week 5 Flashcards
What is the sternoclavicular joint needed for and what ligament support it?
- Needed for good shoulder ROM
- interclavicular ligament
- anterior and posterior sternoclavicular ligament
- costoclavicular ligament
How to sprains and strains happen at the SC joint? How does it happen?
Force transmitted through the clavicle.
FOOSH- fall on outstretched hand.
When the clavicle is driven posteriorly.
What are ss of a SC sprain?
No pain with isometric shoulder motion- cannot change joint angle.
Why are posterior SC joint dislocations medical emergencies?
Subclavian artery, vein, and trachea can be compressed.
How does the AC joint get injured? What tests?
FOOSH
Fall on lateral side of the deltoid.
When clavicle is driven away from the acromion.
Piano key test, ROM tests.
What is a common symptom when there is AC joint seperation?
Trape spasm.
Clavicular Fracture
-fall on tip of clavicle- longitudinal force.
- anterior blow- compressive force.
FOOSH
swelling, spasm, inability to raise arm.
Percussion Test
What deformity is seen with a clavicular fracture.
Tent- bone sticking out looks like tent.
What are some factors that make the GH joint more susceptible to injury?
1- lots of mobility
2- size of glenoid is smaller than the humeral head.
3- labrum decreases articulation by 15%.
Why are you more likely to dislocate something after the first time?
All the supporting structures have been stretched.
When are you most likely to see a shoulder dislocation?
External rotation and abduction - arm being pulled back from behind the head.
What atype of GH dislocations are more common in sport?
Anterior and Inferior- not enough force not posterior dislocation.
What is a Hill-Sachs lesion? How does it occur?
There is a devit on the bone and occurs when the humerus catching or hitting the glenoid.
What is a Bankart lesion? What is a positive test that can represent an injury to the labrum?
Detachment of the lacrum.
A positive biceps test.
What are signs and symptoms of labral pathology?
Pain is deep within shoulder but can point to the area it is hurting.
Feeling of instability.
Shoulder feels stiff.
What are the roles of the rotator cuff muscles (SITS)?
Supraspinatus - abductor
Infraspinatus, teres minor, - external rotators.
Subscapularis - internal rotator.
What are the acute and chronic mechanisms for rotator cuff tendonitis differ? Where is the pain?
Acute- can occur when there is a tremendous increase in activity.
Chronic - small buildup of a tear overtime.
Pain is deep in the subacromional space, internal rotation is very painful.
What will give you a positive impingement test and a positive empty can test?
Subacomial Bursitis.
What can swelling in the subacrominal space cause and what are some signs and symptoms?
Special Tests.
Rotator cuff impingement.
Painful arc of motion, forward shoulder posture.
Neer, Hawkins, Drop Arm Tests.
What rotator cuff muscle typically tears the most? How can it be chronic?
Supraspinatus muscle typically tears the most.
Chronic = one has had a previous acute injury and once they reach over 40 there is just repetitive microtrauma.
What are some signs and symptoms of a long head biceps rupture?
Bulging muscle, pain
“Pop”
Swelling and discoloration.
What are the scapular stabilizers? Why is the scapulothoracic joint critical?
- rhomboids
- levator scapulae
- pectorlais major
- serratus anterior
- trapezius
- rotator cuff muscles.
Important for shoulder abduction.
What is a SICK scapula? What syndrome causes this?
Scapular Malposition
Inferior medial border prominence.
Coracoid Pain
DysKinesis- worst movement.
Can be caused by ovreuse muscle fatigue syndrome.
Why can a supracondylar fracture/ contusion be bad?
Can be bad for neurovascular status?
What is myositis ossificans? Is there any special tests?
A second blow to the same region without the first one healing properly.
No- may be able to feel a lump- laying down of bone.
What does the apprehension test check for?
Anterior dislocation/ integrity of the GH joint.
What does the Neer test used for?
Shoulder impingement in the subacrominal space.
Painful Arc Test
Pain in GH joint and AC joint.
Speeds Test
Biceps Tendonitis
Empty Can Test
Injury to rotator cuff -> compression of supraspinatus.
Horizontal Adduction Test
AC joint compression- piano key on acormion to test for pain.
What does the humeroulnar joint allow for articulation with?
Between the coronoid process and trochlea of the humerus.
What is loose bodies.
When there is an articular cartilage injury and the elbow locks and feels like there is something there.
Radiohumeral joint
articulation between radial head and capitullem. Important in sports because it dislocated in many contact sports.
Proximal Radioulnar joint
articulation between radial head and radial notch of ulna- only radius pivots with annular ligament providing stability.
What ligament gets most injured in the elbow?
Ulnar collateral ligament.
What is Valgus overload?
When the distal aspect of the joint is further from the midline. Valgus stress and rotation traction of the medial ulnar ligament can cause a compressive force on the radial head to impinge the olecranon and olecranon process.
Why is a little leaguer’s elbow injury concerning? What can it progress to?
Bad because growth plates are still open and children can experience pain going into full flexion. It can cause osteochondritis dessicans.
What is the mechanism for radial head fracture?
Longitudinal compression with pronation.
What is humeroulnar dislocation and how does it occur?
When the olecranon pushes into the fossa and up and off the condyles. It occurs through falling backwards and the arm is hyperextension and a large axial force moves through the forearm.
What is a common way radioulnar dislocation occurs?
When an adult pulls on a child’s arm when the shoulder is flexed. The ulnar ligament is intact but the radial head splits out and goes back in.
How does a supracondylar fracture occur? What are some signs and symptoms?
Fall on flexed elbow, hyperextension, valgus or varus force.
SS- deformity, pain, swelling, ecchymosis.
