ENS 265 Exam 3

Function of shoulder joint

-Stabilizes the upper extremity -Acts with elbow to lift, push/pull body/objects -Bear weight on hands with push-ups, crutch/cane use

What is normal blood pressure?

120/80 mmHg

What is normal pulse rate?

60-100 bpm

What injury of the abdomen is described below? MOI: - Inflammation from obstruction or infection - Appendage at junction of terminal ileum & ascending colon S & S: - Initially Nausea/Vomiting - Peri-umbilical pain - Later RLQ pain- *McBurney's Pt.* - Fever, elevated WBC count - Concerned about rupture & Septicemia

Acute Appendicitis

What term describes the triangular depression on the thumb side of our hand and is the notable site of pain for scaphoid fractures?

Anatomical Snuff Box

sternoclavicular joint

Articulation between the clavicle and the sternum

In terms of sudden cardiac death, ____________________ leads to physiologic and anatomic changes in the heart due to repetitive and intense exercise and is reversible if de-conditioned

Athlete's Heart

In terms of sudden cardiac death, __________________________ is caused by trauma to the chest wall occurring within 10-30 milliseconds prior to T-wave peak and triggers ventricular fibrillation. Chance of survival is dependent on defibrillation within 3 minutes of trauma

Commotio cordis

In terms of sudden cardiac death, the following are red flags of __________________________: -Baseball, Softball, Hockey, Lacrosse, Soccer, Football, Karate

Commotio cordis

acromioclavicular sprain grade 3

Complete rupture of AC & CC ligaments Displacement and prominence at the lateral end of clavicle Point tenderness & Loss of motion may need surgery

what type of joint is Glenohumeral

Diarthrodial- Freely movable

sternoclavicular sprain

Direct or indirect blow less than 5% of shoulder injuries 3 Grades Immobilize 3-5 weeks

What EWH injury is described below? MOI: - FOOSH S & S: - Deformity, pain, crepitus Treatment: - Fx- splint in position you find and transport for X-ray. - Dislocation- Activate EMS & monitor vitals

Elbow Fractures/Dislocations

Anterior GH dislocation

Forced abduction and external rotation

posterior GH dislocation

Forced adduction and internal rotation

fossa of scapula

Glenoid Fossa

Where does bicep long head attach to shoulder

Glenoid labrum

In terms of sudden cardiac death, __________________________ is the leading cause of sudden death in young athletes, has a strong genetic link, and is associated with an *enlarged left ventricle* (which places increased force on unchanged blood volume)

Hypertrophic Cardiomyopathy (HCM)

In terms of sudden cardiac death, the following are red flags of __________________________: - Exertional Syncope - dizziness/fainting - Exertional Chest Pain - Difficulty breathing during exercise - Chest &/or referred pain during exercise - Palpitations

Hypertrophic Cardiomyopathy (HCM)

Clavicle Fracture

MOI: FOOSH, fall on tip of shoulder, direct impact. Treatment: Immobilize and send for x-rays the most commonly fractured bone.

What EWH injury is described below? MOI: - Ball or hit to the tip of the finger S & S: - Mallet deformity, Pain, Swelling Treatment: - Splint 3-4 weeks in DIP Hyper- extension - Stack Splint

Mallet Finger

_________________ is a disease of connective tissue and can lead to sudden death due to failures of the cardiac system (think Michael Phelps)

Marfan's Syndrome

acromioclavicular sprain grade 1

Pain & discomfort during movement

acromioclavicular sprain grade 2

Partial displacement & prominence of the lateral end of clavicle; AC & CC ligaments Point tenderness

What EWH injury is described below? MOI: - Repeated wrist flexion, overuse, or chronic valgus force on elbow S & S: - Pain over the medial epicondyle, pain with activity and movement Treatment: - RICE, massage, exercise. If involves the MCL- may need surgery

Pitcher's Elbow (Medial Epicondylitis)

Rotator cuff muscles

SITS Supraspinatus Infraspinatus Teres Minor Subscapularis

What EWH injury is described below? MOI: - FOOSH S & S: - Point tender/pain in the snuffbox, swelling Treatment: - Refer for X-ray - Cast 8-12 weeks due to poor blood supply

Scaphoid (Navicular) Fracture

What EWH injury is described below? MOI: - Hyper-extension of thumb S & S: - Pain, Instability, Unable to grasp Treatment - Splint or cast, Possibly surgery to repair depending on severity

Skier's Thumb (UCL Sprain)

What injury of the abdomen is described below? MOI: - Blunt trauma to *upper left quadrant* - Causes contusion or laceration - Predisposition if have infectious disease in which the spleen is enlarged (splenomegaly); Mononucleosis and Certain Pneumonias S & S: - *Kehr's sign*- pain in left shoulder - Nausea/Vomiting - Rigid abdomen - Vital Sign changes (Low BP, High HR, Signs of shock)

Splenic injury

4 bones of Shoulder girdle

Sternum, Clavicle, Scapula, Humerus

What EWH injury is described below? MOI: - Repeated wrist extension, overuse, fatigue S & S: - Pain over the lateral epicondyle, pain with activity and movement Treatment: - RICE, massage, exercise, brace

Tennis Elbow (Lateral Epicondylitis)

glenohumeral joint

The synovial ball-and-socket joint of the shoulder

rotator cuff tear

The tendons of these muscles also contribute to the structural strength of the shoulder joint. Hard, fast movements, such as in tennis and baseball can tear one of these tendons resulting in pain and decreased mobility of the shoulder. Surgery may be needed to repair a torn tendon.

Shoulder Impingement

When the space between the bone on top of the shoulder (acromion) and the tendons of the rotator cuff rub against each other during arm elevation. repetitive overhead activities Leads to bursitis or RC inflammation

The following are red flags of _________________ - Peritoneal signs (Muscle Guarding, Rebound tenderness, Referred pain - Ex. Kehr's sign) - Unstable Vital Signs (Hypotensive, tachycardic, weak pulse and Sweaty & pale signs of shock)

acute abdomen

Bankart tear

an injury of the anterior glenoid labrum of the shoulder due to repeated (anterior) shoulder dislocation. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it.

What ligament holds the radial head in place?

annular ligament

If a person is feeling "referred pain" in the lower right abdomen at McBurney's point and rebound tenderness, his/her _______ is most likely being affected

appendix

scapulothoracic joint

articulation between the anterior scapula and the thoracic wall

What measures arterial wall pressure?

blood pressure

Humerus

bone of the upper arm

Resting heart rate ___________ (increases or decreases) with training

decreases

In terms of blood pressure, __________ BP is the bottom number

diastolic

Humeral Fracture

direct blow, FOOSH can be emergency situation Treat for shock if needed Immobilized out 2-6 months

Movements of scapulothoracic joint

elevation/depression protraction/retraction upward/downward rotation

Movements of the acromioclavicular joint

elevation/depression; rotation; protraction/retraction

Movements of GH joint

flex/ext abb/add int/ext rotation horizontal flex/ext

What movement(s) are found at the elbow joint?

flexion/extension

What movement(s) are found at the finger joints?

flexion/extension and abduction/adduction

What movement(s) are found at the wrist joint?

flexion/extension and ulnar/radial deviation

What movement(s) are found at the thumb joint?

flexion/extension, abduction/adduction, and opposition

If a person is feeling "referred pain" in his/her neck/jaw and inner left arm, his/her _______ is most likely being affected

heart

What is the term for when blood collects in the pleural space and is usually the result of trauma and rib fractures?

hemothorax

Pulse rate ___________ (increases or decreases) with exercise

increases

Systolic BP ___________ (increases, decreases, remains unchanged) with exercise

increases

The _______ (medial or lateral) collateral ligament is on the side of the radius

lateral

The wrist extensor muscles originate on the _______ (medial or lateral) epicondyle of the humerus

lateral

The Stomach and Spleen are found in the ____________ quadrant of the abdomen.

left upper

3 parts of the sternum

manubrium, body, xiphoid process

The _______ (medial or lateral) collateral ligament is on the side of the ulna

medial

The wrist flexor muscles originate on the _______ (medial or lateral) epicondyle of the humerus

medial

impingement syndrome

occurs when inflamed and swollen tendons are caught in the narrow space between the bones within the shoulder joint

A _________________ pneumothorax is associated with an open rib fracture (i.e. being punctured by a javelin). It is important to leave the object in, splint, and transport.

open

What is the term for when gas or air is trapped in the pleural space?

pneumothorax

The following are red flags of _____________ and ____________: - Sudden onset of pleuritic chest pain - Shortness of breath (Dyspnea) - Rapid, shallow breath (Tachypneic) - Bluish skin (Cyanotic) - Increased HR (Tachycardia) - Low BP (Hypotension) - Cough - Fatigue - Tracheal shift - Decreased or absent breath sounds

pneumothorax and hemothorax

What movement(s) are found at the radio-ulnar joint?

pronation/supination

Diastolic BP ___________ (increases, decreases, remains unchanged) with exercise

remains unchanged

The Cecum and Appendix are found in the ____________ quadrant of the abdomen.

right lower

The Gallbladder and Bile Duct are found in the ____________ quadrant of the abdomen.

right upper

Bicep Tendon Rupture

rupture of long head of biceps caused by prolonged tendinitis or forced flexion, often result of degeneration of tendon, snapping sensation with large deformity ("popeye" appearance) surgery /rehab

If a person is feeling "referred pain" in the upper left shoulder, his/her ________ is most likely being affected

spleen

A _________________ pneumothorax occurs without trauma (i.e. Chronic bronchitis, Pneumonia, Asthma, Others)

spontaneous

SLAP tear

superior labral tear from anterior to posterior hyper extended/ stretched arm

In terms of blood pressure, __________ BP is the top number

systolic

A _________________ pneumothorax is associated with a collapsed lung

tension

acromioclavicular joint

the joint formed by the acromion of the scapula and the clavicle

humeral head

top of the humerus connecting it to the scapula

What is the anatomical term for the "funny bone"?

ulnar nerve