Upper limb pathologies 1 Flashcards Preview

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Flashcards in Upper limb pathologies 1 Deck (41)
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1
Q

Rotator cuff muscles function

A

stabilize the humeral head in the glenoid, physiological movement of shoulder

2
Q

rotator cuff muscle shoulder pain

A

subacromial pain syndrome/ impingement, rotator cuff tendinopathy, rotator cuff tears

3
Q

what causes rotator cuff tendinopathy- tendon compression

A

tendon compression- extrinsic factors- compression between greater tubercle of humerus and superior aspect glenoid, intrinsic- tendon pathology that occurs within the tendon

4
Q

what causes rotator cuff tendinopathy- other

A

tendon overuse/ underuse, genetics, nutrition

5
Q

risk factors for rotator cuff shoulder pain

A

over 50’s, people with diabetes, people who work with their shoulder above 90°- overuse

6
Q

clinical presentation- rotator cuff related shoulder pain

A

pain and impairment of shoulder movement/ function, usually during elevation and lateral rotation
numerous factors, but excessive or mal-adaptive load seem to be a major influence

7
Q

painful arc- rotator cuff related shoulder pain

A

flexion abduction- begins pain free, then 90° is pain, then as they reach full abduction there is no pain

8
Q

management- rotator cuff related shoulder pain

A

surgery of phsyio- exercises to improve scapula rhythm- increase lower trap activities, strengthening
exercise, education, load magnification

9
Q

lateral epicondylitis

A

most common overuse syndrome in the elbow. tendinopathy involving the extensor muscles of forearm
affects 1-3% of population
most common in 40/50s

10
Q

prognosis, cause and risk factors- lateral epicondylitis

A

prognosis- most cases are self limiting
cause- excessive/ repetitive use- musicians, racquet sport
smoking and obesity are risk factors

11
Q

lateral epicondylitis- clinical presentation

A

pain located around lateral epicondyle of elbow pain often radiates down in line with extensors
variable pain- intermittent/ continuous, varying in severity

12
Q

lateral epicondylitis- clinical presentation- aggravating

A

aggravated by resisted wrist/ finger extension, forearm supination, extension of middle finger- provides secondary stress to ECRB, as it acts as a fixator on 3 MC
stretching the tendon can reproduce symptoms as can gripping

13
Q

lateral epicondylitis and medial epicondylitis- physiotherapy

A

load management- stop overuse/ underuse, exercise, brace/ taping- minimise symptoms- offloading, education- explain what the problem is, what’s causing it, how to avoid it

14
Q

lateral epicondylitis and medial epicondylitis - treatment other

A

NSAID, corticosteroid injection, shockwave therapy, surgery

15
Q

medial epicondylitis

A

overuse tendinopathy, similar to tennis elbow but affecting the CF origin of the flexors and pronators, less common than LE, involves PT and FCR

16
Q

medial epicondylitis- who is affected

A

age 40-60, female>male, associated with manual work,

17
Q

medial epicondylitis- clinical presentations

A

pain on medial aspect of the elbow- tender on palpation, aggravated by resisted/ repetitive wrist flexion or pronation, valgus stress, stretching
also aggravated by throwing/ gripping

18
Q

medial epicondylitis- affect

A

reduced grip strength, can involve ulna nerve (20%)- may have P and N of 5th and half of 4th MC

19
Q

De quervains tenosynovitis

A

reactive thickening/ inflammation of the tendon sheath around EPB and APL, may occur spontaneously (idiopathic) or can be initiated by overuse of the thumb, overuse may involve eccentric lowering of the wrist into ulna deviation with load

20
Q

De quervains tenosynovitis- who is affected

A

40-50 year olds, common in men, common in new mothers

21
Q

De quervains tenosynovitis- how does it develop

A

swelling of sheath, leading to eventual thickening of sheath, adhesions may develop between the tendon and the sheath which restrict normal tendon movement, enclosed tendons can become constricted

22
Q

De quervains tenosynovitis- clinical presentation

A

pain on radial side of wrist that can be referred to the thumb, aggravated by resisted thumb extension/ abduction, or by stretching the affected tendons (finkelstein test), tender to palpate

23
Q

De quervains tenosynovitis- medical treatment

A

NSAIDs, splinting- immobilize thumb- can calm fingers down, but pain may come back after removed, corticosteroid injection, surgery

24
Q

De quervains tenosynovitis- physioterhapy

A

splinting, load management- increase ability of tendon to withstand load, education, exercises

25
Q

strains

A

muscle or tendon injury involving over contracting or lengthening of muscles that causes tearing of collagen

26
Q

where are strains common

A

in 2 joint muscles, movement at one joint increases the tension of muscles and leads to overstretching of muscle, or eccentric contraction during deceleration phase , more common in type 2 muscle fibres

27
Q

management for strains

A

depends on severity of strains, POLICE/PRICE, mobilization ASAP- encourages better healing, proprioception, endurance training, surgery

28
Q

sprains

A

stretch and/or tear of a ligament, usually caused by the joint being forced suddenly outside its usual ROM, and tearing inelastic collagen, 3 grades, common in ankle

29
Q

management of sprains

A

POLICE/ PRICE, early mobilization, early weight bearing, exercises education, return to sport, surgery

30
Q

carpal tunnel syndrome

A

most common peripheral nerve enlargement syndrome, median nerve is compressed where it passess through the carpal tunnel

31
Q

what causes carpal tunnel syndrome

A

oedema, tendon inflammation, hormonal changes, manual activities can contribute to nerve compression in this area

32
Q

carpal tunnel syndrome risk factors

A

diabetes, type 1 and 2, menopause, hypothyroidism, obesity, arthritis, pregnancy

33
Q

carpal tunnel syndrome prognosis

A

depends on severity of symptoms, mild to moderate- respond well to conservative, servere- more likely to require surgery

34
Q

carpal tunnel syndrome- clinical presentation

A

intermittent nocturnal paraesthesia that increases in frequency, then develops into waking hours, loss of sensation, pain, symptoms are likely to follow median nerve disruption, but can spread over a wider area, can progress to difficulty with fine motor tasks

35
Q

carpal tunnel syndrome- more severe cases

A

weaknesses of median nerve innervated muscles, atrophy

36
Q

carpal tunnel syndrome- how to test

A

test strength of thumb, add/ abd, flex/ ext, to be affected, test sensation of hand- light touch likely to be affected, need to differentiate with nerve compression from spine

37
Q

carpal tunnel syndrome- tenneles sign test and phalens test

A

tenneles- tap area where median nerve passess through carpa tunnel- see symptoms,
phalens test- put hand in position that causes compression and hold it there for a period of time and look for symptoms

38
Q

carpal tunnel syndrome- management

A

education- lifestyle modification, load management, splinting- night time, exercise, corticosteroid injection, surgery, mild carpal tunnel- should be recovering within 6 weeks

39
Q

repetitive strain injury

A

aches and pain in your body caused by repetitive movements or poor posture while doing certain activities, type 1 RSI= caused by health conditions (carpal tunnel or tendonitis)
Type 2- symptoms don’t fit in with any health conditions- no swelling or problems with nerves

40
Q

causes of RSI

A

doing repetitive activities, doing an activity that involves lifting or carrying heavy objects, carrying out an activity for long periods, poor posture, using vibrating condition

41
Q

symptoms RSI

A

pain and tenderness in your muscles and joints, aches, stiffness, tingling, numbness, weakness, cramp