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SCS > Chapter 10 from textbook > Flashcards

Chapter 10 from textbook Flashcards

1
Q

four mechanisms of dynamic stability in the shoulder

A
  1. bulk of muscle creating passive tension
  2. contraction of muscles that create approximation of the joint spaces, compression of articular surfaces
  3. joint motion which limits/tightens
  4. barrier effect of muscle
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2
Q

what is the difference bewteen RTC disease and instability:

A

disease is things like tendinopathy, muscle strains, impingements, and instability has to do with the labrum

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3
Q

Hill Sachs lesion

A

dent on the humerus where it hits into the glenoid, most commonly with an anterior dislocation

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4
Q

bankart lesion

A

the anterio-inferior labrum detaches from the labrum due to disruption of the humerus with a dislocation of the

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5
Q

what is the most common location of a clavicle fracture?

A

mid shaft

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6
Q

how long for bone to heal

A

6-8 weeks

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7
Q

posterior instability will present like…

A

posterior pain, uniplanar subluxation and pain with sagittal movements.

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8
Q

GH to scap movement

A

120 degrees GH to 60 degreees scap upward rotations

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9
Q

anterior shoulder dislocation vs posterior shoulder dislocation MOI

A

anterior: FOOSH, abducted, ER and extended arm

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10
Q

Rockwood classifications, which types often require the least amount of time to RTP

A

types 1 and 2, 10 days to 2 weeks to return

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11
Q

according to the rockwood, if the AC ligament is just strained, what type is this

A

type 1

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12
Q

how does the AC ligament look in types 2-5

A

torn

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13
Q

type 1 rockwood,

A

ac lig sprained, AC joint ok, CC ligament ok, delt and trap ok

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14
Q

type 2 rockwood

A

AC lig torn, AC joint stretched, CC lig stretched, muscles possibly detached

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15
Q

type 3

A

AC lig torn, AC joint, clavicle displaced upward/superior, CC torn and streched, muscules likely damanged

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16
Q

type 4 rockwood

A

AC lig torn, AC joint, clavicle dislocated posteriorly into trap, CC lig partial or complete tear, and muscles likely detached

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17
Q

type 5 rockwood

A

AC lig torn, AC joint dislocated up badly, CC torn, msucles detached

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18
Q

type 6 rockwood

A

AC torn, AC joint dislocated collarbone downward, CC intact, and muscles either intact or detached.w

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19
Q

what is the most common MOI of a AC joint injruey

A

blow to the superiorlateral contact with the adducted shoulder

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20
Q

what is the sequence of events for RTC disease

A

microtrauma, tendinopathy, bursitis, osteophytes and then a tear

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21
Q

instrinsic vc extrinsic factors RTC disease

A

intrinsic, weakness, scap dysfunction,
external: activities or job

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22
Q

what part fo the plexus is involved in a stinger or burner?

A

upper cerivcal trunk (lower trunk , divisions and cord hard to hurt)

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23
Q

MOI of a stinger

A

cervical lateral flexion, depression and traction

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24
Q

can you go back to a game after a stinger or burner

A

yes if bilateral strength and sensation and no more sxs

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25
Q

paget schroetter disease

A

effot thrombosis usually in baseball due to high ROM of the shoulder in axillary-subclavian vein

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26
Q

2 CKC UE test for RTP?

A
  1. UE CKC test (tape 91cm) males 21, females 23 (can be on knees )
  2. UE Y-balance: looking 10% LSI
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27
Q

another functional UE RTP test

A

seated shot put with 6# ball

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28
Q

whatare the number 1 and number 2 types of dislocations in kids

A

shoulder is number 1 elbow is number 2

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29
Q

what is tennis elbow and what is golfers elbow

A

tennis is lateral
golfers is medial

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30
Q

what makes up most support of the elbow in extreme flexion and extension ROM

A

osseous structures

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31
Q

primary stailizers of the elbow joint

A

ulnotrochlear articulation, MCL, LCL

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32
Q

secondary stabilizers of the elbow

A

radial head, anterior and posterior capsule, common flexors and extensors

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33
Q

LCL origin

A

from the lateral epicondyle

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34
Q

what are the 4 components of hte LCL

A

the lateral ulnar collateral ligament, lateral radial collateral ligament, accessory lateral collateral ligament and the annular ligament

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35
Q

what is the primary elbow varus restraint

A

the lateral radial collateral ligament

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36
Q

what is the MCL complex made of

A

the anterior, posterior and transverse bandsw

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37
Q

what is the primary valgus restraint

A

the anterior band of the MCL.

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38
Q

what does the posterior band of the MCL do

A

restraint against pronation of the ulna

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39
Q

osis vs itis

A

osis is more of a degenerative thing, and itis is an acute inflammation

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40
Q

what hurts with lateral epiocondyllitis

A

the CRB is painful with resistance, and occasionally the extensor digitorum communis.

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41
Q

what is golfers elbow

A

medial epicondylitis

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42
Q

what muscle groups are hurt with ME

A

common flexor group, FCR, PL, PT, FCU and FDS

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43
Q

what are the two most commonly hurt things in ME

A

FCR and PT

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44
Q

describe medial apopohsitis

A

this is an overuse elbow injury in which the medial elbow is having pain and difficulty. medial elbow pain, and difficulty with speed and velocity

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45
Q

what is little league shoulder

A

a progression of medial elbow apophysitis, this is an avulsion fracture, from traction of valgus stress on ME.

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46
Q

which phases of movement cause the most pain in little league shoulder

A

late cocking and early acceleration

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47
Q

what is the best treatment for elbow apopysitis or LLS

A

rest and a change of position for 4-6 weeks. if this still creates sxs, full shut down until sxs resolve.

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48
Q

what is the common MOI for a distal biceps tear

A

when the elbow is suddenly pulled into extension from a flexed and supinated position

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49
Q

what is the common location of a distal biceps rupture

A

the radial tuberosity

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50
Q

what is posterior olecranon impingement or valgus extensio overload (VEO)? and what phase of movement causes it?

A

from throwing, and when the elbow is in full extension during ball release. osteophyts form from the repetitive extension on the medial side.

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51
Q

signs and symptoms of posterior oclecranon impingement/VEO?

A

clicking, locking, catching, crepitus, and occasional UCL laxity

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52
Q

normal flexion of the elbow

A

150 degrees

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53
Q

what is panners disease

A

OCD of the capitulum from poor blood supply

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54
Q

ages of panners

A

4-9

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55
Q

what causes panner

A

valgus force with lateral compression

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56
Q

is panner’s self lmiting

A

yes, with rest

57
Q

what is the difference between an oblique stress fracture and trasnverse on olecranon

A

oblique from inc valgus and extension force
transverse from triceps pulling and from extension forces

58
Q

what is the typical MOI of a radial head stress fracture

A

FOOSH in a pronated position

59
Q

what is the Mason Classification

A

for radial head fractures, scaled from 1-4

60
Q

mason classification 1

A

non displaced, no distruption mechanically, non op is treatment

61
Q

type 2 mason classification

A

displaced oer 2mm, angulation of >30 degrees, non-op or op, may need excision for pateints, or ORIF

62
Q

mason classification type 3

A

comminuted fracture of radial head, need excision, fixation (less than 3 seg) or replacement

63
Q

type 4 mason classficiation

A

fracture with elbow dislocation, excision, fixation if less than 3 seg, replacement, check soft tissue.

64
Q

what is the most common fracture type in elbows in kids

A

supercondylar humeral fracture

65
Q

MOI of supercondylar fractures

A

FOOSH in extension

66
Q

gartland classification scale

A

for supercondylar humerus fractures

67
Q

gartland type 1

A

supercondylar humeral fracture, non displaced less than 2mm non surgical

68
Q

gartland type 2

A

displaced supercondylar humeral fracture, with postreior cortex intact, need surgery if unstable or displaced or angulated

69
Q

type 3 gartland

A

displaced with no corticol cortex, surgical open or closed fixation

70
Q

salter harris classification

A

for growth plate fractrures

71
Q

salter harris 1:

A

no bone fracture, epiphysis serparates completly from the metaphysis

72
Q

salter 2:

A

separation throughout growth plate then out through a portion of the metaphysis, triangular shape!

73
Q

salter 3:

A

extensions from the joint surface to the weak zone and extends along the plate into the periphery.

74
Q

salter 4:

A

surgery indicated extends through joing surface, epiphysis, full thick issue at growth plate, into metaphysos, complete split

75
Q

salter type 5:

A

uncommon with compression of plate, poor prognosis

76
Q

what bundle of the elbow ligaments are omost important for valgus strength

A

anterior bundle, of UCL/MCL

77
Q

what muscle adds to stability of the UCL

A

the FCU

78
Q

where is the posterior and anterior band of the UCL tightest

A

in higher degrees of flexion, over 90 degres. and anterior band is tightest less than 90 degrees flexion

79
Q

which is more accurate for UCL tear MRI or MRA

A

MRA as per research

80
Q

when can throwing start post UCL-R

A

throwing at 4 months, on mound at 6 months

81
Q

what is cubital tunnel syndrome

A

Ulnar nerve entrapment, in the cubital tunnel in the ME

82
Q

what is the most common kinds of nerve compression entrapments

A

CTS number one, than cubital tunnel

83
Q

where will cubutal tunnel give you NT

A

in the little finger and ring finger

84
Q

what will you get (what sign) with cubutal tunnel

A

Wartenberg’s sign, where you cannot bring and adduct your little finger, and it drifts into extension/abduction

85
Q

what is radial tunnel syndrome

A

compression of postreior interosseous nerve, off of the radial nerve in the tunnel

86
Q

the radial nerve splits into the sensory nerve and post inteross nerve where

A

proximal to the supinator

87
Q

where will you have focal ppoint tenderness with post int nerve entrap

A

at the supinator, 3-5 cm distal to the LE in the supinator

88
Q

what happens if there is compression at the arcade of frosche

A

motor componenet of the Post int nerve (radial) finger and wrist extension weakness.

89
Q

what is pronator syndrome

A

medial nerve entrapment between the two pronator heads

90
Q

whta can the ligament of Schruthers compress

A

the median nerve

91
Q

with median nerve compression, what signs and sxs do you get

A

thumb, index, middle and 1/2 ring finger

92
Q

how can you differentiate if the median nerve is being compressed at PT or the ligament of schruthers/arch

A

will have pain with prontation testing in PT and will have pain with resisted middle finger extension at the arch

93
Q

what is the most common carpal fracture

A

a scaphoid fracture is

94
Q

MOI for scaphoid fracture

A

FOOSH (forced DF of wrist can happen too,not as common )

95
Q

what are the borders of the anatomical snuff box

A

EPB, EPL and APL (double E’s double L’s)

96
Q

how will a scaphoid fracture present,

A

pain with anatomical snuffbox palpation, pain with gripping, wrist extension, radial deviation

97
Q

RTP following scaphoid fracture non op vc op,
when does rehab start

A

12-15 weeks non op, op 8-12 weeks REHAB STARTS WEEK 6

98
Q

what is the distal aspect of Guyon’s canal

A

the hook of the hamate

99
Q

what is in the guyon canal

A

ulnar artery and nerve

100
Q

MOI of a hamate hook fracture

A

FOOSH, repetitive stress from a bat or racquet,
non dominant hand in baseball and golf, dominant hand in racquet

101
Q

RTP after hook hamate fracture

A

4-6 weeks post op, 6 weeks in cast if non op

102
Q

____% chance of non union in hook hamate fractures

A

85

103
Q

boxers fractrue is

A

fracture of 5Th MCfrom punching.b

104
Q

boxer fractures with angulate in which direction

A

volarly

105
Q

what is tricky about a boxer fracture if there is a rotation component to it

A

the 5th MC may actuvally be under the 4th when a fist is made

106
Q

RTP boxers fracture

A

3-4 week in cast, then rehab starting at 6 weeks.

107
Q

TFCC components

A

radioulnar dorsal and palmar ligaments, ulnolunate ligament, ulnotrquitral ligament, and ECU

108
Q

MOI TFCC issue

A

FOOSH, with pronation, hyperextension and rotation

109
Q

when is TFCC issues painful

A

full wrist flex or ext and forced ulnar deviation

110
Q

what is the best imaging study to look at TFCC

A

fat suppressed MRI

111
Q

post op TFCC RTP

A

3-4 months

112
Q

how should wrist be splinted if TFCC suspected

A

wrist in slight flexx, with no room for Rad dev or ulnar dev

113
Q

gamekeepers thumb

A

thumb UCL, skier falls onto poles

114
Q

where is the thumb UCL tightest and loosest,

A

tight in thumb flexion, loose in thumb extnesion

115
Q

what is a stener lesion

A

avulsion of the proximal UCL through the adductor apoineurosis

116
Q

should a stener lesion have imaging

A

yes

117
Q

how are partial tears of thumb UCL managed

A

thumb splica cast several weeks ago

118
Q

RTP following thumb UCL repair

A

4 months

119
Q

what is mallet finger

A

when the extensor digitorim communis tendon/extensor mechanism is disrupted. cannot hold finger in extension with PIP stabilized

120
Q

what is the most common finger injury and which finger

A

mallet, and middle finger

121
Q

what is a lag sign

A

when the DIP cannot be held in extension with PIP is stabilized

122
Q

if there is blood under a nail in a finger deformity

A

refer immediately.

123
Q

can you RTP with mallet finger

A

yes if you splint in extension

124
Q

how to treat finger conditions

A

splinting for 8 weeks.

125
Q

what is jersey finger

A

avulsion.rupture of the FDP from the volar base of DIP

126
Q

where does the FDP act

A

on fingers 2-3-4

127
Q

MOI of jersey finger

A

forced extension of the DIP while it is flexed.

128
Q

how to know if it is just FDP or FDS as well

A

if just DIP cannot be flexed, FDP, if PIP cannot be flexed, FDS

129
Q

if jersey finger is surgically managed, how long to heal

A

12-16 weeks

130
Q

how long do you have to avoid gripping for jersey finger

A

6-8 weeks

131
Q

what is the most common cause of carpal instability

A

scapholunate dissociateion between the scapolunate ligament.

132
Q

what is a colle’s fracture

A

a radial styloid fracture non displaced

133
Q

how is the S/L ligament hurt

A

in wrist extension with UD

134
Q

signs and sxs of S-L dissociation

A

pain and clicking with wrst movements, scaphoid will be volar and lunate will be dorsalw

135
Q

what is watson’s sign

A

identified instability, deviate the wrist from full UD to RD and apply volar pressure on scaphoid, if there is a clunk, this is positive

136
Q

if you suspect s-l dissociation how do you splint,

A

in neutral,

137
Q

s-l dissociation casting post op for how long, rehab starts at…., RTP at …

A

10 weeks
12 weeks
RTP at 4-6 months

138
Q
A

SCS (26 decks)

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