of joint
  3. joint instability and tendon rupture
40
Q

what are ganglion cysts?

A

mucinous filled cysts found adjacent to a tendon or synovial joint

41
Q

firm, smooth, rubbery, should transilluminate

A

ganglion cyst

42
Q

how to treat a ganglion cyst?

A

if swelling is causing localized discomfort, surgical excision

43
Q

second most common soft tissue swelling of hand?

A

giant cell tumour of tendon sheath

44
Q

where do you normally find giant cell tumour of tendon sheath?

A

palmar surface

45
Q

what is the danger of a giant cell tumour of tendon sheath?

A

can envelope digital nerve or artery and erode bone.

MSK (15 decks)

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