Orthopedic Management and Injuries Quiz
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Questions and Answers

What is the primary management for atraumatic or chronic anterior dislocations?

  • Observation and sling (correct)
  • Steroid injections
  • Immediate surgical intervention
  • Physical therapy and rehabilitation

Which imaging technique is most commonly used to diagnose clavicular fractures?

  • Ultrasound
  • MRI
  • X-ray (correct)
  • CT scan

What is the most common mechanism of injury for clavicular fractures?

  • Twisting the arm during a fall
  • Falling on an outstretched hand (correct)
  • Direct blow to the shoulder
  • Contact during sports activity

Which type of joint sprain involves elevation of the AC joint?

<p>Type 3 (A)</p> Signup and view all the answers

What describes a Bankart lesion?

<p>Labral tear in the anteroinferior direction (D)</p> Signup and view all the answers

What is the most common type of sternoclavicular dislocation?

<p>Anterior dislocation (B)</p> Signup and view all the answers

What is the typical treatment for a non-displaced sternoclavicular dislocation?

<p>Splint or Figure of 8 Bandage (D)</p> Signup and view all the answers

In the case of anterior sternoclavicular dislocation, what is a possible complication if left untreated?

<p>Vascular problems (B)</p> Signup and view all the answers

Which structure is at risk in posterior sternoclavicular dislocations?

<p>Mediastinal structures (A)</p> Signup and view all the answers

What is the commonly used imaging technique to assess sternoclavicular dislocation?

<p>Plain serendipity radiographic views and AP views (C)</p> Signup and view all the answers

What type of fracture is associated with a Reverse Hill-Sachs Lesion?

<p>Compression fracture of the anteromedial aspect (A)</p> Signup and view all the answers

Which of the following ligaments is NOT associated with the acromioclavicular joint?

<p>Clavicular ligament (A)</p> Signup and view all the answers

Which provocative test is NOT used to assess anterior instability?

<p>Posterior Drawer Test (A)</p> Signup and view all the answers

How long is the typical healing period for a sternoclavicular dislocation treated conservatively?

<p>6 weeks (A)</p> Signup and view all the answers

What is the mechanism of injury (MOI) commonly associated with anterior dislocations?

<p>Abduction and external rotation (D)</p> Signup and view all the answers

What is the percentage of sternoclavicular joint dislocations compared to all joint dislocations in the body?

<p>Less than 1% (D)</p> Signup and view all the answers

Which imaging view is specifically indicated for assessing Hill-Sachs lesions?

<p>Stryker Notch View (B)</p> Signup and view all the answers

What does the Jerk Test assess?

<p>Posterior instability (A)</p> Signup and view all the answers

Which statement about dislocation is correct?

<p>It involves complete separation of the humeral head from the glenoid (B)</p> Signup and view all the answers

What should be avoided in rehabilitation concerning shoulder injuries?

<p>D2 Flexion PNF Pattern (A)</p> Signup and view all the answers

In which position does anterior subluxation most likely occur?

<p>Abduction and external rotation (B)</p> Signup and view all the answers

What is the primary cause of medial scapular winging?

<p>Problems with the long thoracic nerve (A)</p> Signup and view all the answers

Which treatment is primarily recommended for children aged 3-8 years with nerve impairment due to scapular winging?

<p>Surgical correction (A)</p> Signup and view all the answers

What is a common symptom observed in lateral scapular winging?

<p>Scapula internal rotation (D)</p> Signup and view all the answers

Which of the following is a typical clinical feature of snapping scapula syndrome?

<p>Sensation of shoulder popping or grinding (A)</p> Signup and view all the answers

What kind of sound is associated with more severe conditions in snapping scapula syndrome?

<p>Louder grating sound (C)</p> Signup and view all the answers

Which of the following treatments is often included in nonsurgical management of shoulder conditions?

<p>Strengthening of neck and periscapular muscles (C)</p> Signup and view all the answers

What demographic is primarily affected by proximal humeral head fractures?

<p>Elderly women with osteoporosis (A)</p> Signup and view all the answers

What might be a complication following surgery for shoulder injuries?

<p>Brachial plexus injuries (D)</p> Signup and view all the answers

Which condition is characterized by pain, swelling, and ecchymosis in the upper arm after a fall?

<p>Proximal humeral head fracture (C)</p> Signup and view all the answers

How is the sensation experienced if there is neurologic involvement in shoulder injuries?

<p>Complete loss of sensation (A)</p> Signup and view all the answers

What is a common characteristic of Complex Regional Pain Syndrome?

<p>It often leads to crippling contractures of the limb. (B)</p> Signup and view all the answers

Which test is used to evaluate thoracic outlet syndrome?

<p>Wright Test (B)</p> Signup and view all the answers

Which type of proximal humerus injury is characterized by C nerve involvement?

<p>Type II (Causalgia) (C)</p> Signup and view all the answers

What percentage of all fractures are accounted for by proximal humerus injuries?

<p>4-6% (B)</p> Signup and view all the answers

What is NOT a common treatment for thoracic outlet syndrome?

<p>Antibiotics (A)</p> Signup and view all the answers

What is a primary symptom to assess in patients with thoracic outlet syndrome?

<p>Paresthesia (D)</p> Signup and view all the answers

In which condition do sensory changes, trophic skin changes, and autonomic dysfunction appear?

<p>Complex Regional Pain Syndrome (C)</p> Signup and view all the answers

Which of the following symptoms is NOT related to thoracic outlet syndrome?

<p>Joint swelling (B)</p> Signup and view all the answers

What is a common side effect of proximal humerus injuries in elderly patients?

<p>Peripheral nerve damage (A)</p> Signup and view all the answers

Which test would be inappropriate for diagnosing proximal humeral fractures?

<p>Electromyography (D)</p> Signup and view all the answers

What is the main contributing factor to primary impingement of the shoulder?

<p>Anatomical changes like a hooked acromion (B)</p> Signup and view all the answers

Which of the following exercises is NOT typically included in conservative treatment for shoulder conditions?

<p>Surgical reattachment (D)</p> Signup and view all the answers

What imaging technique is considered the gold standard for diagnosing shoulder conditions?

<p>MRI (C)</p> Signup and view all the answers

Which test is used to identify biceps tendon rupture?

<p>Popeye's sign (C)</p> Signup and view all the answers

What is the most common cause of anterior shoulder pain related to primary impingement?

<p>Hooked acromion (C)</p> Signup and view all the answers

What is the clinical presentation of adhesive capsulitis?

<p>Restricted glenohumeral joint flexion and abduction (D)</p> Signup and view all the answers

Which SLAP lesion type is characterized by a curved labrum?

<p>Type 2 (A)</p> Signup and view all the answers

What is the primary goal of physical therapy in managing biceps tendonitis?

<p>Pain relief and maintaining ROM (C)</p> Signup and view all the answers

Which condition is most likely associated with scapular winging?

<p>Long thoracic nerve dysfunction (C)</p> Signup and view all the answers

What is the typical age demographic for individuals most affected by adhesive capsulitis?

<p>40-60 (A)</p> Signup and view all the answers

In the context of shoulder injuries, what does the term 'FOOSH' stand for?

<p>Fall onto outstretched hand (A)</p> Signup and view all the answers

Which characteristic is NOT associated with calcific tendonitis of the supraspinatus tendon?

<p>Overactive muscles (A)</p> Signup and view all the answers

What is a common treatment modality for pain management in shoulder conditions?

<p>Anti-inflammatory medications (C)</p> Signup and view all the answers

Which provocative test is specifically utilized to evaluate biceps tendon involvement?

<p>Ludington’s Test (A)</p> Signup and view all the answers

Flashcards

Anterior Sternoclavicular Dislocation

A type of shoulder joint dislocation where the medial end of the clavicle moves forward, commonly caused by direct trauma to the joint.

Posterior Sternoclavicular Dislocation

This is a type of shoulder joint dislocation where the medial end of the clavicle moves backward, often resulting in more severe pain and potential vascular problems.

Sternoclavicular Joint

This term refers to the joint formed between the clavicle and the sternum (breastbone).

Splint or Figure-of-Eight Bandage

A type of treatment used for sternoclavicular dislocations, where the shoulder is kept immobile for a period of time.

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Sternoclavicular Dislocation Surgery

A surgical procedure that may be necessary for sternoclavicular dislocations, especially when there is a large displacement or the clavicle sticks out prominently.

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Acromioclavicular Joint

This refers to the joint between the acromion (part of the shoulder blade) and the clavicle.

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Ligaments Supporting the Acromioclavicular Joint (3)

These are the ligaments that support the acromioclavicular joint.

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Plain Radiographic Views of the Sternoclavicular Joint

X-rays taken from different angles to visualize the shoulder joint and assess the severity of the dislocation.

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AC Joint Sprain

A condition where the acromioclavicular joint is injured, causing pain and instability in the shoulder.

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Type 3-6 AC Joint Sprain

A type of AC joint sprain where the acromioclavicular ligament is completely torn.

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Clavicular Fracture

A fracture that occurs in the collarbone, usually due to a fall directly onto the shoulder.

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Bankart Lesion

A type of shoulder injury where the labrum, a ring of cartilage around the shoulder socket, is torn.

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AC Joint Impingement

A type of shoulder injury where the space between the shoulder blade and the collarbone is compressed, causing pain and limited movement.

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Reverse Hill-Sachs Lesion

A compression fracture of the anteromedial aspect of the humeral head, often occurring with anterior shoulder dislocations.

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Apprehension Test

A test that provokes pain or instability in the shoulder by moving the arm into a position that stretches the anterior structures of the joint.

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Anterior Drawer Test

A test to assess shoulder instability, where the humeral head is pulled forward to check for excessive movement.

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Jerk Test

A test that assesses the integrity of the posterior structures of the shoulder joint by applying a posterior force to the humerus.

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Posterior Load and Shift Test

A test used to assess potential shoulder instability by applying a posterior force to the humerus while the arm is abducted and externally rotated.

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Shoulder Subluxation

Occurs when the humeral head partially slips out of the glenoid fossa, often causing a feeling of catching or instability.

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Shoulder Dislocation

Complete separation of the humeral head from the glenoid fossa, causing significant pain and loss of function.

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D2 Flexion PNF Pattern

This pattern of movement should generally be avoided after an anterior shoulder dislocation, as it can increase the risk of recurrence.

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Medial Scapular Winging

A condition where the scapula (shoulder blade) fails to descend and develop normally, often due to weakness in the serratus anterior muscle caused by a long thoracic nerve injury.

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Lateral Scapular Winging

A condition where the scapula (shoulder blade) protrudes outward, usually because of weakness in the trapezius muscle due to an accessory nerve injury.

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Snapping Scapula Syndrome

A condition where the scapula rubs against the ribs, causing a 'popping' or 'grinding' sound, often associated with pain, weakness, and abnormal scapular movement.

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Proximal Humeral Head Fracture

A break in the upper part of the humerus bone (the upper arm bone), typically occurring near the shoulder joint. Most common in elderly individuals due to falls or younger individuals due to high-energy trauma.

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Two-Part Surgical Neck Fracture

A common type of proximal humeral head fracture that occurs in elderly individuals with osteoporosis, typically after a fall.

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Supraspinatus Inactivity

A condition where the supraspinatus muscle, the primary abductor of the shoulder, becomes inactive, resulting in difficulty raising the arm. This can happen due to a fracture in the surgical neck of the humerus.

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Axillary Artery Injury

A complication of proximal humeral head fractures that can occur due to injury to the axillary artery, which supplies blood to the shoulder and upper arm.

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Complex Regional Pain Syndrome (CRPS)

A complex neuropathic pain syndrome characterized by intense pain, autonomic dysfunction, and potential contractures in the affected limb. Often caused by a nerve injury.

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Thoracic Outlet Syndrome

A condition that affects the space between the clavicle and the first rib, causing pain, numbness, and weakness in the arm and hand.

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Scalenus Anticus Syndrome

A type of Thoracic Outlet Syndrome that affects the space between the scalene muscles in the neck.

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Hyperabduction Syndrome

A type of Thoracic Outlet Syndrome that happens in the space between the coracoid process and the pectoralis minor muscle.

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Costoclavicular Syndrome

A type of Thoracic Outlet Syndrome affecting the space between the clavicle and the first rib.

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Halstead Test

A test used to assess Thoracic Outlet Syndrome by checking for changes in blood flow and nerve function during arm positioning.

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Adson Test

This test assesses blood flow to the hand by compressing the subclavian artery at the clavicle.

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Wright Test

A test for Thoracic Outlet Syndrome that involves checking for changes in blood flow to the hand during arm positioning.

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Allen's Test

A test for Thoracic Outlet Syndrome that involves raising the arm to a 90-degree angle and then checking for changes in blood flow and nerve function.

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Roos Test

A specific test for Thoracic Outlet Syndrome that involves performing various arm positions to assess for changes in blood flow and nerve function.

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Adhesive Capsulitis

A condition involving pain and restriction in shoulder movement, particularly flexion and abduction, caused by thickening and tightening of the shoulder joint capsule.

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SLAP Lesion

A type of shoulder injury involving a tear of the superior labrum, the rim of cartilage around the shoulder socket, often at the site where the biceps tendon attaches.

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Scapular Winging

A condition where the shoulder blade (scapula) moves away from the rib cage, causing a wing-like appearance, usually due to weakness in the serratus anterior or trapezius muscles.

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Biceps Tendonitis

The condition where the biceps tendon, particularly its long head, becomes inflamed, often seen in individuals over 40 with a history of impingement or rotator cuff tears.

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Biceps Tendon Rupture

An injury where the biceps tendon tears, usually at the proximal end of the long head, causing possible sharp pain, snapping sensations, and a bulge in the lower arm.

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Calcific Tendonitis

A condition where calcium deposits form in the shoulder tendons, most commonly in the supraspinatus tendon, causing sharp pain and difficulty with shoulder movement.

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Impingement Syndrome

A group of conditions involving compression of the tendons and bursa in the shoulder, often beneath the acromion bone, leading to pain and restricted movement.

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Hawkins-Kennedy Test

The test where the examiner internally rotates the shoulder and then brings the arm forward to assess for pain, potentially indicating impingement.

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Neer's Test

The test where the examiner passively flexes the arm overhead, aiming to recreate pain, indicating possible impingement.

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Load and Shift Test

A group of tests used to assess the stability of the shoulder joint by applying pressure and shifting the humeral head, detecting possible instability or laxity.

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O'Brien's Test

A test used to assess shoulder instability by applying pressure to the arm in a specific position to see if the arm moves, typically indicating labral tears or instability.

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Anterior Glenohumeral Dislocation

The most common type of shoulder dislocation, involving the displacement of the humerus (upper arm bone) out of the glenoid socket.

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Scapular Fracture

A rare type of scapular fracture, often occurring alongside serious injuries, characterized by tenderness over the scapula and shoulder region.

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Sprengel Deformity

A congenital condition where the shoulder blade is abnormally high and positioned, resulting in a winged appearance and possible shoulder limitation.

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Rotator Cuff Tear

An injury causing a tear or rupture of the rotator cuff tendons, the group of muscles that stabilize the shoulder, potentially leading to significant pain and weakness.

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Study Notes

Sternoclavicular Dislocations

  • More common (3 of all cases)
  • Direct trauma to the SC joint
  • Medial end of the clavicle becomes more prominent
  • Mechanism of injury (MOI): High energy (MVA, contact sports)
  • Posterior dislocations are less common, more painful, and more severe
  • Vascular problems and risk to mediastinal structures are possible
  • Breathing and swallowing difficulties are potential complications
  • Note: Sternoclavicular (SC) joint dislocations account for less than 1% of joint dislocations overall

Acromioclavicular Joint Sprains

  • Ligaments: Acromioclavicular, Coracoclavicular, and Coracoacromial ligaments
  • Types of Sprains: Vary in severity from a stretched ligament (Grade 1) to a complete ligament rupture (Grade 6)
  • Complete disruption of ligaments can result in posterior displacement of the distal clavicle
  • Treatment varies from observation/sling to surgical intervention depending on the severity

Clavicular Fractures

  • Fractures based on location (medial, distal third)
  • MOI (Mechanism of Injury): Fall on outstretched hand (FOOSH) or Fall on Shoulder (FOS)
  • Diagnosis via X-Ray
  • Age: Predominantly under 25 years old

Glenohumeral Joint (GHJ) Injuries

  • Subluxation: Humeral head displacement on the glenoid fossa
  • Dislocation: Complete separation of the humeral head from the glenoid fossa.
  • Anterior dislocations are more common than posterior dislocations
  • Common MOI: Abduction and external rotation
  • Possible associated injuries: Axillary nerve traction, Bankart lesion, Hill-Sachs lesion, and Reverse Bankart and Hill-Sachs lesion

Impingement Syndrome and Rotator Cuff Tears

  • Common cause of shoulder pain
  • Impingement involves compression of the rotator cuff tendons and bursa between the humeral head and acromion.
  • Supraspinatus tendon is the most commonly implicated tendon -Elderly often experience rotator cuff tears—either partial or full-thickness

Glenoid Labrum Tears

  • Cartilage (labrum) that deepens the glenoid fossa
  • Injuries: Can involve rotator cuff and biceps tendons
  • Common tear location: Superior Labrum Anterior-Posterior (SLAP) lesion, at the bicep tendon attachment point

Degenerative Joint Disease of the Shoulder (Osteoarthritis)

  • Narrowing of the glenohumeral joint space
  • Cartilage destruction
  • May involve the glenohumeral or acromioclavicular (AC) joints

Biceps Tendon Ruptures

  • Injury to the long head of biceps brachii tendon
  • Seen in individuals over 40 years old, often with a history of shoulder impingement

Calcific Tendonitis of the Supraspinatus Tendon

  • Calcium deposits (Hydroxyapatite) in the supraspinatus tendon
  • Idiopathic, more common in supraspinatus
  • Most often accompanied by pain and restricted shoulder range of motion

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Description

Test your knowledge on the management of shoulder dislocations, imaging techniques for clavicular fractures, and related injuries. This quiz covers topics including Bankart lesions, sternoclavicular dislocations, and the assessment of joint sprains. Perfect for students and professionals in orthopedic medicine.

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