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48 Cards in this Set

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  • Back
What bones make up the shoulder?
Clavicle

Humerus

Scapula
What joints make up the shoulder?
Scapulothoracic

Acromioclavicular

Glenohumeral

Sternoclavicular
Shoulder separation is what?
AC joint separation
Symptoms of shoulder separation. x4
1. Pain to AC
2. Swelling to AC
3. Deformity to AC

4. Unable to lift arm
Diagnostic of shoulder separation is based on what?

What does this tell us?
AP

Tells us six types of possible diagnositics
Treatments for Shoulder Separation.
If:

Type I and II - sling

Type III - controversial (surg. or non)

Type IV, V, and VI - Surgery
Shoulder arthritis is common to what population group?
Greater than 50 years old
What is shoulder arthritis?
Destruction of shoulder cartilage and loss of joint space.
Symptoms for shoulder arthritis. x5
1. Pain with activity
2. Pain relieved by rest
3. Loss of motion
4. Muscle wasting

5. CREPITUS
Treatments for shoulder arthritis.
Non-surgical:

Cortical steroids
Heat / Ice
NSAIDs
Stretching

SURGICAL:

Total joint replacement
Fracture of clavicle:

- symptoms x6
1. Pain
2. Swelling
3. Deformity

4. Unable to lift arm
5. Crepitus
6. Hx of signficant injury
Fracture of clavicle:

- treatments x2
Sling

Figure 8 clavicle strap
Proximal Humerus fractures are predominant in what age group?
Elderly with osteoporosis
In fractures to the proximal humerus, what must you be on the lookout for?
Bone pathology (cysts & tumors)
What other injuries could occur as a result of proximal humerus fracture?
Brachial plexus injury

Axillary artery injury (check pulses)
Symptoms of proximal humerus fracures. x3
Pain

Swelling

Discoloration
What diagnostics would you order for a proximal humerus fx?
Trauma series:

- AP
- Lateral
- Axillary
Treatments for Proximal humerus injury?
If:

Minimally displaced (<1cm)
- sling and exersize

Significantly displaced (>1cm)
- surgery

> 40 y.o. with displacement
- Joint replacement
A scapula fx most commonly results from what?
High energy trauma
90% of patients with scapula fx will also have what?
Associated life threatening injuries to:

Lung
Spinal Cord
Head
Symptoms of Scapula fx. x3
1. Pain to back of shoulder

2. Skin abrasion/swelling

3. Tenderness of palpation.
Why are fractures of the scapula so easily missed?
Associated injuries are more focused on.
Treatment for scapula fx.
Non-operative (sling)

If glenoid > 2 mm displaced, surgical management.
Frozen shoulder:

- what is it?
- onset
- etiology
Decreased active and passive ROM

Insidious

Unknown
Frozen shoulder:

- Diagnostic tests?
X-rays
(will appear nl, but r/o tumor)

MRI
(if not improved in 3 months)
Frozen shoulder:

- Treatments
- Recovery period
NSAIDs

Arthroscopic surgical release
(if associated with IDDM)

Physical therapy

2 to 2.5 years
What is Glenohumeral instability?
Inability to keep humeral head centered on the glenoid socket.
List and Categorize the types of Glenohumeral Instability.
Unintentional shoulder dislocation:

(Traumatic)
(Unilateral)
(Bankart's lesion)
(Surgery)

Intentional shoulder dislocation

(Atraumatic)
(Multidirectional)
(Bidirectional)
(Rehabilitation)
(Inferior Capsule Repair)
List the stereotypical patient with a frozen shoulder.
Female

40-65

Symptoms on non-dominant hand
Glenohumeral instability would manifest what symptoms? x4
Laxity exam

Apprehension

Sulcus sign

Sensation (Deltoid)
Treatments for Glenohumeral instability.
ACUTE:

Reduction
Immobilization
Physical therapy

ATRAUMATIC

Physical Therapy
Psych eval?
Impingement syndrome impinges what? x7
Coronoid process
Acromion process
Bicep tendon

Coracoacromial ligament
Acromioclavicular joint
Rotator cuff
Subacromial bursa
Physical findings of impingement syndrome. x7
Bursa injection
Anterolateral shoulder pain
Neer's impingement sign

Crepitus
Atrophy of muscle
Supraspinatus weakness
Hawkin's impingement sign
X-ray's are usually negative for impingement syndrome, but what might you find in the radiograph.
Subacromial bone spur
Treatment for Impingement syndrome. x4
Steroids
NSAIDs

Physical Therapy
Arthroscopic surgery.
What is the most common type of Rotator Cuff Tears?
Supraspinatus tendon tear
What are the physical findings of rotator cuff tears?
Weakness, catching, grating

ROM
(passive - full)
(active - little or none)

Atrophy of supra & infraspinatus

Pain at night (Chief Complaint)
Treatment for Rotator cuff tears. x4
corticosteroids
NSAIDs

PT
Surgery
Define Bicep tendon rupture and what is it associated with?
Proximal tear of bicep tendon

usually associated with rotator cuff tear.
Physical findings of bicep tendon rupture?
Sharp Pain

Weakness in flexion/SUPINATION

Bulge in lower arm
Elbow dislocations/instability is usually due to what arm orientation during a fall?
Arm extended
What question must be answered when assessing an elbow dislocation/instability?
Where is the distal segment?
Most dislocations of the elbow are where?
Posterior
Little Leaguer's elbow or Golfer's elbow is actually what?
Medial Epicondylitis
Tennis Elbow is actually what?
Lateral Epicondylitis
What is Posterior Interosseus Nerve (PIN) Syndrome?

What nerve is affected here?
Compression by arcade of Frohse or suppinator.

Radial nerve
What is the Cubital Tunnel Syndrome?

What nerve is affected here?
Ulnar Hand numbness
and
Weakness of 1st dorsal interosseus muscle

Ulnar nerve
What is Pronator Syndrome?

What nerve is affected here?
Pain with resisted pronation

Median nerve