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Clin Med II - Exam 2 > Wells - UE > Flashcards

Wells - UE Flashcards

1
Q

what is the soc dx for rotator cuff tear

A

MRI

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2
Q

what is the 1st line surgical tx for rotator cuff tear

A

arthroscopy

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3
Q

what is the last muscle movement to return after rotator cuff repair

A

internal rotation → tucking in shirt

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4
Q

a person is only allowed __ rotator cuff repairs in their lifetime

A

2

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5
Q

what is the non operative tx for rotator cuff injuries

A
  1. PT bid x 2 weeks
  2. NSAIDs → make sure no contraindications!!
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6
Q

what UE injury might a dry waller have who complains of a painful arc

A

impingement syndrome

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7
Q

what are the tests for impingement syndrome

A

neers

hawkins

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8
Q

steroid + lidocaine injections can be __ for impingement syndrome

A

diagnostic

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9
Q

for impingement syndrome, should you image or treat first

A

treat first

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10
Q

what surgery may be required or severe/acromial hook impingement syndrome

A

acromioplasty

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11
Q

what is the tx for a grade I-III AC separation

A

conservative

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12
Q

what is the test for biceps tendonitis

A

speeds

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13
Q

which type of instability is way more common in a shoulder dislocation

A

anterior

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14
Q

what is the test for shoulder dislocation

A

apprehension test

+/- sulcus sign

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15
Q

what must you do when reducing a shoulder dislocation

A

pre and post reduction films

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16
Q

what might you suspect if you see hill sachs lesion, bankhart lesion, and axillary nerve injury

A

complications of shoulder dislocation

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17
Q

what is an axillary n lesion

A

complication of humeral neck fx

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18
Q

what 2 muscles are paralyzed in an axillary n lesion

A

deltoid

teres minor

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19
Q

what does this injury make you think

A

axillary n lesion → delta atrophies rapidly

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20
Q

what is a hill sach’s lesion/fx

A

complication of shoulder dislocation → cortical depression in posterolateral head of humerus

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21
Q

what is this xray showing

A

hill-sachs lesion

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22
Q

what is a bankhart lesion

A

complication of shoulder dislocation → injury of anterior (inferior) labrun of shoulder

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23
Q

what is this xray showing

A

bankhart lesion

→ can have bony (glenoid) and/or soft tissue (labrum) trauma

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24
Q

what is a SLAP lesion

A

superior labral anterior posterior

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25
Q

what might you think when a pt complains of “painful catching or clicking” in the shoulder

A

SLAP lesion

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26
Q

what is the gold standard if you suspect a labral tear (ex SLAP lesion)

A

MRI arthrogram

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27
Q

what type of imaging is this and what is it showing

A

MRI arthrogram → causes tear to glow

SLAP lesion/torn labrum

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28
Q

what injury might you suspect if a pt complains of acute pain w. lifting/bench pressing and you see bruising and declivity in the muscle

A

pectoralis major rupture

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29
Q

4 key points for fractures

A
  1. when in doubt → xray and refer!
  2. peds: low threshold for referral
  3. pain, pallor, pulselessness → emergent surgery required
  4. delayed healing in smokers, DM, high altitude
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30
Q

humerus fx are usually caused by __;

think what pt population

A

fall

osteoporotic women

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31
Q

what is this called, and what injury does it make you think of

A

bicep muscle/tendon rupture

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32
Q

what is the tx for bicep muscle/tendon rupture

A

surgery per ortho

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33
Q

which recovery takes longer, RC tear or SLAP lesion

A

SLAP lesion

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34
Q

what education would you give a pt about recovery for lateral epicondylitis (tennis elbow)

A

hard to treat

long time to heal

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35
Q

for lateral epicondylitis, cortisone injxns and surgery are

A

a last resort

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36
Q

medial epicondylitis (golfers elbow) is caused by what type of injury

A

pronation injury

37
Q

what are symptoms of ulnar n subluxation

A

chronic pain

paresthesias

electric shock

weakness

38
Q

what injury does tommy john surgery treat

A

cubital tunnel syndrome (ulnar n subluxation)

39
Q

what is the mc location for olecranon bursitis

A

radial head

40
Q

what do the fat pad and sail signs make you think of

A

joint effusion → olecranon bursitis

41
Q

have a low threshold for xray if there is

A

a traumatic event

42
Q

what is the tx for elbow fx

A

splint and sling vs ORIF

43
Q

what is the mc pediatric fx

A

supracondylar

44
Q

what is the main concern with peds supracondylar fx

A

growth plate/vessel/nerve damage → must ensure proper healing

45
Q

what injury is characterized by entrapment of the anular ligament

A

nursemaid’s elbow

46
Q

what is the mc FOOSH injury

A

distal radius fx

47
Q

what does “dinner fork deformity” make you think of

A

distal radius fracture

48
Q

what xray is best to see the carpal bones

A

oblique

49
Q

what is the tx for distal radial fx’s

A
  1. splint
  2. recheck
  3. cast
  4. sugar tong x 6 weeks
  5. short cast
50
Q

what position functions should you test after casting a radial fx

A

hold a can of soda

avoid extreme flexion/extension/radial/ulnar deviation positioning

51
Q

what must you test after radius fx casting (besides position fxn)

A

neurovascular fxn at finger tips

52
Q

what injury do you think of when a pt c.o pain over the anatomic snuff box

A

scaphoid fx

53
Q

what xray should you order for a scaphoid fx

A

scaphoid view → ulnar deviation of wrist

54
Q

what injury is this

A

scaphoid fx

55
Q

what is the tx for a scaphoid fx

A
  1. xray
  2. even if negative xray → thumb spica splint
  3. re-xray in 1 week
56
Q

what is a major complication of a scaphoid fx

A

avascular necrosis dt backwards vasculature

57
Q

what injury is associated w. the terry thomas sign

A

wrist ligamentous injury

58
Q

in a wrist ligamentous injury, if the xray is negative but the pt has pain over the carpal ligaments/cartilage, what test should you order

A

MRI arthrogram

59
Q

what imaging is good to show soft tissue injury

A

MRI arthrogram

60
Q

what test would show nerve compression w. a ganglion cyst

A

allen test

61
Q

which n is compressed in carpal tunnel syndrome

A

median n

62
Q

what injury would you suspect if a pt c.o pain in the front of the wrist and numbness or tingling into the thumb, index, middle, and ½ of ring finger

A

carpal tunne syndrome

63
Q

what imaging should you order if a pt’s hx is consistent w. CTS and their symptoms are not improving w. conservative tx

A

EMG/NCVS

64
Q

what is a major concern w. CTS

A

atrophy or nerve death

65
Q

what injury is very common in new moms

A

De Quarvain’s tenosynovitis

66
Q

what test would you use if you suspect deQuarvain’s tenosynovitis

A

Finkelstein

67
Q

which type of tendon injury is more concerning

A

flexor → needed for grip

68
Q

what is the tx for mallet finger

A

must tx w. stack spint x 6 weeks for 24 hr/day

69
Q

what happens if the pt w. mallet finger removes a stack splint too early and the finger tip drops

A

must start all over again (6 weeks, 24 hr/day)

70
Q

what is the mc location for duputreyn’s contracture

A

4th and 5th fingers

71
Q

what is the tx for trigger finger injury

A

hand surgeon for tendon sheath release

72
Q

what is the moi of a butonniere deformity

A

jam injury

73
Q

in a butonniere deformity, the PIP is __

and the DIP is __

A

flexed

extended

74
Q

what is the tx for a boutonniere deformity

A

figure 8 splint

75
Q

in a swan injury, the PIP is __

and the DIP is __

A

hyperextended

flexed

76
Q

what is no man’s land

A

the palm of the hand

77
Q

what is the tx for a palm laceration

A

local block

clean it out

refer to hand surgeon immediately!!

78
Q

Bouchard’s nodes are in the

A

PIP

79
Q

heberdons nodes are in the

A

DIP

80
Q

what is the mc location for early OA

A

thumb: basilar joint/CMCJ

81
Q

what is the tx for CMCJ OA

A
  1. conservative tx
  2. if conservative tx fails → LRTI (ligament reconstruction and tendon interposition)
82
Q

what injury occurs in skiers thumb

A

stretch or lateral tear of the ulnar collateral ligament

83
Q

what are 5 important considerations for non surgical fx recovery

A
  1. intraarticular is always a more complicated recovery
  2. early intervention w. PT/OT is vital
  3. threaten pt’s to stop smoking so they can heal
  4. splint fx for 1st 1-3 days → THEN cast when swelling has gone down
  5. RICE is your friend
84
Q

proximal blocks are done by

A

anesthesia

85
Q

we will use __ blocks regularly

A

digital

86
Q

radiculopathy from an impinged n root can mimic

A

joint pain

87
Q

nerve pain can cause

A

weakness

88
Q

cervical spine pain can mimic

A

shoulder pain

Clin Med II - Exam 2 (14 decks)

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