MSK Exam 10? Flashcards by Amanda Beach

3 bones in shoulder

clavicle
scapula
proximal humerus

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articular surfaces in shoulder

glenohumeral
sternoclavicular
acrocioclavicular
scapulothoracic

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5 main mm of shoulder

deltoid- abduction
supra- abduction
infra- ext rotation
subscap- internal rotation
teres minor- external

Rotator cuff

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intrinsic injury of shoulder

glenohumeral ligaments- sprain or tear
muscle or tendon inflammation, tear, strain: rotator cuff and deltoid
bones: fracture, inflamed capsule

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extrinsic causes shoulder pain

referred

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neuro causes shoulder pain

Cervical nerve root compression
supraspinatus nerve compression
brachial plexus
herpes zoster
spinal cord lesion
cervical spine disease

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abdominal cause shoulder pain

hepatobiliary disease

diaphragm irritation

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CV causes shoulder pain

MI
axillary vein thrombosis
thoracic outlet syndrome

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thoracic causes shoulder pain

upper lobe pneumonia
apical lung tumor
pulmonary embolus

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common causes of intrinsic shoulder path

impingement
tendinopathy
tendon tear
AC separation
OA
adhesive capsulitis (frozen shoulder)
bursitis
instability
SLAP lesion

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characterisitic of intrinsic shoulder issue

pain can be positional

more easily localized with palpation and movement

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way to test suprascap

empty can

or 90 degree and resist their AB duction

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way to test subscap

lift off

or tuck elbow in, 90 degrees and have them push medially against R with their wrist

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infraspinatus teres minor test

forearm laterally against R

90 degrees

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most intrinsic shoulder pain

supraspinatus

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what protects supraspinatus

sub acromial bursa

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what space can compress supraspinatus

head of humerus and acromion

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night pain in shulder
atrophy sup and post mm
pain crepitus while abducting arm

impingment

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tests for impingment

hawkins and near impingement

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weakness of rotator cuff can lead to what

superior subluxation humeral head when should abduct beyond 90 degrees
predisposing to impingement

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what ligaments can be affected when falling on tip of shoulder

AC and corcaoclavicular

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what is Tx for grade 1-3 AC separation

4-5

1-3 conservative

4+ surgical

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lost active and passive ROM inshoulder

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arthritis!

loss of joint space

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arthritis

imaging to distinguish soft tissue path

MRI

risk factor frozen shoulder

limit of steroid injections each year

differentiate between bursitis and tendonitis

pain with active vs passive ROM tendon hurst with active bursa with passive too

Dx bursitis

clinical exam and inject then test ROM and strength again after

What is SLAP lesion

superior labrum anterior to posterior | where biceps anchors to labrum

acute SLAP lesion

falling and grab something

MRI definition of SLAP lesion

O'Brians

what is new imaging for joint problems instead of MRI

contrast injection into joint with serial XR or fluoroscopy

posterior pain aroun dhip could be

SI lumbar unusual true hip pain

lateral hip pain ddx

bursitis

lateral hip pain with paresthesia

meralgia paresthetica

anterior/groin pain ddx

hip pain osteonecrosis sepsis, fracture synovitis

lower anterior thigh pain

referred true hip upper femur femoral neck lumbar radiculopathy

if neither direct P not ROM reproduces "hip pain" | what is ddx

hernia, lower abdominal pathology | referred pain from lumbar area

trochanteric bursitis

exaggerated or abnormal movement of gluteus medius and TFL over greater trochanter

what type of pain with trochanteric bursitis

lateral hip pain, just posterior superior to point of trochanter

important part of PE with hip pain cc

gait analysis

key exam feature in OA hip

restricted abduction and internal rotation pain limited flexion and morning stiffness

in OA of hip the groin is aggravated by what

movement more than palpation

when will OA pain hurt the most

morning and end of the day

what is meralgia paresthetica

lateral femoral cutaneous nerve susceptible to impingement | especially when course under inguinal lig

burning of lateral thigh | no weakness of DTR changes

meralgia paresthetica

if burning lateral thigh and with weakness and DTR changes

not! meralgia paresthetica | because involving more than sensory

osteonecrosis

compromised vascular supply to femoral head joint collapse in 3-5 years groin pain, weight bearing and motion induced

steroids and excessive alcohol intake can cause what hip path

osteonecrosis

occult fracture imaging

MRI | XR not enough

presentation of referred pain of hip

lumbar ans SI joint whenever groin pain with back pain Sx extend beyond knee paresthesia present

fabere test

hip, psoas or SI problem flex abduct externally rotate then extend if painful then +

osgood- schlatter

tibial tuberosity avulsion osteochondritis of tibial tubercle apophysitis of tibial tubercle at insertion of patellar tendon

Tx osgood schlatter

pain contro; continnue activity leg strengthening with physical therapy

76 u.o L shoulder pain burning and radiates to back of shoulder low neck area ddx?

ruptured supraspinatus cervical n compression/radiculopathy (5, 6) OA

MSK Exam 10? Flashcards

(56 cards)