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