Shoulder Part 2: Exam 3 Flashcards Preview

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Flashcards in Shoulder Part 2: Exam 3 Deck (63):
1

Injuries to the shoulder complex

-bony
-ligament
-muscle
-tendon
-overuse

2

What causes a clavicle fracture?

-FOOSH
-direct impact
-fall on tip of shoulder

3

What does FOOSH mean?

Fall on out stretch hand

4

Symptoms of clavicle fracture

-Clavicle may appear lower or more prominent in the middle third
-pain on palpation
-swelling
-deformity
-point tenderness

5

Management of clavicle fracture

-closed reduction
-sling
-immobilize with figure 8brace for 6-8 weeks
-may require surgery

6

Where is the most common place for a clavicle fracture?

Middle third

7

What causes a scapula fracture?

Direct impact or force transmitted thru humerus

8

Symptoms of scapula fracture

Pain during shoulder movement
-swelling
-point tenderness

9

Management of scapula fracture

-sling immediately
-follow up with x-ray
-sling for 3 weeks

10

What causes a humeral shaft fracture?

-direct blow
-FOOSH

11

What is the danger of a humeral fracture?

Nerve and blood supply

12

Symptoms of humerus fracture

-pain
-swelling
-point tenderness
-decreased ROM

13

Management of humerus fracture

-immediate application of splint, treat for shock, refer

14

Difference in management of humeral fracture and proximal fracture

H: remove from activity for 3-4 months
P: incapacitation for 2-6 months

15

What causes a SC sprain?

-indirect force
-Blunt trauma

16

Symptoms of grade 1 SC sprain

Pain and slight disability

17

Symptoms of grade 2 SC sprain

-pain
-subluxation with deformity
-swelling
-point tenderness
-decreased ROM

18

Grade 3 SC sprain symptoms

-gross deformity (dislocation)
-pain
-swelling
-decreased ROM

19

When is a SC sprain life threatening?

If it dislocates posteriorly

20

Management of SC sprain

-RICE
-reduction
-immobilize for 3-5 weeks
-graded reconditioning

21

what causes an AC sprain?

-direct blow
-upward force from the humerus
-FOOSH

22

Symptoms of AC sprain

-pain with direct Alsatian and stress to joint

23

What can AC sprain be confused with?

AC joint contusion

24

How many grades of AC sprain?

1-6 based on severity

25

Grade 2 AC sprain symptom

-deformity

26

Grade 3+ AC sprain

Need surgery

27

AC sprain management

-ice
-stabilization
-refer
-agressive rehab
-specialized padding

28

Grades 1-3 non operative

3-4 days and weeks of immobilization respectively

29

GH sprain cause

Forced abduction or external rotation or a direct blow

30

Symptoms of GH sprain

-pain during movement especiallyy when recreating MOI
-decreased ROM and pain with palpation n

31

Management GH sprain

-RICE 24-48 hours
-sling
-modalities and passive/active ROM after initial inflammatory hase
-begin strength when pain free

32

What should you be aware of with GH sprain?

Potential developments of chronic conditions (instability)

33

Acute subluxation and dislocation cause

-translation of humeral head from glenoid

34

Most common MOI for dislocation

Forced abduction and external rotation

35

Symptoms of Sub and Dis

-pain and deformity
-dead arm
-palpation of humeral head in axillaire

36

Management of sub and Dis

-RICE
-reduction by doctor
-immobilize for 3 weeks
-isometrics in sling
-progress to resistance exercises
-protective bracing

37

Possible sub and dis complications

-bank art lesion
-SLAP lesion

38

Blankart lesion

Permanent anterior defect of labrum

39

SLAP lesion

Defect in superior labrum
-biracial nerves may be compromised
-rotator cuff injury
-fracture
-bicep tendon sub

40

Cause of chronic recurrent instabilities

-traumatic
-atraumatic
-microtrauma
-congenital
-neuromuscular

41

What happens as supporting tissue becomes more lax

Mobility increases resulting in damage to other soft tissue structure

42

Symptoms of anterior instability

-clicking
-pain
-dead arm
-positive apprehension test

43

Posterior instability symptoms

-impingement
-loss of internal rotation
-increased laxity

44

Multidirectional instability symptoms

-inferior laxity
-positive sulcus sign
-pain and clicking with arm at side
Possible signs of anterior and posterior

45

Management of instability

-conservative treatment
-extensive strengthening
-avoid joint mobilization and flexibility exercises
-restraints and harnesses to limit motion
-surgery

46

What causes impingement

-overhead activities

47

Impingement

Decreased space under coracoacromial arch---> mechanical compression or tendons and bursa

48

Exacerbating factors in impingement

-laxity
-inflammation
-postural mal-alignment

49

Symptoms of impingement

-diffuse pain
-pain on palpation of subacromial space
-in overhead athletes doctors may see increased GH external rotation and decreased internal rotation

50

What causes rotator cuff tear?

Acute trauma or impingement

51

What types of rotator cuff tears are there?

Partial or complete thickness

52

When does full thickness tear occur?

Athletes with a long history (does not occur in young athletes)

53

Management of rotator cuff tear

-pain med
-immobilization
-electrical stimulation
-NSAIDs and ultrasound
-restore appropriate mechanics and strengthen rotator cuff to depress and compress humeral head to restore space

54

Frozen shoulder (adhesive capulitis)

-Contracted and thickened joint capsule with little synovial fluid
-chronic inflammation with contracted inelastic rotator cuff muscles
-generalized pain with motions resulting in resistance of movement

55

Symptoms of frozen shoulder

Pain in all directions with both passive and active motion

56

Management of frozen shoulder

Aggressive joint mobilizations and stretching of tight muscles

57

What causes bicep rupture

-powerful contraction

58

Where does bicep rupture occur?

Near origin of muscle at bicep groove

59

Symptoms of bicep reupture

-hears snap
-budge near middle of bicep
-definite weakness with elbow flexion and supination

60

Management of bicep rupture

-ice for hemmhorage
-arm in sling
-refer
-surgery required
-older person might not require surgery

61

Bicep tenosynovitis cause

-repetitive overhead ballistic activity that involves repeated stretching of biceps causing irritation of the tendon haft

62

Symptoms of bicep T

Tenderness over bicipital groove
-swelling
-crepitis
-inflammation
-overhead pain

63

Management of Bicpe T

-RICE and ultrasound to treat inflammation
-NSAIDs
-gradual program of strengthening and stretching