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MSK - Orthopedics > Upper Limb Coretext > Flashcards

Upper Limb Coretext Flashcards

1
Q

What are the muscles of the rotator cuff?

A

Supraspinatous

Infraspinataous

Teres Minor

Subscapularis

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2
Q

Name the muscles numbered

A
  1. Supraspinatus
  2. Infraspinatus
  3. Teres Minor
  4. Subscapularis
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3
Q

Where do the supraspinatus, infraspinatus and teres minor muscles attach on to?

A

Greater tuberosity of the humerus

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4
Q

What shoulder problems are common in each age group?

young

old

elderly

A

Young- instability

Old- rotator cuff tears

Elderly - Glenohumeral Osteoarthritis

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5
Q

What is Impingement sydrome?

A

The tendons of the rotator cuff (usually the supraspinatus muscle) are compressed in the tight subacromial space during movement resulting in pain.

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6
Q

What range of motion is known as the painfull arc?

A

60-120 degrees of abduction

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7
Q

Name three causes of impingement syndrome

A
  1. Tendonitis Subacromial Bursitis
  2. Acromioclavicular OA with inferior osteophytes
  3. A hooked acromion rotator cuff tear
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8
Q

What is the management plan for Impigement Syndrome?

A

Treatment is conservative

NSAIDs

Physiotherapy

Subacromial Injection

Subacromial decompression surgery if necessary

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9
Q

What is a rotator cuff tear?

A

Tendons of a rotator cuff muscle tear.

Can be partial or full thicknes

Classic history of a sudden jerk

degenerative changes in the tendons

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10
Q

What is the management plan for Rotator cuff tears?

A

Physiotherapy to strength remain cuff muscles

Surgical Rotator Cuff repair.

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11
Q

What is another name for Adhesive Capsulitis?

A

Frozen Shoulder

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12
Q

What is adhesive capsulitis?

A

Progressive pain and siffness of the shoulder in patients between 40 and 60 - resloving after 18-24 months

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13
Q

What is the principle clinical sign of frozen shoulder?

A

Loss of external rotation

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14
Q

How do you treat frozen shoulder?

A

Phsyiotherapy

Analgesic - Intra-articular injections

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15
Q

What can be seen on this X-ray?

A

Acute calcific tendonitis

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16
Q

What would the patient experiance in acute calcific tendoitis?

A

Acute onset of severe shoulder pain

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17
Q

What tendon is usually affected in acute calcific tendonitis?

A

Suprapspinatous tendon

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18
Q

What is the prognosis of acute calcific tendonitis?

A

Self limiting with pain easing as the calcification reabsorbs

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19
Q

What are the two types of shoulder instability that exist?

A

Traumatic instabiliy

Atraumatic - patients with generalized ligamentous laxity

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20
Q

What is Carpal Tunnel syndrome?

A

Compression of the median nerve as it passes through the carpal tunnel.

21
Q

What nerve is affected in carpal tunnel sydrome?

A

Median nerve

22
Q

What do patients with carpal tunnel syndrome present with?

A

Symptoms affecting only the thumb and raidal 2.5 fingers

  • Parathesia of the thumb
  • Loss of sensation
  • weakeness
  • Clumbsiness
23
Q

What are some of the secondary causes of Carpal Tunnel Syndrome?

A

Rheumatoid Arthritis
Pregnancy

Diabetes

Chronic renal failure

24
Q

What is the management plan for carpal tunnel syndrome?

A

Non operative

wrist splints at night to prevent flexion.

Steroid Injections

Surgical treatments

Carpal tunnel decompression - division of the carpal ligament under local anaesthetic

25
Q

What is Cubital Tunnel Syndrome?

A

Compression of the Ulnar nerve at the elbow behind the medial Epicondyle

26
Q

What do patients with cubital tunnel syndrome usually present with?

A

only the 1.5 ulnar fingers are affected

Paraesthesiae

Weakness

27
Q

What is the management plan for cubital tunnel sydrome ?

A

surgery to release any tight structures

28
Q

What examination can be preformed to diagnose carpal or cubital tunnel syndrome?

A

Nerve conduction studies

29
Q

Where do the tricept muslces insert?

A

Olecranon process

30
Q

What is another name for Lateral Epicondylitis?

A

Tennis elbow

31
Q

What are the clincial features of Tennis Elbow?

A

Painful and tender lateral epicondyle

painful middle finger and wrist extension

32
Q

What is the management plan for tennis elbow

A

Self limiting condition

Rest

Physiotherapy

NSAIDs

sometimes steroids

sometimes brace

33
Q

What is another name for Medial epicondylitis?

A

Golfers elbow

Golf - medial

Tennis - lateral

34
Q

What is the management plan for medial epicondylitis?

A

self limiting

Physio

rest

NSAIDs

Injection carries risk of injury to the ulna nerve

35
Q

If you have a Total Elbow Replacement what is the maximum weight you can lift?

A

2.5kg

36
Q

What can you see here?

A

Dupuytren’s contracture

37
Q

What is Dupuytren’s contracture?

A

Ploiferative connective tissue disorder where specialized palmar fascia undergoes hyperplasia resulting in contractures at the MCP and PIP joints.

38
Q

What type of collagen is produce in Dupurytren’s contracture and what collagen is normally produced?

A

Type 3 rather than type 1

39
Q

What do people with dupuytren’s contracture present with?

A

Contractures of the ring and little fingers

40
Q

What is the management plan for duputures contracture

A

Mild - leave it

Severe - surgery

41
Q

Why do people get trigger finger?

A

Tendonitis of a flexor tendon to a digit resulting in nodular enlargement of the affected tendon which gets stuck in the fascial pully over the tendon neck

42
Q

How do you treat trigger finger

A

Steroid injection around the tendon within the sheath

or

Surgery

43
Q

What joints of the hand does OA usually occour in ?

A

DIP and PIP

1st carpometacarpal joint (base of thumb) common in woman

44
Q

What hand joints are spared in Rheumatoid Arthritis?

A

DIPs

45
Q

What are the three stages of Rheumatoid Arthritis in the hand?

A
  1. Synovitis and tenosynovitis
  2. Erosions of the joint
  3. Joint instability and tendon rupture
46
Q

What is a ganglion cyst?

A

Common mucinous filled cysts found adjacent to a tendon or synovial joint

47
Q

What do people with ganglion cysts present with?

A

pain and irriation

cosmetic reasons

48
Q

What is going on here?

A

Giant cell tumour of the tendon sheath

49
Q
A

MSK - Orthopedics (12 decks)

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