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MS ORTHO > Upper Limb Injuries > Flashcards

Upper Limb Injuries Flashcards

1
Q

Shoulder

Anatomical joints ( 3 )

A
  • Glenohumeral
  • Acromioclavicular
  • Sternoclavicular
  • Impingement syndrome
  • thoracic outlet syndrom

Notes:
Aber - lose lack position

Close pack

  • ligament tight
  • increase congruence
  • dislocatable

Open pack

  • ligament lax/ loose
  • decrease congruence

Axillary nerve symptoms
- weak deltoids/ atrophy

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2
Q

Glenohumeral joint injuries

A
  • glenoid fossa + humeral head
  • easily dislocatable ; earky dislocated joint
  • MOI: Aber
  • MC direction injury: anterior and inferior part of the joint capsule
  • MC structured affected: Axillary nerve ( c5- c6 )
  • 1/3 of humeral head approximately with glenoid fossa
  • Stability:

> Static ( all structure except the muscles )

  • Bony congruence
  • Glenoid Labrum- rim that surround the glenoid fossa
  • ( + ) intraarticular pressure- suction motion to avoid early dislocation
  • GH ligaments ( sup, mid and inf )
  • GH joint capsule

> Dynamic
* scapular stabilizing muscles
A. long head of biceps tendon- intracaps T.
- indicate of any injury affected jt. capsule manifest may include long head of biceps tendon
- ( muscles ) traps, rhomboid, serratus anterior, levator scap, lats and pecs minor.
B. Rotator cuff muscles
- SITS ms.

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3
Q

Long head of biceps tendon ( 5 )

A
  1. Bankart
  2. Hill- Sachs
  3. Reverse Bankart
  4. Reverse Hill Sachs
  5. Bennetts lesion
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4
Q

Bankart ( ANT INF ABER )

A
  • tearing of anterior inferior joint capsule
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5
Q

Hill Sachs ( ANT INF ABER )

A
  • compression fracture of the posterior lateral humeral head
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6
Q

Reverse Bankart. ( Post ADIR )

A
  • tearing of the posterior inferior joint capsule
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7
Q

Reverse Hill Sachs ( Posterior Adir )

A
  • compression fracture of the anterior humeral head
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8
Q

Bennetts lesion

A
  • ossification of the posterior glenoid labrum and inferior glenohumeral joints
  • MC basketball players
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9
Q

SLAP lession

A
  • rep. Over head ax.
  • superior labrum angerior posterior lsion
  • repetitive overhead activities.
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10
Q

Management

A

cocher maneuver
PNF exercise

Cocher maneuver
- relocation for anterior inferior point instability
- injury or affectation: Aber
- relocation : Adir 
PNF exercise
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11
Q

AC joint injuries

A
  • acromion process + clavicle
  • MOI: fall on outstretch hand ( FOSH )
  • MC direction of injury: superior
  • Stability:
    > Static ligaments: ( 3 )
  • AC ligament
  • thoracoclavicular ligament
  • coracoacromial ligament.

Note: FOSH
SH: AC jt injury
WHICH: colles fracture, scaphoid fracture

-classification of AC joint sprain:
Rockwood Classification

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12
Q

classification of AC joint sprain:

Rockwood Classification

A
  1. Ac sprain+ cc intact
  2. ac torn + cc Sprain
  3. Ac and cc torn + cc space widens
  4. 3 + clavicular displace post.
  5. 3 + cc space widens > 100% + ms attributed clavicular detached
  6. 3 + clavicular displace inferiorly
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13
Q

C. Adhesive capsulitis ( 5 )

A
  1. Rotator cuff tears
  2. Rotator cuff tendonitis
  3. Bicipital tendonitis
  4. Bursitis
  5. Calcific tendonitis

frozen shoulder

  • “ diabetic periarthritis”
  • most important cause: immobilization
  • primary cause: idiopathic
  • secondary cause ( systemic ): diabetes
  • MC among females
  • Self- limiting up to 2 yeats
  • MC LOM ER
  • Stages
  • CAPSULE PATTERN : INJURY OF JOINT CAPS
    ER > AB > IR
I= 1-3 months ( pain & increase LOM ) - freezing
II= 3-9 months ( increase pain and LOM )- freezing
III= 9-15 months ( decrease pain and maintenance of LOM ) - frozen
IV= 15-24 months - thawing

Self limiting - up to 2 years

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14
Q

Sternoclavicular joint ligament ( 4 )

A

Anterior sternoclavicular
Posterior sternoclavicular
Costoclavicular
Interclavicular

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15
Q

Impingement syndrome

A
  • compression of structures in the subacromial space
  • MC cause: repetitive or sustained elevation of shoulder > 90 degrees
  • Classification:
    Neers Classification of shoulder Impingement
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16
Q

Classification:

Neers Classification of shoulder Impingement

A

I. Edemea + inf. + hemorrhage
II. Fibrosis
III. Development of bony spurs + traumatic rupture
IV. Mulit. Tendon rupture

17
Q

Rotator cuff tears

A
  • MC athletes

- deoriob& cofield classification:

18
Q

deoriob& cofield classification:

A
  • small ( < 1 cm )
  • medium ( 1-3 cm )
  • large ( 3-5 cm )
  • massive ( > 5 )
19
Q

Rotator cuff tendonitis

A
  • CC: ( + ) pain during shoulder movement ( > 90 degrees )

- swimmers shoulder

20
Q

Bicipital tendonitis

A
  • inf: long humeral of biceps triceps

- bicipital groove “ inter tubercular sulcus “

21
Q

Bursitis

A
  • inflammation of the subacromial bursa

- PROM

22
Q

Calicific tendonitis

A
  • “ periendinitis calcarea “
  • Ca ++ deposits on the insertion of the tendon into the house
  • ## MC structures affected: supraspinatus and infraspinatus
23
Q

Thoracic outlet syndrome

A
  • impinged subclavian vein and subclavian arteries and inf. part of the brachial plexus
  • ulnar nerve ( c8-t1 )
    impinged vein that passed through thoracic outlet
  • claw hand deformity- add pollicis
  • deformity of cervical rib
  • scalene muscles ( anterior and mid )
  • deformity clavicular and 1st rib ( costoclavicular space decrease
  • pancoast rimor

Causes: elbow ( 6 )

24
Q

Causes: elbow ( 6 )

A 
Lateral epicondylitis
Medial epicondylitis
Pulled elbow
Olecranon bursitis
Cubital tunnel syndrome
25
Q

Lateral epicondylitis

A
  • tennis elbow = back swing II.
  • structure affected: ECRB and extensor digitorum communis
  • result from repetitive wrist /
26
Q

Medial epicondylitis

A
  • golfers elbow
  • forehand swing
  • structure affected: FCR & pronation teres
  • result from repetitive wrist: flexion
27
Q

Pulled elbow

A
  • nursemaid elbow
  • dislocation of radial head from anular ligament
  • LOM: supination
28
Q

Olecranon bursitis

A
  • student - sig katog
  • can be aseptic or septic
  • normal ROM
29
Q

Cubital tunnel syndrome

A
  • medial side
  • compression neuropathy of the ulnar nerve
  • result from Repetitive elbow flexion
30
Q

Hyperextension overload syndrome

A
  • pitchers elbow

- MOI: abduction & hyper extension

MS ORTHO (21 decks)

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