Shoulder-Clavicle-Brachial Disorders Flashcards Preview

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Flashcards in Shoulder-Clavicle-Brachial Disorders Deck (66)
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1

Bones & Joints of the Shoulder

Clavicle
Sternum
Scapula
Humerus
Ribs
SC joint
AC joint
Glenohumeral joint
Scapular thoracic joint

2

Muscles of the Shoulder

Supraspinatus
Infraspinatus
Subscapularis
Teres minor
Pectorals major
Biceps
Deltoid
Trapezius
Serratus anterior
Rhomboid

3

Types of Conditions of the Shoulder

Traumatic
Overuse
Instability
Fractures
Age related processes
Nerve injuries

4

What is AC separation typically a result of?

Falling directly on the tip of the shoulder
Hockey player getting checked into the boards

5

Describe Grade 1 AC Separation

Strain of the acromioclavicular ligament

6

Describe Grade 2 AC Separation

Tear of acromioclavicular ligament

7

Describe Grade 3 AC Separation

Tear of acromioclavicular & coracoclavicular ligaments

8

Clinical Findings with AC Separation

Tenderness at AC joint
Possible deformity at AC joint
Pain with adduction
+ cross arm test
+ Paxinos test
Pain with doing a dip

9

Treatment of AC Separation

Rest
Ice
NSAIDs
Sling for comfort
Weaver-Dunn procedure- reconstruction of CC ligament
Return to activity: when patient is comfortable

10

MOI of a Clavicle Fracture

Falling directly on the tip of the shoulder
Hockey player getting checked into the boards

11

Clinical Findings with Clavicle Fracture

Tenderness to palpation
Pain with adduction
Patient sitting with shoulders rolled forward
Deformity at fracture site

12

Treatment of Clavicle Fractures

Rest
Ice
NSAIDs
Sling for comfort
Surgery: significant displacement
Return to activity: 8 weeks

13

Rotator Cuff Tendonitis

Overuse injury
Result of inability to train appropriately
Result of a "weekend warrior"

14

What is happening internally with rotator cuff tendonitis?

Inflammation of cuff tendon
Degenerative fraying
Bursitis

15

Clinical Presentation of a Rotator Cuff Tendonitis

Pain after an aggravating activity
Pain can be insidious without specific injury
Localized to anterior/lateral shoulder
Pain worse with reaching overhead/behind the body
Pain at night/difficulty sleeping

16

Clinical Exam Findings for a Rotator Cuff Tendonitis

Tender to palpation
Painful arc of motion/elevation
Full ROM
Pain with resisted supraspinatus testing
No weakness
+ Hawkins
+ Neers

17

Treatment of Rotator Cuff Tendonitis

6 weeks of rest
Graduated throwing program
PT for strengthening
Subacromial steroid injection

18

Risk Factors for a Rotator Cuff Tear

Smoking
Age
Fall

19

Which rotator cuff muscles are most commonly torn?

Infraspinatus
Supraspinatus

20

How is the subscapularis generally torn?

Trauma

21

Clinical Presentation of a Rotator Cuff Tear

Pain with reaching overhead
Nocturnal pain
Can't get comfortable lying on shoulder
Weakness
Pain over anterior/lateral shoulder
Pain radiates to deltoid tuberosity
Pain insidious or sudden
May have felt pop at time of injury

22

Clinica Exam Findings of a Rotator Cuff Tear

Tender to palpation
Painful arc of motion/elevation
Full passive ROM
Pain with resisted supraspinatus testing
Weakness
+ Hawkins
+ Neers
Belly compression test
Lift off test
Bear hugger test

23

If there is weakness with external rotation, what is the probable muscle that is torn?

Infraspinatus

24

If there is weakness with empty can test, what is the probable muscle that is torn?

Supraspinatus

25

If there is weakness with internal rotation, what is the probable muscle that is torn?

Subscapularis

26

Treatment of a Rotator Cuff Tear

Rest
Ice
NSAIDs
PT for strengthening
Subacromial steroid injection
MRI to determine size of cuff tear
Surgical repair

27

Define Calcific Tendonitis

Deposition of calcium "hydroxyapatite" in the rotator cuff tendon

28

Which phase is calcific tendonitis more painful & inflammatory?

Liquid or tooth paste phase

29

Clinical Presentation of Calcific Tendonitis

Insidious or sudden
"White knuckle pain"
Pain with any movement of shoulder
Unable to sleep

30

Clinical Exam Findings of Calcific Tendonitis

Tenderness over greater tuberosity
Limited AROM due to pain
Pain with firing of the rotator cuff
Full PROM
Weakness of cuff due to pain