Shoulder part 1 Flashcards Preview

PHTH 7232 Ortho > Shoulder part 1 > Flashcards

Flashcards in Shoulder part 1 Deck (49):
1

tenodesis

the surgical suturing of the end of a tendon to a bone. Like when the long head of the biceps is shortened and attached to the bicipital groove

2

What is the clinical relevance of palpating the clavicle

Clavicle is the most commonly fractured bone in the body.

It usually fractures at mid-third where it transitions from anterior convexity to posterior concavity.

3

PIP

proximal interphalangeal joint

4

DIP

Distal Interphalangeal joint

5

ACDJD

Acromioclavicular (AC) Degenerative Joint Disease

Often presents in older patients

6

Clinical Significance: anterior joint line (of GH joint)

cannot directly palpate, but do palpate area because if patient has had chronic subluxation or dislocations then this area could be problematic

7

Internal Rotation Muscles of GH joint (5)

  • Latissimus dorsi
  • Teres major
  • Anterior deltoid
  • Subscapularis
  • Pectoralis major

8

External rotation muscles of GH joint  (3)

  1. Infraspinatus
  2. Teres Minor
  3. Posterior Deltoid

9

Flexion muscles of GH joint (2 pectoral girdle, 2 arm)

  • Anterior deltoid
  • Pectoralis Major: Clavicular head

 

  • Coracobrachialis?
  • Biceps brachii; Long & Short heads?

10

Abduction muscles of GH joint (3)

  • Middle Deltoid
  • Supraspinatus

 

  • Above 90 degrees: Pectoralis major, sternal head

11

Adduction muscles of GH joint (5-6)

  1. Subscapularis
  2. Anterior Deltoid (below 90 degrees?)
  3. Posterior Deltoid (below 90 degrees?)
  4. Teres Major
  5. Latissimus Dorsi
  6. Pectoralis major: Sternal head always, Clavicular head below 90 degrees
     

12

Extension muscles of GH joint (4)

  1. Subscapularis
  2. Posterior Deltoid
  3. Teres Major
  4. Latissimus Dorsi

13

Elevation muscles of scapulothoracic joint (2)

  • Upper Trapezius
  • Levator Scapulae

14

Upward rotation muscles of scapulothoracic joint (2-4)

  • Upper, Middle, and Lower Trapezius
  • Serratus Anterior

15

Scapular retraction muscles (2-3)

  • Middle Trapezius
  • Rhomboid major & minor

16

scapular depression muscles (3)

  • Lower Trapezius
  • Latissimus Dorsi
  • Pectoralis minor
     

17

Downward rotation muscles of scapulothoracic joint (3-4)

  • Rhomboid major & minor
  • Levator scapulae
  • Latissimus dorsi
     

18

Scapular protraction muscles (1)

Serratus anterior

19

os acromiale

failure of distal end of acromion to ossify

20

SAD

subacromial decompression

The most common shoulder surgery

21

Physis

  • GROWTH plate
  • Specialized cartilaginous tissue interposed b/w metaphysis & Epiphysis in LONG bones in children
  • Provides GROWTH in LENGTH of long bone

22

physis

GROWTH plate Specialized cartilaginous tissue interposed b/w metaphysis & Epiphysis in LONG bones in children Provides GROWTH in LENGTH of long bone

23

What is the clinical significance of the suprasternal notch?

there is none

24

where is the anterior (GH) joint line

from coracoid process to the inferior axillary fold

25

Anterior Impingement syndrome

where the subscapularis get's compressed against the coracoid process. I think it is also called coracoid impingement syndrome.

Could show up when palpating the coracoid process.

26

coracoid impingement syndrome

probably the same as anterior impingement syndrome.

Subscapularis gets compressed against the coracoid process.

27

what structure(s) can be palpated by moving fingers off the anteriolateral edge of the acromion onto the humeral head?

superior facet of the greater tubercle of the humerus (supraspinatus tendon).

If you slide fingers posteriorally, you should feel middle and inferior facet, where conjoined tendons of infraspinatus and teres minor attach.

28

Which tendon is most often involved in RCT? Which is the second?

1. Supraspinatous tendon

2. Infraspinatus tendon

29

When palpating, should the transition from superior to middle facet of the greater tubercle of the humerus jump out at you?

No! it is very subtle

30

What will you find about 1.5 - 2 body inches of the anterior (and lateral?) side of the acromion?

The Bicipital Groove and Transverse Humeral Ligament (THL) that covers it.

31

What is the clinical significance of palpating the long head biceps tendon?

the biceps is a common problem when you have impingement issues

32

Tendinopathy

The term tendinopathy is a generic descriptor of the clinical conditions ( both pain and pathological characteristics) associated with overuse in and around tendons

33

What 2 things might be involved/considered after finding pain over LHB tendon in bicipital groove upon palpation?

  1. Tendinopathy
  2. Tenodesis

34

tenodesis

the surgical suturing of the end of a tendon to a bone. In the LH biceps tendon it is attached to the bicipital groove

35

What is the clinical significance of the soft spot palpable just below the posterior lateral portion of the acromion?

it is where a lot of subacromial injections are done

it is a posterior arthroscipic portal site.

it is where internal impingement most commonly occurs.

For us it is a landmark

36

What is the clinical significance of palpating the superior angle of the scapula?

  • Levator scapula attaches here
  • Referral from C-spine (called something that sounds like flower sign)
  • Rule out fractures

37

What is the clinical significance of palpating the medial border of the scapula?

check for pain and if something might be going on

38

Clinical significance for palpating axillary border of the scapula

Axillary border can be fractured, but it is not very common

39

Is it common for the SC joint to get injured?

No

40

What is the most common injury seen in SC joint and which population is it found in?

anterior subluxation in wrestlers

41

SC joint posterior subluxation

VERY SERIOUS because of underlying structures (trachea & carotid artery)

Also very rare!

42

What is the most common problem in AC joint?

AC sprain

43

Characteristics of AC sprain or AC problems?

Think of Ron (a class of 2017 classmate with this condition)

  • Asymmetry(looks like clavicle is riding up, but really scapula is dropping down)
  • AC OA is common
  • AC DJD is common in older people
  • AC osteolitis is another problem that we may find

44

OA is

Osteoarthritis

45

RA is

Rheumatoid arthritis

46

osteolysis

active resorption of bone matrix by osteoclasts.

Sometimes found in weight lifters

47

GH joint ligaments to palpate

  • Anterior capsule
  • Posterior capsule
  • Transverse humeral ligament (over LHB tendon)

48

CA ligament

  • it is the Coracoacromial ligament. Find between coracoid process and anterior edge of acromium.

 

  • Doesn't jump out of you
  • Small fibrous band
  • palpate inferior to superior
  • one of the most vital ligaments in regards to impingement

49

What is the most vital ligament in subacromial impingment?

CA ligament (Coracoacromial ligament)