Wells - UE Flashcards by Alice Richards

what is the soc dx for rotator cuff tear

MRI

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what is the 1st line surgical tx for rotator cuff tear

arthroscopy

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what is the last muscle movement to return after rotator cuff repair

internal rotation → tucking in shirt

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a person is only allowed __ rotator cuff repairs in their lifetime

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what is the non operative tx for rotator cuff injuries

PT bid x 2 weeks
NSAIDs → make sure no contraindications!!

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what UE injury might a dry waller have who complains of a painful arc

impingement syndrome

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what are the tests for impingement syndrome

neers

hawkins

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steroid + lidocaine injections can be __ for impingement syndrome

diagnostic

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for impingement syndrome, should you image or treat first

treat first

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what surgery may be required or severe/acromial hook impingement syndrome

acromioplasty

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what is the tx for a grade I-III AC separation

conservative

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what is the test for biceps tendonitis

speeds

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which type of instability is way more common in a shoulder dislocation

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what is the test for shoulder dislocation

apprehension test

+/- sulcus sign

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what must you do when reducing a shoulder dislocation

pre and post reduction films

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what might you suspect if you see hill sachs lesion, bankhart lesion, and axillary nerve injury

complications of shoulder dislocation

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what is an axillary n lesion

complication of humeral neck fx

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what 2 muscles are paralyzed in an axillary n lesion

deltoid

teres minor

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what does this injury make you think

axillary n lesion → delta atrophies rapidly

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what is a hill sach’s lesion/fx

complication of shoulder dislocation → cortical depression in posterolateral head of humerus

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what is this xray showing

hill-sachs lesion

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what is a bankhart lesion

complication of shoulder dislocation → injury of anterior (inferior) labrun of shoulder

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what is this xray showing

bankhart lesion

→ can have bony (glenoid) and/or soft tissue (labrum) trauma

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what is a SLAP lesion

superior labral anterior posterior

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what might you think when a pt complains of “painful catching or clicking” in the shoulder

SLAP lesion

what is the gold standard if you suspect a labral tear (ex SLAP lesion)

MRI arthrogram

what type of imaging is this and what is it showing

MRI arthrogram → causes tear to glow SLAP lesion/torn labrum

what injury might you suspect if a pt complains of acute pain w. lifting/bench pressing and you see bruising and declivity in the muscle

pectoralis major rupture

4 key points for fractures

1. when in doubt → xray and refer! 2. peds: low threshold for referral 3. pain, pallor, pulselessness → emergent surgery required 4. delayed healing in smokers, DM, high altitude

humerus fx are usually caused by \_\_; think what pt population

fall osteoporotic women

what is this called, and what injury does it make you think of

bicep muscle/tendon rupture

what is the tx for bicep muscle/tendon rupture

surgery per ortho

which recovery takes longer, RC tear or SLAP lesion

SLAP lesion

what education would you give a pt about recovery for lateral epicondylitis (tennis elbow)

hard to treat long time to heal

for lateral epicondylitis, cortisone injxns and surgery are

a last resort

medial epicondylitis (golfers elbow) is caused by what type of injury

pronation injury

what are symptoms of ulnar n subluxation

chronic pain paresthesias electric shock weakness

what injury does tommy john surgery treat

cubital tunnel syndrome (ulnar n subluxation)

what is the mc location for olecranon bursitis

radial head

what do the fat pad and sail signs make you think of

joint effusion → olecranon bursitis

have a low threshold for xray if there is

a traumatic event

what is the tx for elbow fx

splint and sling vs ORIF

what is the mc pediatric fx

supracondylar

what is the main concern with peds supracondylar fx

growth plate/vessel/nerve damage → must ensure proper healing

what injury is characterized by entrapment of the anular ligament

nursemaid's elbow

what is the mc FOOSH injury

distal radius fx

what does “dinner fork deformity” make you think of

distal radius fracture

what xray is best to see the carpal bones

oblique

what is the tx for distal radial fx's

1. splint 2. recheck 3. cast 4. sugar tong x 6 weeks 5. short cast

what position functions should you test after casting a radial fx

hold a can of soda avoid extreme flexion/extension/radial/ulnar deviation positioning

what must you test after radius fx casting (besides position fxn)

neurovascular fxn at finger tips

what injury do you think of when a pt c.o pain over the anatomic snuff box

scaphoid fx

what xray should you order for a scaphoid fx

scaphoid view → ulnar deviation of wrist

what injury is this

scaphoid fx

what is the tx for a scaphoid fx

1. xray 2. even if negative xray → thumb spica splint 3. re-xray in 1 week

what is a major complication of a scaphoid fx

avascular necrosis dt backwards vasculature

what injury is associated w. the terry thomas sign

wrist ligamentous injury

in a wrist ligamentous injury, if the xray is negative but the pt has pain over the carpal ligaments/cartilage, what test should you order

MRI arthrogram

what imaging is good to show soft tissue injury

MRI arthrogram

what test would show nerve compression w. a ganglion cyst

allen test

which n is compressed in carpal tunnel syndrome

median n

what injury would you suspect if a pt c.o pain in the front of the wrist and numbness or tingling into the thumb, index, middle, and ½ of ring finger

carpal tunne syndrome

what imaging should you order if a pt's hx is consistent w. CTS and their symptoms are not improving w. conservative tx

EMG/NCVS

what is a major concern w. CTS

atrophy or nerve death

what injury is very common in new moms

De Quarvain's tenosynovitis

what test would you use if you suspect deQuarvain's tenosynovitis

Finkelstein

which type of tendon injury is more concerning

flexor → needed for grip

what is the tx for mallet finger

must tx w. stack spint x 6 weeks for 24 hr/day

what happens if the pt w. mallet finger removes a stack splint too early and the finger tip drops

must start all over again (6 weeks, 24 hr/day)

what is the mc location for duputreyn's contracture

4th and 5th fingers

what is the tx for trigger finger injury

hand surgeon for tendon sheath release

what is the moi of a butonniere deformity

jam injury

in a butonniere deformity, the PIP is \_\_ and the DIP is \_\_

flexed extended

what is the tx for a boutonniere deformity

figure 8 splint

in a swan injury, the PIP is \_\_ and the DIP is \_\_

hyperextended flexed

what is no man's land

the palm of the hand

what is the tx for a palm laceration

local block clean it out **refer to hand surgeon immediately!!**

Bouchard's nodes are in the

PIP

heberdons nodes are in the

DIP

what is the mc location for early OA

thumb: basilar joint/CMCJ

what is the tx for CMCJ OA

1. conservative tx 2. if conservative tx fails → **LRTI (ligament reconstruction and tendon interposition)**

what injury occurs in skiers thumb

stretch or lateral tear of the ulnar collateral ligament

what are 5 important considerations for non surgical fx recovery

1. intraarticular is always a more complicated recovery 2. early intervention w. PT/OT is vital 3. threaten pt's to stop smoking so they can heal 4. splint fx for 1st 1-3 days → THEN cast when swelling has gone down 5. RICE is your friend

proximal blocks are done by

anesthesia

we will use __ blocks regularly

digital

radiculopathy from an impinged n root can mimic

joint pain

nerve pain can cause

weakness

cervical spine pain can mimic

shoulder pain

Wells - UE Flashcards

(88 cards)