UE part 1 trigger

Question 1

what rotator cuff muscles do external rotation

Answer 1

teres minor and infraspinatus

Question 2

hornblower tests what muscles

Answer 2

infraspinatus and teres minor

Question 3

gerber lift off tests what muscle

Answer 3

subscapularis

Question 4

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

Answer 4

serratus anterior

Question 5

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

what does a positive test suggest?

Answer 5

neer impingement test

+ = rotator cuff tear or impingement syndrome

Question 6

what test assesses for impingement of the supraspinatus tendon specifically

Answer 6

hawkins kennedy

Question 7

what test assesses for AC joint pathology or arthritis

Answer 7

crossover test

Question 8

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

Answer 8

jerk test -> posterior shoulder instability

Question 9

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

Answer 9

shoulder impingement

Question 10

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

Answer 10

impingement syndrome

Question 11

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.

Answer 11

shoulder impingement

Question 12

when do you use anesthetic injection for diagnosis?

Answer 12

differentiating between impingement and tear.

improvement of empty can after injection = impingement

Question 13

when do you consider corticosteroid injections and PT in impingement disorder

Answer 13

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

Question 14

caused by repetitive overhead moevement

Answer 14

rotator cuff tendonitis

Question 15

risk factors include increased BMI, DM, and HLD

Answer 15

rotator cuff tendonitis

also pitching (repetitive movements duh)

Question 16

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

Answer 16

stage 1 tendonitis

Question 17

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

Answer 17

stage 2 tendonitis

Question 18

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

Answer 18

rotator cuff tendonitis

Question 19

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

Answer 19

Rotator cuff tendonitis

Question 20

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

Answer 20

scapular Y view

Question 21

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

Answer 21

axillary

Question 22

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

Answer 22

stage 1 rotator cuff tendonitis

stage 2 = refer to PT (no activity)

Question 23

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

Answer 23

rotator cuff tear

Question 24

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

Answer 24

rotator cuff tear

Question 25

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

Answer 25

chronic rotator cuff tear

Question 26

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

Answer 26

adhesive capsulitis cervical disc dz, dupuytrens

Question 27

MRI shows contracted capsule and loss of inferior pouch

Answer 27

adhesive capsulitis

Question 28

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

Answer 28

adhesive capsulitis

Question 29

when do you do an arthroscopic capsular release

Answer 29

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

Question 30

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

Answer 30

anterior

Question 31

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

Answer 31

posterior

Question 32

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

Answer 32

inferior

Question 33

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

Answer 33

hills sach lesion

Question 34

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

Answer 34

bankart lesion

Question 35

can be reduced with stimson technique or with longitudinal traction

Answer 35

anterior shoulder dislocation

Question 36

can be reduced with axial traction

Answer 36

inferior shoulder dislocation

Question 37

can be reduced with traction-countertraction

Answer 37

posterior shoulder dislocation

Question 38

Falling directly on an ADducted shoulder can cause what injury

Answer 38

acromioclavicular injury

Question 39

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

Answer 39

AC joint injury

Question 40

when are Zanca X Rays used in UE

Answer 40

good for viewing AC injuries and clavicle fractures

Question 41

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

Answer 41

grade 1 and 2 AC injuries

Question 42

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!

Answer 42

AC grade 3 injury

Question 43

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

Answer 43

anterior sternoclavicular dislocation

Question 44

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

Answer 44

posterior sternoclavicular dislocation

Question 45

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

Answer 45

sternoclavicular injuries

Question 46

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

Answer 46

anterior sternoclavicular dislocation

Question 47

where do we see skin tenting

Answer 47

clavicular fractures

Question 48

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

Answer 48

CT chest w con

Question 49

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

Answer 49

biceps tendinopathy

Question 50

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

Answer 50

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

Question 51

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

Answer 51

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

Question 52

When is ORIF indicated for a proximal humeral fx?

Answer 52

* Displacement of > 1 cm or > 45deg angulation * Displacement of greater tuberosity > 0.5 cm (rotator cuff involved)

Question 53

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

Answer 53

prosthetic humerus

Question 54

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

Answer 54

humeral shaft fx with angulation <20 d