shoulder and upper arm conditions

Question 1

clavicle fracture etiology

Answer 1

fall onto lateral or superior shoulder

Question 2

clavicle fracture PE: inspection

Answer 2

guarded, deformity, ecchymosis, bleeding

Question 3

clavicle fracture PE: palpation

Answer 3

focal tenderness over clavicle

Question 4

clavicle fracture PE: strength

Answer 4

guarded, limmited by pain

Question 5

clavicle fracture PE: sensation

Answer 5

intact, check radial nerve

Question 6

clavicle fracture treatment

Answer 6

refer

Question 7

distal clavicle fracture treatment

Answer 7

surgical - heal poorly without

Question 8

AC separation: mechanism

Answer 8

fall onto lateral shoulder (classic is being tackled)

Question 9

AC separation: presentation

Answer 9

pain, guarding, often deformity

Question 10

AC separation PE: inspection

Answer 10

often a visible deformity, tenting of skin

Question 11

AC separation PE: palpation

Answer 11

tenderness at AC joint

Question 12

AC seperation PE: ROM

Answer 12

can accomplish motion and RTC fxn intact

Question 13

AC separation PE: sensation

Answer 13

intact, check axillary nerve

Question 14

what to look for on AC separation xray

Answer 14

spacing between coracoid and clavicle

Question 15

when should you refer for a clavicle fracture?

Answer 15

skin tenting, overriding greater than 1.5 cm

Question 16

when should you consider surgery for an AC separation?

Answer 16

grade 3 and above

Question 17

impingement syndrome etiology

Answer 17

pinching of the supraspinatus tendon over the humeral head and below the acromion

Question 18

hallmark of impingement syndrome

Answer 18

pain

Question 19

tests for impingement syndrome

Answer 19

arc of pain - 90 to 120 degrees
hawkins maneuver - internal rotation at 90 degrees
impingement test - downward force on acromion with forward flex

Question 20

AC joint arthritis etiology

Answer 20

pain at the AC joint with overhead arm use or push pull movement

Question 21

AC joint arthritis findings

Answer 21

pain on crossed arm adduction
localized pain at the AC joint with forward flexion, abduction

Question 22

rotator cuff tears: treatment

Answer 22

surgery

Question 23

what muscles make up the rotator cuff

Answer 23

supraspinatus, infraspinatus, teres minor, subscapularis

Question 24

rotator cuff tear: presentation

Answer 24

weakness > pain, poor ROM in some

Question 25

rotator cuff tear PE: inspection

Answer 25

maybe atrophy

Question 26

rotator cuff tear PE: palpation

Answer 26

minimal tenderness

Question 27

rotator cuff tear PE: ROM

Answer 27

forward flexion, abduction

Question 28

rotator cuff tear PE: special tests

Answer 28

drop arm, virtually diagnostic when positive

Question 29

difference between impingement and RTC

Answer 29

maintained rotator cuff strength with impingement

Question 30

glenohumeral dislocation etiology

Answer 30

fall with axial load and external rotation

Question 31

glenohumeral dislocation PE: inspection

Answer 31

deformity

Question 32

glenohumeral dislocation PE: palpation

Answer 32

gently and with neuro exam

Question 33

glenohumeral dislocation PE: sensation

Answer 33

test peripheral nerves (axillary, musculocutaneous, ulnar)

Question 34

what imaging view is best for shoulder dislocation

Answer 34

axillary view Scapular Y

Question 35

glenohumeral dislocation treatment

Answer 35

reduction, PT

Question 36

adhesive capsulitis

Answer 36

frozen shoulder contraction and scarring of the joint capsule insidious onset female 40-55

Question 37

adhesive capsulitis presentation

Answer 37

stiffness loss of function (ADL's)

Question 38

adhesive capsulitis PE: palpation

Answer 38

diffuse tenderness

Question 39

adhesive capsulitis PE: ROM

Answer 39

limited by stiffness more than pain ACTIVE = PASSIVE ROM

Question 40

adhesive capsulitis treatment

Answer 40

pain management and PT

Question 41

thoracic outlet syndrome etiology

Answer 41

compression of the subclavian artery. can involve brachial plexus SUPER RARE

Question 42

what can thoracic outlet syndrome mimic

Answer 42

carpal tunnel syndrome, cubital tunnel syndrome, radiculopathy, musc, axillary, and radial nerve palsy

Question 43

thoracic outlet syndrome tests

Answer 43

loss of radial pulse with raising arm over head

Question 44

thoracic outlet syndrome presentation

Answer 44

pain + tingling that can radiate from neck to shoulder, arm, forearm, and fingers

Question 45

SALT etiology

Answer 45

long thoracic nerve palsy leading to serratus anterior nerve palsy which leads to scapular winging

Question 46

SALT presentation

Answer 46

loss of tone of rhomboid major, minor and trapezius muscles