Week 119 - Shoulder trauma

Question 1

why does vit c deficiency cause scurvy?

Answer 1

cofactor for hydroxylases

Question 2

what analgesic provides retrograde amnesia?

Answer 2

midazolam

Question 3

what amino acids are primarily found in collagen?

Answer 3

lysine and proline

Question 4

why is the shoulder commonly dislocated?

Answer 4

unstable

Question 5

what is an example of a disease involving mutations in type 1 collagen

Answer 5

osteogenesis imperfecta

Question 6

a tear in what can cause pain in the shoulder?

Answer 6

glenoid labrum

Question 7

what is an example of a disease involving mutations in type 2 collagen

Answer 7

chondrodysplasia

Question 8

what type of dislocation is caused from the division of the acromioclavicular and coracoclavicular ligaments

Answer 8

acromioclavicular dislocation

Question 9

what is an example of a disease involving mutations in type 3 collagen

Answer 9

ehlers-danlos syndrome

Question 10

what is prominent from a AC dislocation?

Answer 10

distal clavicle

Question 11

what would a patient present with if they had osteogenesis imperfecta?

Answer 11

weak bones

Question 12

where do clavicle fractures usually occur?

Answer 12

lateral end

Question 13

what would a patient present with if they had chrondodysplasia?

Answer 13

abnormal cartilage, joint and bone deformities

Question 14

what type of dislocation is common from a high energy injury like a road traffic accident?

Answer 14

sternoclavicular dislocation

Question 15

what would a patient present with if they had ehlers danlos syndrome?

Answer 15

fragile skin, blood vessels, hypermobile joints

Question 16

what are the rotator cuff muscles?

Answer 16

supraspinatous infraspinatous teres minor subscapularis

Question 17

extracellular matrix is also made up of what else apart from collagen

Answer 17

proteoglycan and non-collagenous proteins

Question 18

what is the action of supraspinatous

Answer 18

abduction

Question 19

what non-collagenous protein stimulates bone/cartilage formation?

Answer 19

bone morphogenic proteins

Question 20

what is the action of infraspinatous

Answer 20

lateral rotation

Question 21

what non-collagenous protein regulates bone mineralisation?

Answer 21

osteopontin, osteonectin, osteocalcin

Question 22

what is the action of teres minor

Answer 22

lateral roation

Question 23

what type of bone is where crystals lie inside the collagen fibrils?

Answer 23

lamellar bone

Question 24

what is the action of subscapularis

Answer 24

medial roation

Question 25

what type of bone is where crystals lie outside the collagen fibrils?

Answer 25

woven bone

Question 26

what nerve innervates supraspinatous

Answer 26

suprascapular nerve

Question 27

what type of bone is unmineralised

Answer 27

osteoid bone

Question 28

what nerve innervates infraspinatous

Answer 28

suprascapular nerve

Question 29

rickett's and osteomalacia are examples of disease involving what malfunction in osteoid?

Answer 29

doesn't calcify

Question 30

what nerve innervates teres minor

Answer 30

axillary nerve

Question 31

name the cell - precursor cell which differentiates into bone forming cells

Answer 31

osteoprogenitor

Question 32

what nerve innervates subscapularis

Answer 32

subscapular nerve

Question 33

name the cell - deposits osteoid and controls mineralisation

Answer 33

osteoblast

Question 34

posterior shoulder dislocation is important because of?

Answer 34

major vessels

Question 35

name the cell - become surrounded by newly formed bone and are derived from osteoblasts

Answer 35

osteocyte

Question 36

what investigation can be performed is there is suspected damage from a dislocation?

Answer 36

CT

Question 37

name the cell - involved in bone resorption

Answer 37

osteocyte

Question 38

which rotator cuff muscle is only responsible for 15 degrees of movement in abduction?

Answer 38

supraspinatus

Question 39

what are the cavities called in which osteocytes reside in bone?

Answer 39

lacunae

Question 40

if a patient cannot externally rotate their shoulder far what condition does it indicate

Answer 40

frozen shoulder

Question 41

what structures link lacunae together

Answer 41

canaliculi

Question 42

restriction of active movements during assessment of the shoulder suggest pathology of what?

Answer 42

rotator cuff muscles

Question 43

where does bone mineralisation homeostasis take place?

Answer 43

spongey bone

Question 44

restriction of active and passive movements during assessment of the shoulder suggest pathology of what?

Answer 44

shoulder joint itself

Question 45

what is a distinctive pattern of arranged lamellae around a central canal

Answer 45

haversian system/osteon

Question 46

what test is done for impingement of the shoulder?

Answer 46

hawkins-kennedy

Question 47

what is composed of chondrocytes within ECM rich with proteoglycans?

Answer 47

cartilage

Question 48

what is shoulder impingement?

Answer 48

impingement of the tendons of the rotator cuff muscles causing inflammation

Question 49

what type of cartilage is articular cartilage made up of?

Answer 49

hyaline

Question 50

what test suggests capsulitis

Answer 50

scarf test

Question 51

what type of cartilage forms growth plates?

Answer 51

hyaline

Question 52

what test is used for shoulder instability/anterior dislocation?

Answer 52

apprehensive test

Question 53

what type of cartilage links the ends of ribs to the sternum?

Answer 53

hyaline

Question 54

a patient presents with shoulder pain and the inability to perform overhead activities, they are also finding it difficult to sleep

Answer 54

impingement

Question 55

what type of cartilage has elastic fibres scattered in the ECM?

Answer 55

elastic

Question 56

thickening of the joint capsule

Answer 56

adhesive capsulitis

Question 57

what type of cartilage forms the annulus fibrosa of the intervertebral discs?

Answer 57

fibrocartilage

Question 58

what clinical features can present with impingement?

Answer 58

bony spurs

Question 59

what are catilage cells called?

Answer 59

chrondocytes

Question 60

shoulder pain can also be the result of referred pain from which nerve root?

Answer 60

C5

Question 61

why does articular cartilage lack a perichondrium

Answer 61

compression would occlude vessels

Question 62

adhesive capsulitis is associated with what chronic condition?

Answer 62

diabtes

Question 63

which zone of cartilage is first degraded in OA?

Answer 63

superficial zone of uncalcified cartilage

Question 64

What is the large, aggregating proteoglycan that is present in cartilage and that traps water?

Answer 64

aggrecan

Question 65

Why is the trapping of water by this proteoglycan important for the mechanical properties of the tissue?

Answer 65

gives the joint ability to resist compressive loads

Question 66

What is the name of the cavity in which a chondrocyte lies (similar to an osteocyte)?

Answer 66

lacuna

Question 67

Where is elastic cartilage found?

Answer 67

epiglottis, ear

Question 68

Where else is fibrocartilage found?

Answer 68

ligament/tendon enthesis

Question 69

what causes impaired collaegn synthesis?

Answer 69

vit c deficiency

Question 70

what is the main analgesic used in a dislocated shoulder injury?

Answer 70

morphine

Question 71

what condition is caused by impaired collagen sysnthesis?

Answer 71

scurvy

Question 72

what is the condition described by when two articular surfaces are partly in contact and presents with symptoms of dislocation

Answer 72

sublaxation

Question 73

what investigation can be used to look into a joint?

Answer 73

arthroscopy

Question 74

what is bone ECM primarily made up of?

Answer 74

collagen type 1

Question 75

what is the critical component in a dislocation?

Answer 75

force

Question 76

what four factors of force are important in a dislocation?

Answer 76

magnitude, direction, speed and duration

Question 77

what secretes collagen type 1?

Answer 77

osteoblasts

Question 78

what nerve can be damaged from a dislocated shoulder?

Answer 78

axillary nerve

Question 79

What is a Hill?Sachs lesion?

Answer 79

a depression in the posterolateral head of theÿhumerus bone

Question 80

Muscles effected in Erb?s palsy?

Answer 80

Abductors and external rotators of the shoulder are affected

Question 81

Where is the weakest position for the shoulder joint?

Answer 81

abducted to 90 degrees and externally rotated

Question 82

Signs of Klumpke?s paralysis?

Answer 82

Ulnar claw hand deformity

Question 83

Signs of Erb?s palsy?

Answer 83

Waiters tip deformaty. Arm medially rotated, the forearm is extended and pronated

Question 84

What is Klumpke?s paralysis?

Answer 84

Lower Brachial Plexus: C8-T1 injury

Question 85

What is a Bankart lesion?

Answer 85

an injury of the anterior (inferior) glenoid labrum of the shoulder

Question 86

What is Erb?s palsy?

Answer 86

Upper Brachial Plexus: C5-C6 injured

Question 87

What is the most common side effect of a shoulder disslocation?

Answer 87

Trapping of the auxillary nerve

Question 88

What is a common side effect of a trapped auxillary nerve

Answer 88

Loss of sensation in the skin over a small part of the lateral upperÿarmÿ(an area known as the regimental badge/patch)