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Eval-Shoulder/Elbow
Shoulder and Elbow Injuries
38
Other
Undergraduate 2
12/07/2010

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Cards

Term
Coracobrachialis
Definition
flexion/ abduction of arm

ORIGIN: coracoid process
INSERT: medial humerus
Term
Pects
Definition
adduction/ internal rotation of arm

ORIGIN: lateral humerus
INSERT: clavicle and sternum
Term
Serratus Anterior
Definition
depress, protract, and upward rotate scap

ORIGIN: upper 8th ribs
INSERT: medial border of scap
Term
Lats
Definition
adduction
external/ internal rotation

ORIGIN:inferior lateral border of scap, lower thoracic and lateral border of spinous process
INSERT: medial intertubular groove of humerus
Term
Supraspinatus
Definition
abduction

ORIGIN: supraspinous fossa of scap
INSERT: greater tuberosity of humerus
Term
Infraspinatus
Definition
external rotation

ORIGIN: infraspinous fossa of scap
INSERT: greater tuberosity of humerus
Term
Teres Minor
Definition
external rotation

ORIGIN: lateral upper 2/3 of axillary border of scap
INSERT: greater tuberosity of humerus
Term
Subscapularis
Definition
internal rotation

ORIGIN: anterior surface of scap
INSERT: lesser tuberosity of humerus
Term
Biceps
Definition
flexion on GH joint and when humerus is externally rotated, long head assists with GH

ORIGIN: long head: supraglenoid tuberosity of scap
short head: coracoid process of scap
INSERT: radial tuberosity
Term
Bicipital Groove
Definition
long head of biceps pass through

stability in groove maintained by transverse humeral ligament
Term
Triceps
Definition
extension and adduction of humerus w/ flexed elbow

ORIGIN: long head: infraglenoid tuberosity of scap
INSERT: olecrenon process of ulna
Term
Biceps Rupture
Definition
Signs and symptoms: sudden sharp pain, audible pop/snap, pain, tenderness at shoulder and elbow, difficulty w supination and pronation, bulging in arm above elbow

management: PRICEM, possible surgery
Term
Biceps Luxation
Definition
Signs and symptoms: popping, clicking, catching, limited motion

management: possible surgery, PRICEM, sling, leave arm in internal rotation
Term
Bicipital Tendonitis
Definition
inflammation of the upper biceps tendon due to overuse and overhead activities

Signs and symptoms: can be assessed at bicipital groove, red and swollen tendon, thickened covering, pain and tenderness, possible snapping feeling

management: NSAIDS, rest, possible surgery
Term
Subacromial Bursitis
Definition
pain in shoulder joint due to bursa or tendon inflammation caused by overuse

Signs and symptoms: pain outside of shoulder, worse when overuse activity is being done, or laying on it, pain with 60-90 degrees flexion

management: rest, NSAIDS, ice, PT, massage
Term
Subdeltoid Bursitis
Definition
inflammation of upper biceps tendon, associated with impingment

Signs and symptoms: pain, especially with 60-90 degrees of flexion
Term
Rotator Cuff Impingment
Definition
structures and tendons pinched in subacromial space under coacoacromial arch due to repetitive use or postural malalignments

Signs and symptoms: pain/stiff around acromion, increased pain with activities, ERG, GIRD

Stage 1- ache AFTER activity, POT, pain during straight arm full extension

Stage 2- aching DURING activity and worse at pm with some restriction
Term
Rotator Cuff Tendinopathy
Definition
caused by muscle imbalance between internal and external rotators, capsular laxity, poor scap control, and impingment

predisposed because: poor vascularity, shape/placement

Signs and symptoms: deep pain during and after activity, issues with ADL

TYPES OF TEARS: partial thickness: short longitudinal legions, common in supraspinatus, associated with impingment--> untreated becomes full thickness tears, unable to control arm, fall at 90 degrees
Term
Clavical Fracture
Definition
break of clavicle usually in change of shape due to fall, FOOSH, or direct blow

Signs and symptoms: localized pain, swelling, crepitus, loss of some shoulder motion, arm may be held pinned against side

management: figure 8 brace (holds shoulders in retracted position), sling, or brace
Term
Cervical Radiculopathy
Definition
compression of nerve roots caused by herniated disks and inflammation

Signs and symptoms: paresthesia, weakened muscles, pressure and spasm in cervical region

management: cervical distraction, MRI, rest, traction, surgery
Term
Brachial Plexus "Burner"
Definition
acute trauma to brachial plexus

caused by: traction force to brachial plexus or impingement (external rotation and lateral flexion to same side)

Signs and symptoms: radiating pain down upper extremity, possible dangling arm, tenderness in Erbs point

management: cervical ROM, and functional exercises, re education of muscles
Term
Herniated Disks
Definition
extrusion of nucleus pulpus through a weakened region in annulus fibrosus with impingement on nerve roots

Signs and symptoms: neck pain, restricted motion, radicular pain

management: rest, immobilization, cervical traction, estim, surgery
Term
Scapular Fracture
Definition
high energy/blunt trauma to scapula (i.e. motorcycle accident or falling from high distance)

TYPES: scapular body, scapular neck, glenoid (require surgery)

Signs and symptoms: extreme pain with arm movement and swelling around back of shoulder

management: sling or surgery
Term
Humeral Fracture
Definition
caused by direct blow or FOOSH

Signs and symptoms: pain, swelling, tenderness, bruising, limited motion, arm might appear shorter than other

TYPES: proximal, midshaft, distal

management: immobilization, NSAIDS, surgery for compound or severe fracture
Term
Glenoid Labrum Tear
Definition
caused by repetitive overhead motions, lifting heavy objects, FOOSH, causes in-fluid movements

Signs and symptoms: catching, locking, popping, instability, pain, tenderness to anterior shoulder

TYPES: bankart, SLAP, hill-sach

management: PRICEM, rehab, surgery
Term
Sternoclavicular Sprains
Definition
caused by longitudinal force acting on clavicle usually FOOSH, compression forces

Signs and symptoms:pain at SC joint, localized swelling, possible bruising

management: ice, sling, strengthening of surrounding muscles, decrease inflammation
Term
Acromioclavicular Sprains
Definition
Common in Hockey

MOI: landing on forward flexed outstretched arm or elbow (drives scapula to clavicle, blow to superior acromion process

Signs and symptoms: localized pain at AC joint, displacement of clavicle may be obvious, step deformities and piano keys

GRADE: I- no surgery, modalities, cortisone
II or higher- surgical means
Term
Subluxation
Definition
incomplete separation from joint surfaces
Term
Anterior Glenohumeral Dislocation
Definition
MOI: forced abduction, external rotation, and extension forcing humeral head out of glenoid cavity, forced under the coracoid process anteriorly

Signs and symptoms: flattened deltoid contour, unable to touch opposite arm, slight abduction and external rotation

management: immobilization, PRICEM, reduction, cold packs reducing hemmorage
Term
Posterior Glenohumeral Dislocation
Definition
MOI: forced adduction and internal rotation of shoulder or internally rotated FOOSH

Signs and symptoms: severe pain/disability, anterior deltoid muscle flattened , acromion/ coracoid process are prominent, limited external rotation and elevation

management: reduction, protective bracing

can return to play when they can internally rotate strength equal to 20% of patients body weight
Term
Glenohumeral Instabilities
Definition
can be anterior, posterior, or multi direction

Signs and symptoms: pain, possible torn labrum, positive for shoulder apprehension test, may have lateral deltoid numbness

managment: redcution, PRICEM, Xrays, shoulder strength exercises
Term
Epiphyseal Fractures
Definition
fracture to growth plate of long bone, prevalent in 10-16 year olds

TYPES: 1-5

Signs and symptoms: gross deformity, tenderness over ends of bones, pain, swelling, crepitus

management: ice, stabilization, splint/cast, possible surgery
Term
Avulsion Fractures
Definition
separation of bone fragment from its cortex at attatchment of ligament or tendon--> sudden twist of stretch of tendon

Signs and symptoms: deformity, point tenderness, swelling, pain, crepitus

management: ice, stabilization, refer to ER, splint/cast, requires surgery
Term
Long Thoracic Nerve Contusion
Definition
Caused by blunt trauma

Signs and symptoms: muscle weakness to serratus anterior, scapula will be winged, protraction limited

management: PRICEM, if muscle atrophies refer to physician
Term
Thoracic Outlet Syndrome
Definition
compression of brachial plexus, subclavian artery/vein (neurovascular bundle) due to compression in space between rib and clavicle, anterior and middle scalenes, and pects

Signs and symptoms: paresthesia, pain, cold sensation, impaired circulation, muscle weakness

management: conservative approach, corrects anatomical position, stretching, exercise
Term
What are the four joints/articulations of the shoulder?
Definition
AC joint
SC joint
GH
Scauplothoracic
Term
What four muscles make up the rotator cuff?
Definition
supraspinatus
infraspinatus
teres minor
subscapularis
Term
What motions occur at the subscapular thoracic joint?
Definition
elevation
depression
retraction
protraction
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