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Int Spec (Ortho) > Upper Limb Orthopaedics > Flashcards

Upper Limb Orthopaedics Flashcards

1
Q

Cubital tunnel syndrome results in compression of which nerve?

A

Ulnar nerve

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2
Q

Lateral epicondylitis is also known as what?

A

Tennis elbow

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3
Q

What investigation can be used to confirm a diagnosis of an upper limb compressive neuropathy, i.e. carpal or cubital tunnel syndrome?

A

Nerve conduction studies

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4
Q

Weakness in initiation of abduction suggests a rotator cuff tear has affected which muscle?

A

Supraspinatous

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5
Q

Most cases of a rotator cuff tear will settle without surgery over what time period?

A

1-2 years

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6
Q

Tinel’s test can be used to identify carpal tunnel- what is done in this test?

A

Percussion over the median nerve

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7
Q

The elbow joint is most likely to be affected by which type of arthritis?

A

Rheumatoid arthritis

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8
Q

DeQuervain’s tenosynovitis is a painful condition which affects the extensor tendons, as they run through a tunnel on which side of the wrist?

A

Radial side

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9
Q

What is the mainstay of treatment for both medial and lateral epicondylitis?

A

Rest, analgesia and physiotherapy

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10
Q

How is DeQuervain’s tenosynovitis treated?

A

NSAIDs, splinting and rest

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11
Q

Hyperextension at the PIP joint with flexion at the DIP joint describes what abnormality of the hands?

A

Swan neck deformity

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12
Q

Where are ganglion cysts most likely to be found?

A

At the DIPs and the wrist

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13
Q

Biceps tendonitis causes anterior shoulder pain which will be exacerbated by which movements?

A

Flexion of the elbow and shoulder, and pronation of the forearm

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14
Q

Osteoarthritis of the glenohumeral joint can cause pain, crepitus and loss of movement. What is often the first movement to be lost?

A

External rotation

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15
Q

How does acute calcific tendonitis present?

A

Acute onset of severe shoulder pain

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16
Q

What is the main anatomical structure that is affected in trigger finger?

A

A1 pulley

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17
Q

Pain from impingement syndrome can be recreated using what clinical test?

A

Hawkin’s-Kennedy test (internally rotating a flexed shoulder)

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18
Q

An important test for DeQuervain’s tenosynovitis is Fincklestein’s test- describe what happens here?

A

Ask the patient to make a fist and the examiner presses down on the base of the thumb- this should elicit pain

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19
Q

Acute calcific tendonitis involves calcium deposition where?

A

In the supraspinatous tendon

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20
Q

A ‘Popeye deformity’ of the upper limb is a sign of what pathology?

A

Biceps tendon rupture

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21
Q

The tendon of which rotator cuff muscle is most likely to be compressed in impingement syndrome?

A

Supraspinatous

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22
Q

Clinical features of lateral epicondylitis include pain and tenderness over the lateral epicondyle- the pain is often worse on what movement?

A

Resisted middle finger and wrist extension

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23
Q

How are giant cell tumours of the tendon sheath treated?

A

Surgical excision

24
Q

Phalen’s test can be used to identify carpal tunnel- what is done in this test?

A

Hyperflexion of the wrist

25
Q

Ganglion cysts are filled with what?

A

Synovial fluid

26
Q

What clinical test can be used to assess for weakness of the ulnar nerve innervated muscles in the hand, as a result of cubital tunnel syndrome?

A

Froment’s test

27
Q

Carpal tunnel syndrome results in the compression of which nerve?

A

Median nerve

28
Q

Patients with cubital tunnel syndrome typically complain of pain and paraesthesia affecting which digits?

A

The ulnar one and a half digits

29
Q

In the painful phase of adhesive capsulitis, steroid injections can be useful for pain relief. Where can these be injected?

A

Glenohumeral joint

30
Q

Medial epicondylitis is also known as what?

A

Golfer’s elbow

31
Q

Where are giant cell tumours of the tendon sheath most likely to be located?

A

The PIP joint of the middle or index finger

32
Q

Flexion at the PIP joint with hyperextension at the DIP joint describes what abnormality of the hands?

A

Boutonniere’s deformity

33
Q

The principle sign of adhesive capsulitis is the loss of which movement?

A

External rotation

34
Q

The diagnosis of a rotator cuff tear can be diagnosed on one of which two imaging methods?

A

Ultrasound or MRI

35
Q

How can trigger finger be treated?

A

Steroid injections and splints

36
Q

How long does it usually take for adhesive capsulitis to resolve?

A

18-24 months

37
Q

In those aged under 20 years, what is the chance of re-dislocation after one anterior shoulder dislocation?

A

80%

38
Q

Dupuytren’s contracture may occur as a side effect of therapy with what drug?

A

Phenytoin

39
Q

When are symptoms of carpal tunnel syndrome often worse?

A

At night

40
Q

Patients with carpal tunnel syndrome typically complain of pain and paraesthesia affecting which digits?

A

The thumb and the radial two and a half digits

41
Q

Describe a classical history of a degenerate rotator cuff tear?

A

A sudden jerk in someone aged > 40 leads to subsequent pain and weakness

42
Q

Weakness in internal rotation of the shoulder suggests a rotator cuff tear has affected which muscle?

A

Subscapularis

43
Q

In patients with recurrent shoulder dislocations, what surgical treatment can be used to stabilise the shoulder?

A

Bankhart repair

44
Q

What condition is responsible for causing medial elbow pain, with a tender point over the flexor origin?

A

Medial epicondylitis

45
Q

Cases of impingement syndrome which do not respond to conservative treatment may respond to what surgical management?

A

Subacromial decompression

46
Q

Having which other medical condition is the most significant risk factor for the development of adhesive capsulitis?

A

Diabetes

47
Q

What are the two main risk factors for the development of DeQuervain’s tenosynovitis?

A

Pregnancy and rheumatoid arthritis

48
Q

What is the aim of physiotherapy for a rotator cuff tear?

A

To strengthen the other rotator cuff muscles to compensate for the loss of supraspinatous

49
Q

Weakness in external rotation of the shoulder suggests a rotator cuff tear has affected which muscle?

A

Infraspinatous

50
Q

What condition is characterised by progressive pain and stiffness of the shoulder in patients aged between 40 and 60 years?

A

Adhesive capsulitis (frozen shoulder)

51
Q

Impingement syndrome should be managed in the first instance with analgesia and physiotherapy. What are the best options for analgesia?

A

NSAIDs and subacromial steroid injections

52
Q

Rotator cuff tears are most likely to involve which muscle?

A

Supraspinatous

53
Q

Why should steroid injections be avoided in cases of medial epicondylitis?

A

Risk of damage to the ulnar nerve

54
Q

Dupuytren’s contracture is a fixed flexion deformity of the digits as a result of what?

A

Thickening and contracture of the palmar fascia

55
Q

Lateral epicondylitis tends to occur in individuals who regularly perform what movement?

A

Resisted extension at the wrist

56
Q

Impingement syndrome typically causes pain on what movement?

A

60-120 degrees of abduction

Int Spec (Ortho) (10 decks)

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