Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med IV Exam 1 > Shoulder and UE Injuries > Flashcards

Shoulder and UE Injuries Flashcards

(88 cards)

Start Studying
1
Q

What artery supplies the proximal humerus w/ blood?

A

Axillary Artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 branches of the axillary artery?

A

Ant humeral circumflex artery

Pos humeral circumflex artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Muscles of the Rotator Cuff

A

Supraspinatus
Infraspinatus
Subscapularis
Teres Minor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Function of supraspinatus

A

Abduction

Superior stabilizer of the shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Function of Infraspinatus

A

External rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Function of Teres Minor

A

External rotation in 90deg of abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Function of subscapularis

A

Internal rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MOI of Clavicle fx

A

Fall w/ arm adducted

Sports injury during football, ice hockey

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clavicle fx presentation

A

Pain w/ active/passive ROM esp abduction/flexion of shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you tx clavicle fx?

A
  • SLING
  • Start w/ glenohumeral ROM within 1wk
  • Conservative tx if non or minimally dispalced (sling, ice NSAIDS, analgesics, passive ROM)

-Displaced –> ORIF w/ plate & screws, sling, ROM, analgesics, PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

MOI of AC joint injury?

A
  • Direct force to lateral aspect of shoulder w/ arm ADDUCTED
  • Acromion driven INFERIORLY & MEDIALLY w/ respect to clavicle
  • Common in young athletic ppl (hockey)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

During an AC joint injury, in what direction does the acromion move in respect to the clavicle?

A

INFERIORLY & MEDIALLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

AC joint injury presentation

A
  • pain in affected shoulder
  • decrease ROM
  • TTP over AC joint
  • Visible deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What test can you do to diagnosis AC joint injury?

A. Empty can test
B. Cross arm test
C. Hawkin Impingement test
D. Phalen test

A

CROSS ARM TEST

-pt elevated affected arm 90deg, then actively adducts it

pos = pain in ac joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Grade I AC joint injury

A

Sprain on AC ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Grade II AC joint injury

A

Tear of AC ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Grade III AC joint injury

A

Tear of AC ligament & coracoclavicular ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How would you tx a grade I and II AC joint injury?

A

Conseravatively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How would tx a grade III + AC joint injury?

A

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MOI of AC joint dislocation

A
  • tackled during football

- grade III AC joint injury –> increase CC distance & superior displacement of distal clavicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Sternoclavicular Joint Dislocation MOI

A

Uncommon

Fall on ABDUCTED and EXTENDED arm
*may not dislocate till days after injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Would you be more worried with a posterior or anterior dislocation of the sternoclavicular joint? Why?

A

Posterior dislocation; worried about neuro structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

If a pt has a fx in the diaphysis of the humerus, what neurovascular structure are you worried about?

A

Radial Nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Proximal humerus fx presentation

A
  • Mod-severe shoulder pain that increase w/ shoulder movement
  • swelling & ecchymosis
  • pt holds ADDUCTED arm against side
  • neurovascular injury more likely to occur in displaced fx or fx-dislocation (involve axillary or suprascapular n)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What kind of pt population is more likely to get a proximal humerus fx? MOI?
ELDERLY >60yo Fall from standing
26
Tx of proximal humerus fx?
Nondisplaced --> Conservatively (sling, ice, analgesic, sleep semi-recumbant, gentle ROM 2wks later, ROM elbow) Unstable humerus neck fx --> ORIF Reverse total shoulder replacement
27
Shoulder dislocation presentation
- Obvious deformity w/ humeral head dislocated ANTERIORLY - affected arm at side of body in EXTERNAL ROTATION - shoulder loses roundness & will be fully anteriorly to palpation
28
Are shoulder dislocations more likely to be anterior or posterior?
ANTERIOR (95%)
29
MOI of shoulder dislocation
Posterior --> fall from height, epileptic seizures, or electric shock
30
What x-ray views do you want for shoulder dislocation/instability?
AP Axillary Scapular Y
31
What do you want to do immediately to a dislocated shoulder?
REDUCE SHOULDER ASAP Sling immobilization for 2wks Early PT
32
Impingement syndrome presentation
- onset of pain w/ active ROM of shoulder - pain w/ overhead activities - pain on internal rotation (putting on jacket) - tenderness over anterolateral shoulder at greater tuberosity - decrease active ROM but have PRESERVED passive ROM
33
MOI of impingement syndrome
Pain from compression of tissues between humeral head & coracoacromial arch Recent hx of over activity Pt >40yo
34
What is the most common cause for impingement syndrome?
Partial RC tears
35
What special test can be used to dx impingement syndrome? A. Empty can test. B. Hawkin Impingement test C. Cross arm test D. Phalen test
HAWKIN IMPINGEMENT TEST - eval impingement of RC and subacromial bursa - pt seated or standing w/ shoulder forward flexed to 90 deg and elbow flexed to 90deg - stabilize top of shoulder while internally rotating arm at forearm - Postive = pain in anterior shoulder or reproduction of pt sx w/ test
36
What x-ray views do you want with impingement syndrome of the shoulder?
AP Lateral Grashey Scapular Y
37
Tx for impingement syndrome?
Conservative - Activity modification - PT - NSAIDs - Corticosteorid injection Surgical - arthroscopic acromioplasty w/ coracoacromial ligament release - bursectomy - debridement or repair of RC tears
38
Rotator cuff tear presentation
- weakness or pain w/ overhead movement - inability to sleep on affected side - obvious WEAKNESS noted w/ light resistance testing - difficulty lifting arm w/ limited active ROM; passive ROM in tact
39
Which RC muscle is common torn?
Supraspinatus
40
MOI of RC tears?
Acute - fall on oustretched arm - pulling on shoulder Chronic -repetitive injuries w/ overhead movements & lifting Pt >40yo
41
What findings may you see on an x-ray for RC tears?
High riding humeral head
42
RC tear tx
Partial tear --> heal w/ scarring -tx conservatively w/ PT Full thickness tear --> do not heal well -should tx w/ surgery esp if young
43
What is a SLAP lesion? and how does it happen?
Injuries of glenoid labrum at point of attachment of long head of biceps FOOSH Throwing sports athletes (baseball/softball)
44
What diagnostic imaging would you get if you suspect SLAP lesion?
MR arthrogram*** High signal found on T2WI
45
Adhesive Capsulitis presentation
Inflammatory phase: pain out of proportion of clinical findings (last 4-6mo) Freezing phase: shoulder gets progressively stiffer (last 4-6mo) Thawing phase: resolution; regaining ROM (up to 1yr) -pain w/ decrease passive & active ROM
46
MOI for Adhesive Capsulitis
Thickening of entire joint capsule of shoulder Triggered by minimal or no trauma Commonly seen in pt 40-65yo Women (perimenopausal or w/ DM or thyroid dz)
47
Tx of adhesive capsulitis
``` NSAIDs PT Intra-articular corticosteroid injections +/-oral prednisone Surgical tx ```
48
Calcific Tendonitis presentation
- very painful shoulder triggered by minimal or no trauma - acute onset - pt looks in pain and tired
49
MOI of calcific tendonitis
- deposition of calcium hydroxyapatite within substance of tendon - most commonly supraspinatus - middle age pt 30-60yo - Diabetic 2-4x >non-diabetic
50
Tx of Calcific tendonitis
- Analgesic/anti-inflammatory med - Subacromial local anesthetic/steroid injection --> immediate relief - PT w/ US relief - Arthroscopy w/ aspiration of minerialized material
51
What is another name for frozen shoulder?
Adhesive Capsulitis
52
What is the bimodal distribution seen in humerus fractures?
Male in 3rd decade --> high velocity trauma | Women in 7th decade --> low velocity falls
53
Humerus Fx presentatoin
- severe pain - referred pain to shoulder or elbow - swelling & ecchymosis - significant tenderness to palpation & crepitus
54
MOI of humerus fx
- Trauma; direct blow or bending forward | - Midshaft fx --> strong muscle contraction (high-velocity throwing or arm wrestling)
55
What nerve is commonly injured during a midshaft humerus fx? How can you test motor function? Sensory function?
-Radial nerve --> results in weakness of wrist, finger & thumb extension & some weakness of elbow supination - Test motor function by giving "thumbs up" sign & test resisted extension of thumb - Test sensory function at dorsal web space between thumb & index finger
56
How should you tx a non-displaced midshaft humerus fx?
put them in a functional brace; apply it 1-2wks after injury, allowing swelling to go down
57
What is a diagnostic sign on x-ray for elbow fracture?
Posterior fat pad sign or "sail sign"
58
MOI elbow fracture?
FOOSH - radial head fx - supracondylar humerus fx - olecranon fx
59
Radial head fx MOI
FOOSH w/ abducted arm & minimal or mod flexion of elbow joint (0-80 deg)
60
What views on x-ray do you want to for the elbow?
AP External Oblique Lateral
61
Radial arm fx tx
``` Long arm posterior splint for 3-4days Sling for 1-2wks Analgesics Gentle ROM Serial radiographs (2wks) PT ```
62
MOI of supracondylar elbow fx
- extra-articular fx of distal humerus at elbow - almost always d/t ACCIDENTAL TRAUMA - FOOSH from mod height (monkey bars) - Hyper-extended elbow
63
What pt population does a supracondular elbow fx commonly occur in?
PEDIATRIC PTS | age 5-9
64
Olecranon fx presentation
- pain localized to POSTERIOR elbow - palpable defect - inability to extend elbow - effusion around elbow
65
MOI of olecranon fx
Direct blow --> usu results in comminuted fx Indirect blow --> fall onto outstretched UE; usu transverse or oblique fx
66
Can you tx olecranon fx conservatively?
NO | Need ORIF w/ tension band or ORIF w/ plate & screw
67
Are elbow dislocations most commonly anterior or posterior?
Posterior
68
MOI of elbow dislocations
- fall onto an extended arm - hyperextension - posterolateral rotatory mechanism
69
Epicondylitis presentation
- Pain over medial or lateral epicondyle | - Pain ranges from minimal and annoying to debilitating severely affecting activity of daily living
70
What is Tennis Elbow?
- pain over lateral epicondyle | - affects extensor tendons of forearm particularly extensor carpi radialis
71
What is Golfer's Elbow?
- pain over medial epicondyle | - affects flexor tendons of forearm, particuarly pronator teres & flexor carpal radialis muscle
72
Tx for tennis/golfer elbow?
``` Rest Ice cube amssage Brace NSAIDs PT Cortisone ```
73
MOI Both bone forearm fx
Direct trauma --> protecting one's head Indirect trauma --> MVA, fall from height, athletic competition
74
Tx of both bone forearm fx
Sugar tong splint Nondispalced --> cast Displaced --> ORIF
75
Greenstick fx MOI
- incomplete fx of long bone - forearm of child - result from force applied perpendicualr to shaft
76
In a greenstick fx, is the fx produced on the concave or convex cortex?
Convex
77
Greenstick fx tx
- SUGAR TONG SPLINT - analgesics - casting x3-4wks - splinting if pt and family reliable and fx stable
78
What is a buckle fracture?
- incomplete fx - occurs at metaphyseal diaphyseal junction after a FOOSH - stable fx - heals quicker than greenstick fx
79
Tx of buckle fx?
- VOLAR SPLINT - analgesics - casting 3-4wks - splinting if pt & family reliable & fx stable
80
What is a Colles Fx?
- Fx of distal radial metaphyseal region w/ DORSAL ANGULATION & impaction - common fx of distal radius - result of FOOSH - extra-articular
81
Tx Colles Fx?
Conservative - closed reduction - sugar tong splint followed by long/short arm cast 4-6wks Surgical -ORIF followed by cast/splint immobilization for 4-6wks
82
What fractures would you do a sugar tong splint?
Both bone forearm fracture Greenstick Fx Colles Fx
83
What is a Smith Fracture?
- distal radius w/ assoc VOLAR ANGULATION of distal fx fragment - extra-articular transverse fx - aka reverse colles fx
84
MOI Smith Fx?
- Fall onto flexed wrist | - Direct blow to back of wrist
85
What kind of splint would you use for a Smith Fx?
Volar (cock-up) forearm splint - applied midpalmar crease almost to elbow ventrally - Position: neutral forearm (thumb up), wrist at 20deg extension
86
Which is worse, Colles or Smith fx?
Smith Fx bc of flexion
87
65yo women presents with a stiff right shoulder that was previously very painful 4mo ago. No history of any fractures or injury to the right shoulder. Decrease active and passive ROM. What injury may this be? A. SLAP lesion B. Adhesive Capsulitis C. Calcific Tendonitis D. Clavicle Fracture
Adhesive Capsulitis (frozen shoulder) Key words: previously very painful shoulder (inflammatory phase), stiff shoulder (freezing phase); 65yo (perimenopausal women); no trauma
88
What kind of injury is most likely the result of falling off the monkey bars in a 6yo child? A. Radial head fx B. Olecranon fx C. Supracondylar elbow fx D. Elbow dislocation
Supracondylar elbow fx - common pedi elbow fx - 90% d/t hyper-extended elbow

Clin Med IV Exam 1 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions