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48 Cards in this Set
- Front
- Back
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What bones make up the shoulder?
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Clavicle
Humerus Scapula |
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What joints make up the shoulder?
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Scapulothoracic
Acromioclavicular Glenohumeral Sternoclavicular |
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Shoulder separation is what?
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AC joint separation
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Symptoms of shoulder separation. x4
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1. Pain to AC
2. Swelling to AC 3. Deformity to AC 4. Unable to lift arm |
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Diagnostic of shoulder separation is based on what?
What does this tell us? |
AP
Tells us six types of possible diagnositics |
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Treatments for Shoulder Separation.
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If:
Type I and II - sling Type III - controversial (surg. or non) Type IV, V, and VI - Surgery |
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Shoulder arthritis is common to what population group?
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Greater than 50 years old
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What is shoulder arthritis?
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Destruction of shoulder cartilage and loss of joint space.
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Symptoms for shoulder arthritis. x5
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1. Pain with activity
2. Pain relieved by rest 3. Loss of motion 4. Muscle wasting 5. CREPITUS |
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Treatments for shoulder arthritis.
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Non-surgical:
Cortical steroids Heat / Ice NSAIDs Stretching SURGICAL: Total joint replacement |
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Fracture of clavicle:
- symptoms x6 |
1. Pain
2. Swelling 3. Deformity 4. Unable to lift arm 5. Crepitus 6. Hx of signficant injury |
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Fracture of clavicle:
- treatments x2 |
Sling
Figure 8 clavicle strap |
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Proximal Humerus fractures are predominant in what age group?
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Elderly with osteoporosis
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In fractures to the proximal humerus, what must you be on the lookout for?
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Bone pathology (cysts & tumors)
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What other injuries could occur as a result of proximal humerus fracture?
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Brachial plexus injury
Axillary artery injury (check pulses) |
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Symptoms of proximal humerus fracures. x3
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Pain
Swelling Discoloration |
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What diagnostics would you order for a proximal humerus fx?
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Trauma series:
- AP - Lateral - Axillary |
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Treatments for Proximal humerus injury?
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If:
Minimally displaced (<1cm) - sling and exersize Significantly displaced (>1cm) - surgery > 40 y.o. with displacement - Joint replacement |
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A scapula fx most commonly results from what?
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High energy trauma
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90% of patients with scapula fx will also have what?
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Associated life threatening injuries to:
Lung Spinal Cord Head |
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Symptoms of Scapula fx. x3
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1. Pain to back of shoulder
2. Skin abrasion/swelling 3. Tenderness of palpation. |
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Why are fractures of the scapula so easily missed?
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Associated injuries are more focused on.
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Treatment for scapula fx.
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Non-operative (sling)
If glenoid > 2 mm displaced, surgical management. |
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Frozen shoulder:
- what is it? - onset - etiology |
Decreased active and passive ROM
Insidious Unknown |
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Frozen shoulder:
- Diagnostic tests? |
X-rays
(will appear nl, but r/o tumor) MRI (if not improved in 3 months) |
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Frozen shoulder:
- Treatments - Recovery period |
NSAIDs
Arthroscopic surgical release (if associated with IDDM) Physical therapy 2 to 2.5 years |
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What is Glenohumeral instability?
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Inability to keep humeral head centered on the glenoid socket.
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List and Categorize the types of Glenohumeral Instability.
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Unintentional shoulder dislocation:
(Traumatic) (Unilateral) (Bankart's lesion) (Surgery) Intentional shoulder dislocation (Atraumatic) (Multidirectional) (Bidirectional) (Rehabilitation) (Inferior Capsule Repair) |
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List the stereotypical patient with a frozen shoulder.
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Female
40-65 Symptoms on non-dominant hand |
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Glenohumeral instability would manifest what symptoms? x4
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Laxity exam
Apprehension Sulcus sign Sensation (Deltoid) |
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Treatments for Glenohumeral instability.
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ACUTE:
Reduction Immobilization Physical therapy ATRAUMATIC Physical Therapy Psych eval? |
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Impingement syndrome impinges what? x7
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Coronoid process
Acromion process Bicep tendon Coracoacromial ligament Acromioclavicular joint Rotator cuff Subacromial bursa |
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Physical findings of impingement syndrome. x7
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Bursa injection
Anterolateral shoulder pain Neer's impingement sign Crepitus Atrophy of muscle Supraspinatus weakness Hawkin's impingement sign |
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X-ray's are usually negative for impingement syndrome, but what might you find in the radiograph.
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Subacromial bone spur
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Treatment for Impingement syndrome. x4
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Steroids
NSAIDs Physical Therapy Arthroscopic surgery. |
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What is the most common type of Rotator Cuff Tears?
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Supraspinatus tendon tear
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What are the physical findings of rotator cuff tears?
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Weakness, catching, grating
ROM (passive - full) (active - little or none) Atrophy of supra & infraspinatus Pain at night (Chief Complaint) |
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Treatment for Rotator cuff tears. x4
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corticosteroids
NSAIDs PT Surgery |
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Define Bicep tendon rupture and what is it associated with?
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Proximal tear of bicep tendon
usually associated with rotator cuff tear. |
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Physical findings of bicep tendon rupture?
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Sharp Pain
Weakness in flexion/SUPINATION Bulge in lower arm |
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Elbow dislocations/instability is usually due to what arm orientation during a fall?
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Arm extended
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What question must be answered when assessing an elbow dislocation/instability?
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Where is the distal segment?
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Most dislocations of the elbow are where?
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Posterior
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Little Leaguer's elbow or Golfer's elbow is actually what?
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Medial Epicondylitis
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Tennis Elbow is actually what?
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Lateral Epicondylitis
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What is Posterior Interosseus Nerve (PIN) Syndrome?
What nerve is affected here? |
Compression by arcade of Frohse or suppinator.
Radial nerve |
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What is the Cubital Tunnel Syndrome?
What nerve is affected here? |
Ulnar Hand numbness
and Weakness of 1st dorsal interosseus muscle Ulnar nerve |
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What is Pronator Syndrome?
What nerve is affected here? |
Pain with resisted pronation
Median nerve |
