Clinical correlations exam 2

Dislocation of AC joint

hard fall on shoulder or outstretched upper limb “shoulder sepaeration” (Both AC and coracoclavicular ligaments torn)

Dislocation of glenohumeral joint

Typically inferior dislocation, but clinically termed anterior (common) or posterior (rarer), joint capsule and labrum can be ripped, axillary nerve may be damaged

Rotator cuff injury

Typically due to repetitive use of upper limb above horizontal, supraspinatus is most commonly injured, cannot abduct arm first 15 degrees, if arm abducted passively, middle deltoid can complete action

Adhesive capsulitis of glenohumeral joint “Frozen shoulder”

Adhesive fibrosis and scarring between joint, rotator cuff, bursa and deltoid, pt has difficulty abducting arm, but can elevate and rotate scapula to compensate

Paralysis of serratus anterior (winged scapula)

If long thoracic nerve is injured, medial border of scapula moves laterally and posteriorly away from the thoracic wall, arm cannot be abducted above horizontal position

Where is carcinoma most common

superolateral quandrant

when do breasts change

age, hormones, pregnancy/nursing

what is the breast cancer usually

adencarcinoma

what causes dimpling in the breasts

tumor pressing on suspensory ligaments

what causes abnormal contours or an orange peel appreance in the breast

edema

What injury occurs when the angle between the neck and shoulder is greatly increased

Erb-Duchenne palsy

What spinal levels are injured in Erb-Duchnene palsy

C5/C6- paralysis of shoulder and arm muscles, loss of lateral arm sensation

What is an inferior brachial plexus injury called

Klumpke paralysis, if upper limb is suddenly pulled superiorly

what spinal levels are injured in inferior brachial plexus injuries

C8-T1, may avulse roots of spinal nerves from spinal cord, short muscles of hand can’t contract causing claw hand position

What happens in a colles fracture

complete transverse fracture to distal end of the radius, broken fragment often comminuted, dinner fork deformity

what causes a colles fracture

forced dorsiflexion of hand, usually from a fall

What causes damage to the ulnar collateral ligament

overhead throwing sports at high velocity (baseball pitching)

what is the treatment for damage to the ulnar collateral ligament

surgical reconstruction (tommy john) uses a long tendon from the contralateral forearm or leg

What happens in radial head dislocation

transient subluxation of radial head caused by sudden lifting of a child by their upper limb, tears distal attachment may become trapped between capitulum and radial head

who is most likely to have a radial head dislocatio

preschool children, especially girls

what is the treatment for radial head dislocation

placing in a sling for 2 weeks

what causes elbow tendinitis

inflammation from repetitive use of superficial extensors in forearm that strains the common extensor tendon

what happens in elbow tendinitis

pain concentrated around lateral epicondyle and radiates along posterior forearm, tears of the common extensor tendon may need surgical intervention