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MSK > Shoulder Ouchies > Flashcards

Shoulder Ouchies Flashcards

1
Q

What are the 3 bones that make up the shoulder joint?

A

Clavicle
Scapula
Humerus

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2
Q

What are the 4 shoulder joints?

A

Sternoclavicular
Acromioclavicular
Glenohumeral
Scapulothoracic

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3
Q

What is the significance of the glenoid fossa of the scapula?

A

Articulating surface with the humeral head

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4
Q

What is the significance of the coracoid process of the scapula?

A

Anchor point of tendinous and ligamentous attachments

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5
Q

What helps stabilise the highly mobile Glenohumeral joint?

A

Glenoid labrum
Rotator cuff muscles

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6
Q

Which direction is the most common way to dislocate the shoulder?

A

Anteriorly

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7
Q

How does an anterior shoulder dislocation appear?

A

Squaring of the shoulder

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8
Q

How does a posteriorly dislocated shoulder appear on an xray?

A

Humerus looks like a light bulb
It internally rotates so you see the back of it

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9
Q

Which way does the sternocleidomastoid muscle pull the clavicle?

A

Pulls up the medial side

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10
Q

Which way does the Pectoralis major muscle pull the clavicle?

A

Inwards

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11
Q

Which way does the Trapezius muscle pull the clavicle?

A

Upwards

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12
Q

Which way does the weight of the arm pull the clavicle?

A

Downwards with gravity

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13
Q

When the clavicle fractures the medial and lateral segments move differently, which way does the medial side move and what way does the lateral segment move?

A

Medial pulled superiorly

Lateral moved inferomedially

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14
Q

What causes the medial segment of fractured clavicle to move superiorly?

A

Sternocleidomastoid muscles pulls superiorly

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15
Q

What causes the lateral segment of fractured clavicle to move inferomedially?

A

Weight of arm drags it down
Pectoralis major pulls inwards

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16
Q

What is the function of infraspinatus?

A

External rotation

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17
Q

What is the function of subscapularis?

A

Internal rotation

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18
Q

How do you test for the function of subscapularis?

A

Put hand behind back and push against doctors

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19
Q

What is the function of Supraspinatus?

A

Initiates first bit of abduction

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20
Q

What are the muscles of the rotator cuff?

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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21
Q

Where does Supraspinatus, Infraspinatus and Teres minor insert?

A

Greater tubercle of Humerus

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22
Q

Where does subscapularis originate and insert?

A

Origin = Subcapular fossa of scapula

Insert = Lesser tubercle of Humerus

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23
Q

What nerve supplies both Supraspinatus and Infraspinatus?

A

Suprascapular nerve

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24
Q

What are the nerve roots of the Suprascapular nerve?

A

C5 and C6

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25
Q

What is the innervation of Teres minor?

A

Axillary nerve

26
Q

What is the innervation of subscapularis?

A

Subscapularis nerve

27
Q

What is impingement syndrome?

A

Narrowing of the subacromial space

When the Supraspinatus tendon impinges/rubs on the coraco-acromial arch leading to irritation and inflammation

28
Q

What can lead to narrowing of the subacromial space leading to impingement syndrome?

A

Tendinitis
Bursitis
Osteophytes

29
Q

What is the normal cause of tendinitis that leads to impingement syndrome?

A

Over use and weakening of Supraspinatus tendon leads to it becoming inflamed narrowing the space of the joint

30
Q

What bursa usually leads to the bursitis that is responsible for impingement syndrome?

A

Subacromial bursa

31
Q

The thickening of what ligament can cause impingement syndrome?

A

Coracoacromial ligament

32
Q

Where do osteophytes form to cause impingement syndrome?

A

Subacromial space

33
Q

In impingement of the Supraspinatus tendon, what is the presentation?

A

Painful arc

Pain between 60º and 120º

34
Q

What is Calcific Supraspinatus tendinopathy?

A

Deposits of hydroxyapatite (Calcium phosphate) in the tendon of Supraspinatus

35
Q

What aggravates the pain in calcific supraspinatus tendinopathy?

A

ABducting or flexing arm above shoulder
Lying on shoulder

36
Q

How is Calcific supraspinatus tendinopathy treated?

A

Rest
Analgesia
Surgery for persistent symptoms

37
Q

What is Adhesive Capsulitis (Frozen shoulder)?

A

When Glenohumeral joint (Whole shoulder capsule thickens) becomes stiff thick and inflamed which restricts movement

You run out of synovial fluid

38
Q

What are the 3 time periods for Adhesive Capsulitis?

A

Freezing (6-9 weeks)

Frozen (4-6 months)

Thawing (6 months - 2years)

39
Q

What are some risk factors to developing Adhesive Capsulitis?

A

Diabetes
Female
Hyper and Hypothyroidism
Connective tissue disease

40
Q

What is the treatment for Adhesive Capsulitis (Frozen Shoulder)?

A

Physiotherapy
Analgesia
Anti inflammatory drugs

Manipulation under anaesthesia to break adhesions

41
Q

What are the 4 signs on an x-ray that indicate osteoarthritis?

A

Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts

42
Q

How is Osteoarthritis of the shoulder treated?

A

Analgesia
NSAIDs
Steroid injections for swelling
Surgery as last resort

43
Q

What are some risk factors of osteoarthritis?

A

Age (Over 50yrs)
Female
Obesity

44
Q

What is Hemiarthroplasty

A

Where half of the shoulder joint is replaced to treat Shoulder Osteoarthritis

45
Q

What is a reverse total shoulder replacement?

A

Where the ball part of humeral head would be put in the normal place of the glenoid fossa, they are the other way around

46
Q

Why may a reverse total shoulder replacement may be done?

A

In old age the rotator cuff muscles are lost so by moving the joint out the Deltoid takes over

47
Q

If someone has pain on abduction between 60º to 120º of their shoulder, what are they likely suffering with?

A

Impingement syndrome This is the painful arc

48
Q

What is a Bankart lesion?

A

The Glenoid labrum tears in the anterior joint capsule allowing humeral head to move aroun

49
Q

What is a Hilsack legion?

A

Deformity of humeral head caused by recurrent dislocations (dent)

50
Q

Where is the main point that the clavicle fractures?

A

Fractures in the middle third

51
Q

Which way does the shoulder dislocate?

A

Anteriorly

52
Q

What is general impingement syndrome?

A

Compression of rotator cuff in the subacromial space

53
Q

What nerve can be damaged if the clavicle is fractured and the medial segment is pulled up?

A

Suprascapular nerve

54
Q

What are the nerve roots of the subscapular nerve?

A

C3 and C4

55
Q

What movement cannot happen to the arm if the subscapular nerve is damaged?

A

Cannot internally rotate

56
Q

What blood vessels can be damaged from a clavicular fracture?

A

Subclavian artery
Subclavian vein

57
Q

What is it called when a fractured clavicle punctures the lungs?

A

Pneumothorax

58
Q

What nerve is most at risk of being damaged during dislocation of the humeral head?

A

Axillary nerve

59
Q

What sensory region is lost when the Axillary nerve is damaged?

A

Regimental badge region

60
Q

Why do humeral neck fractures likely lead to Axillary nerve damage?

A

Axillary wraps around the surgical neck of the humerus

61
Q

If somebody has a posterior shoulder dislocation, what do you need to consider as potential causes?

A

If they’ve had seizures or an electric shock
(Lightbulb sign)

MSK (36 decks)

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