Upper Extremity Flashcards Preview

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Flashcards in Upper Extremity Deck (34):
1

Rotator Cuff Characteristics

1. occurs with overhead overuse (throwing athletes)
2. underlying GH instability, poor muscle strength, training errors
3. common cause is impingement of the supraspinatous tendon as it passes beneath the subacromial arch

2

Rotator Cuff Clinical Features

1. dull, aching shoulder
2. pain caused by inflammation, fibrosis, tears
3. pain exacerbated by ABD arm

3

Rotator Cuff Diagnostic Studies

1. radiographs r/o calcific tendonitis
2. arthrography/MRI to r/o tears

4

Rotator Cuff Treatment

1. Stop aggravating factors
2. NSAIDs (alleviate inflammation, pain)
3. cortisone injection
4. PT
5. arthroscopic subacromial decrompression
6. surgery

5

Shoulder Dislocation Characteristics

1. fall on outstretched hand
2. dislocation most common

6

Should Dislocation Clinical Features

1. loss of shoulder contour
2. careful neovascular assessment needed

7

Shoulder Dislocation Diagnostic Studies

1. Xray (AP and Y view)
2. Hill-Sachs lesions (humeral head deformities)
3. MRI: Bankart Lesions (tear of glenoid labrum)

8

Shoulder Dislocation Treatment

1. post-reduction films
2. immobilization with sling (velpeau sling)
3. therapy should being sooner for older patients (3 weeks for 40 and under, 1 week for over 40)

9

Adhesive Capsulitis characteristics

1. Frozen Shoulder
2. inflammatory process following injury or spontaneous (increased risk with diabetes)

10

Adhesive Capsulitis Diagnostic

Arthrography

11

Adhesive Capsulitis Treatment

1. NSAIDs
2. passive ROM
3. manipulation under anesthesia

12

Clavicle Fracture Characteristics

1. most common fracture in children and adolescents
2. fall on outstretched arm

13

Clavicle Fracture Clinical Features

1. visible deformity
2. brachial plexus injuries? (pain, weak, reflex/sensory abnormalities)

14

Clavicle Fracture Imaging

1. AP view xray

15

Clavicle Fracture Treatment

1. Children: figure-8 sling 4-6 weeks
2. Adults: sling for 6 weeks

16

AC Separation Characteristics

tearing of AC and/or coracoclavicular ligaments

17

AC Separation Imaging Studies

1. Bilateral AP xray

18

AC Separation Treatment

1. Conservative for mild-moderate (managed with sling and anesthesia)
2. Surgery for more severe

19

Carpal Tunnel Syndrome Characteristics

Compression of median nerve

20

Carpal Tunnel Syndrome Clinical Feature

1. night pain, numbness, paresthesias (sparing little finger), clumsiness, weakness
2. thenar atrophy
3. Tinel sign (tingling with percussion over volar aspect)
4. Phalen test (sxs with full flexion of test for >1 min)

21

Carpal Tunnel Syndrome Diagnostic Studies

1. EMG
2. Nerve conduction

22

Carpal Tunnel Treatment

1. activity modification
2. volar wrist splint
3. NSAIDs
4. steroid injection
5. surgery to decompress nerve

23

Lateral Epicondylitis Characteristics

1. tennis elbow
2. tendinous insertion of extensor carpi radialis brevis

24

Lateral Epicondylitis Clinical Features

pain when lifting objects (esp. in pronation)

25

Lateral Epicondylitis Treatment

1. activity modification
2. counterbalance braces
3. pick up objects in supination
4. PT
5. steroid injections
6. NSAIDs
7. surgery for patients who fail 6 months of treatment

26

Olecranon Bursitis Characteristics

1. acute injury or repetitive trauma to olecranon bursa
2. can occur from infection from S. aureus

27

Olecranon Bursitis Clinical Features

1. swelling overlying the olecranon process, usually painless
2. ROm preserved

28

Olecranon Bursitis Treatment

1. ace wrap compression
2. aspiration of bursa if infected
3. NSAIDS, warm compresses
4. surgical removal

29

Scaphoid Fracture Characteristics

most commonly fracture carpal bone

30

Scaphoid Fracture Clinical Features

pain over anatomic snuffbox

31

Scaphoid Fracture Imaging

1. long-arm thumb spica cast until bone scan/MRI

32

de Quervain disease Characteristics

thumb extensor/abductor stenosing tenosynovitis

33

de Quervain disease Clinical Features

1. pain/tenderness at wrist and base of thumb
2. swelling/thickening of tendon sheath
3. Finkelsteins test

34

de Quervain Treatment

1. thumb spica splint
2. NSAIDs
3. PT
4. steroid injection
5. surgical decompression