Joint Injuries

Question 1

3 injured elements in the “unhappy triad”

Answer 1

1. ACL
2. MCL
3. Medial mesicus

Question 2

*what are the 4 muscles of the rotator cuff

Answer 2

1. supraspinatus
2. infraspinatus
3. teres minor
4. subscapularis

*SItS

Question 3

function of supraspinatus

Answer 3

abducts arm intially (before deltoid; first 15 degrees or so)

Question 4

function of infraspinatus

Answer 4

laterally rotates arm

Question 5

functions of teres minor

Answer 5

adducts and laterally rotates arm

Question 6

functions of subscapularis

Answer 6

medially rotates and adducts the arm

Question 7

MC injured in rotator cuff

Answer 7

supraspinatus

Question 8

pitching injury

Answer 8

infraspinatus

Question 9

spinal segments innervating the rotator cuff muscles

Answer 9

C5-C6

Question 10

*8 bones of the wrist (from bottom medial to lateral, back to medial on top)

Answer 10

1. Scaphoid
2. Lunate
3. Triquetrum
4. Pisiform
5. Hamate
6. Capitate
7. Trapezoid
8. Trapezium

Question 11

MC fractured bone in wrist

Answer 11

Scaphoid –> is prone to avascular necrosis due to a retrograde blood supply

Question 12

dislocation of what wrist bone can cause acute carpal tunnel syndrom

Answer 12

Lunate

just medial to scaphoid on the lower row of wrist bones

Question 13

leading cause of knee pain in patients under 45

Answer 13

Patellofemoral syndrome–> anterior knee pain exacerbated by activity

Question 14

2 tx for patellofemoral syndrome

Answer 14

1. strengthen quadriceps muscle

2. low impact exercise and eliminate excessive stress on knee

Question 15

pain in medial arch, worse with forst steps in the AM; what is characteristic pain site

Answer 15

Plantar fascitis–> local point tenderness at the medial tubercle of calcaneus

Question 16

dislocated vs separated shoulder

Answer 16

dislocated–> head of humerus rotates out of glenoid cavity

separated–> clavicle separates from acromion and coracoid process of scapula

Question 17

shoulder pain with abduction ass. with repetitive over the head activities (tennis, pitching)

Answer 17

shoulder impingement syndrome–> compression of supraspinatus or subacromial bursa by the acromion during abduction

Question 18

What structures can be damaged in an anterior shoulder dislocation (6)

Answer 18

1. Axillary nerve
2. Posterior humeral circumflex artery
3. Supraspinatus tendon
4. Anterior glenohumeral ligaments
5. glenoid labrum
6. posterolateral humeral head

Question 19

frozen shoulder due to immobilization ; what two things seen on athrogram

Answer 19

Adhesive capsulitis–> constriction of the joint capsule an loss of axillary and subscapularis spaces

*x-rays are normal

Question 20

3 ligaments commonly injured during ankle sprain, starting with the most common

Answer 20

1. Anterior talofibular ligament (“Always Tears First”)
2. Calcaneofibular ligament
3. Posterior talofibular ligament

*these are all lateral ligaments

Question 21

3 common pt populations to get adhesive capsulitis

Answer 21

1. pts over 50
2. women
3. diabetics

Question 22

housemaids knee

Answer 22

prepatellar bursitis

Question 23

elbow swelling, nontender

Answer 23

olecrenon bursitis

Question 24

MC type of hip dislocation

Answer 24

posterior–> femoral head slips out of acebatulum posteriorly

Question 25

common scenario for a posterior hip dislocation

Answer 25

MVA where knee strikes dashboard with knee slightly abducted

Question 26

3 structures that can be injured in posterior hip dislocation

Answer 26

1. medial and lateral circumflex artery 2. femoral vein 3. femoral nerve

Question 27

very common cause of shoulder pain

Answer 27

inflammation of subacromial bursa