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MSK > UE part 1 trigger > Flashcards

UE part 1 trigger Flashcards

1
Q

what rotator cuff muscles do external rotation

A

teres minor and infraspinatus

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2
Q

hornblower tests what muscles

A

infraspinatus and teres minor

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3
Q

gerber lift off tests what muscle

A

subscapularis

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4
Q

stabilizing the scapula, flexing the shoulder to 90 degrees and applying posterior force should assess for what muscle weakness if winging is present?

A

serratus anterior

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5
Q

what test compresses the rotator cuff tendons between greater tuberosity & anterior acromion?

what does a positive test suggest?

A

neer impingement test

+ = rotator cuff tear or impingement syndrome

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6
Q

what test assesses for impingement of the supraspinatus tendon specifically

A

hawkins kennedy

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7
Q

what test assesses for AC joint pathology or arthritis

A

crossover test

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8
Q

90d flexion + max internal rotation + elbow flex 90d
Adduct arm across horizontal while pushing humerus in posterior position

what test is this and what does it assess for

A

jerk test -> posterior shoulder instability

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9
Q

pain presenting at 60-120 degrees of abduction is indicative of what

A

shoulder impingement

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10
Q

gradual onset of shoulder pain anteriorly and laterally. night pain and difficulty sleeping on the affected side. pain worsened by overhead activity.

A

impingement syndrome

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11
Q

PE shows tenderness over greater tuberosity and subacromial bursa. pain w abduction between 90-120 as well as when lowering arm back down. crepitus w movement.

A

shoulder impingement

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12
Q

when do you use anesthetic injection for diagnosis?

A

differentiating between impingement and tear.

improvement of empty can after injection = impingement

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13
Q

when do you consider corticosteroid injections and PT in impingement disorder

A

Steroid injections - if no imporvemnet in 4-6 wks
PT if no improvement in 3-4 weeks
OT only if PT fails

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14
Q

caused by repetitive overhead moevement

A

rotator cuff tendonitis

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15
Q

risk factors include increased BMI, DM, and HLD

A

rotator cuff tendonitis

also pitching (repetitive movements duh)

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16
Q

presents with aching/soreness w throwing. decreased accuracy and performance. pain w ADLs. improvement w rest

A

stage 1 tendonitis

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17
Q

posterior shoulder pain with activity and at night. loss of ROM abduction and ext rotation. does not improve w rest

A

stage 2 tendonitis

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18
Q

Passive ROM>Active ROM. pain above 90d abduction. tenderness along affected muscles. + empty can, neers, and hawkins

A

rotator cuff tendonitis

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19
Q

MSK US shows hypoechogenicity, hyperechogenicity, and thickening by >5-6mm

A

Rotator cuff tendonitis

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20
Q

what radiograph view should you obtain for shoulder dislocation, proximal humerus or scapula fx

A

scapular Y view

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21
Q

what radiograph view should you recieve for humeral head and glenoid problems

A

axillary

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22
Q

Rest and no training for 10 days. Intermittent activity after 10 days is tx for what

A

stage 1 rotator cuff tendonitis

stage 2 = refer to PT (no activity)

23
Q

pain worse with activity and at night with weakness, catching, and crepitus when lifting. inability to perform overhead ADLs

A

rotator cuff tear

24
Q

PE shows + drop arm with full PROM and limited/painful AROM

A

rotator cuff tear

25
Q

a shallow space between acromion and humerus on Xray is indicative of what

A

chronic rotator cuff tear

26
Q

risk factors include T1DM, parkiinsons, hypothyroidism, and cerebral hemorrhage

A

adhesive capsulitis

cervical disc dz, dupuytrens

27
Q

MRI shows contracted capsule and loss of inferior pouch

A

adhesive capsulitis

28
Q

tx includes moist heat compression, stretching, PT with TENS unit, and intraarticular steroid injections (3-6 max)

A

adhesive capsulitis

29
Q

when do you do an arthroscopic capsular release

A

in adhesive capsulitis if theres no improvement in s/s after 3 consistent months of rehab

30
Q

pt presents with arm slightly abducted and in external rotation. Acromion is very prominent. what type of dislocation is this

A

anterior

31
Q

pt presents with adducted and internally rotate shoulder. coracoid process is prominent. what type of dislocation is this?

A

posterior

32
Q

presents with fully abducted arm and inability to adduct arm. what dislocation type is this

A

inferior

33
Q

Depression fx of humeral head 2/2 dislocation is called what

A

hills sach lesion

34
Q

glenoid labrum disruption, common in patients <30y/o. what is this also known as?

A

bankart lesion

35
Q

can be reduced with stimson technique or with longitudinal traction

A

anterior shoulder dislocation

36
Q

can be reduced with axial traction

A

inferior shoulder dislocation

37
Q

can be reduced with traction-countertraction

A

posterior shoulder dislocation

38
Q

Falling directly on an ADducted shoulder can cause what injury

A

acromioclavicular injury

39
Q

pt presents supporting arm in an adducted position and reports pain in anterior shoulder over AC joint when abducting.

A

AC joint injury

40
Q

when are Zanca X Rays used in UE

A

good for viewing AC injuries and clavicle fractures

41
Q

sling with rest for 2-3 days but ROM started within 7-10 days. expected full recovery in 2-4 weeks

A

grade 1 and 2 AC injuries

42
Q

use sling for 2-3 weeks. start ROM exercises as soon as tolerated. Expected recovery is 6-12 weeks. only do surgery if injury affects career!

A

AC grade 3 injury

43
Q

severe pain over central chest with swelling and ecchymosis. medial clavicle is prominent

A

anterior sternoclavicular dislocation

44
Q

severe pain in central chest with swelling and ecchymosis. pt is hoarse and reports dysphagia and UE paresthesias

A

posterior sternoclavicular dislocation

45
Q

when do you jump straight to CT as first line imaging due to Xray not being sensitive to these injuries

A

sternoclavicular injuries

46
Q

reduce w posterior traction and then apply a sling/figure 8 harness

A

anterior sternoclavicular dislocation

47
Q

where do we see skin tenting

A

clavicular fractures

48
Q

if medial clavicular fracture is suspected, what imaging should be used

A

CT chest w con

49
Q

Pain reported in the anterior shoulder radiating to the elbow. it is worsened by activity and also at night. symptoms do relieve w rest & ice

A

biceps tendinopathy

50
Q

What is yergason’s test and who is it positive in?

A

pain with supination when stabilizing the elbow at 90d.
present in biceps tendinopathy

51
Q

64 yo pt reports carrying heavy groceries inside when he had a sudden onset of pain in his upper arm. he heard an audible snap and soon after developed ecchymosis and severe isolated swelling and protruding deformity in the mid-anterior portion of his proximal upper extremity. what is the dx and tx

A

rupture of the LHBT

conservative. will lose about 10% of strength. surgery only for young athlete/laborer

52
Q

When is ORIF indicated for a proximal humeral fx?

A
  • Displacement of > 1 cm or > 45deg angulation
  • Displacement of greater tuberosity > 0.5 cm (rotator cuff involved)
53
Q

what tx is indicated in a 4-part fx of the humerus due to risk of blood supply disruption to humeral head

A

prosthetic humerus

54
Q

Splinting with U-shaped coaptation splint for 2 weeks, then humeral fx brace for 6 weeks
encourage ROM of distal upper extremity

A

humeral shaft fx with angulation <20 d

MSK (27 decks)

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