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EXSS 288 Final Exam 2025 (Questions with
Verified Answers) Graded A+
What should you always check for in dislocations? innervation & circulation What is a hill-sahs lesion? articulating surface at top of the humerus is chipped or torn during dislocation How to handle a glenohumeral dislocation? Not a medical emergency unless circulation is compromised. Use a sling & swathe, take individual to ER What joint is associated with shoulder separation? acromioclavicular joint (AC) Mechanism: FOOSH *When you push down on bone, it pops back up (dislocation) ~ Typically non-surgical *One clavicle sits higher than the other Care: Sling & Ice Why is posterior sternoclavicular dislocations worrisome? Can be life-threatening because of obstruction of airway and neurovascular structures (veins & nerves) ~ Call EMS Mechanism: FOOSH *Posterior dislocations & strains are rare Anterior dislocations: sling, swathe & take to ER
True/False: Shoulder pointer contusion has the same signs & symptoms as 1˙ AC separation? True: Happens b/c of fall on or blow to top of shoulder What are four overuse injuries?
- Rotator cuff strain
- Biceps brachii tendinitis
- Impingement syndrome
- Thoracic outlet syndrome What is biceps brachii tendonitis? occurs in Bicipital groove where the tendon is located Eccentric contractions May involve subluxation of tendon (Popping out: partial dislocation) because the ligament that is holding in the bicep tendon is torn What types of athletes face impingment syndrome? Found in overhead athletes Swimmers, throwers, volleyball, etc.
- Pathologies can vary from Subacromial bursitis to Supraspinatus tendinitis to Bicipital tendinitis (long head) to Labral tears *shape of acromion process also affects athlete
Cause of injury: Direct blow, dislocation, falling on an outstreatched arm Care for humerus fracture? Humeral fracture- put in a sling, take to UC or ER for x-ray and pain meds; ice as long as circulation & innervation
- If responding to the fracture on the field, or elsewhere, sling or strap to body, don't need ambulance, can take by car and bring pillow for them to rest their arm on, also bring ice (ice for 20 minutes every 2- 3 hours for 48-72 hours) Cause & symptoms of clavicle fracture Clavicle fractures Mechanism:Fall on outstretched hand (FOOSH) Typically fractures at junction of middle & distal 1/ Can be greenstick fracture in adolescents (bending) This fracture would most likely see a deformity because its so close to the surface Athlete usually supports the arm and tilts their head toward that side with the chin turned toward the opposite side Treatment for clavicle fracture This is not a medical emergency, but you should put the arm in a sling and take them to Urgent Care or ER for pain medications. Treatment is usually figure 8 brace & sling the arm with swathe; may need surgery, use ice as long as innervation is okay; What is the most common fracture in sports? clavicle fracture What can elbow pain result from?
From internal organ dysfunction or referred from a nerve root irritation or nerve impingement or referred from the pain of the neck or shoulder What type of joint is the radio-ulnar? pivot
- pronation/supination waht ligaments are most important for stability against a valgus/varus force in the elbow? Ulnar/medial ligament: most important for stability to a valgus force Radiall/lateral ligament: stability to a varus force What does the annular ligament help with? prevents radial head luxation; forms a sling around the radial head How do acute elbow injuries occur?
Why is the bursa in the elbow frequently injured? Prone to acute/chronic injury because of superficial location & results because of direct blow/fall Treatment of a bursa? Acute condition: ice/compression Chronic: protective therapy pad during competition What kind of fractures are possible in the elbow?
- Supracondylar fracture
- Medial epicondyle fracture
- Radial head fracture
- Olecranon process fracture What is the most common type of elbow fracture? supracondylar fracture What happens during a supracondylar fracture? Distal segment is pushed up and back & May appear as posterior dislocation (Volkmann's Ischemic Contracture) What is volkamann's contracture?
brachial artery & median nerve get pinched in the fracture of the humerus & hand hangs down because of nerve/artery damage Where is medial epicondyle fracture most commonly seen?
- elbow dislocation
- young throwing athletes what type of fracture is a medical epicondylar fracture usually?
- Avulsion Fracture (Common flexor tendon pulls it during Acceleration phase Ulnar collateral ligament pulls it Cocking & acceleration phases How does the radial head of the elbow fracture? 1Repeated compressive stress: (Capitulum & radial head or Valgus stress during throwing (jamming)
- Single bout, excessive compressive stress: (Direct blow or fall outstretched arm) What is the most common elbow dislocation? Most are posterior with olecranon process extending backward
What does the surgical procedure called the "tommy john" repair? Surgical procedure called "tommy john" is often used to repair the medial collateral ligament and joint capsule How is medial epichondylitis "little league/pitcher's/golfer's/ javelin-thrower's/ racquetball elbow" caused? repeated forceful flexion of the wrist leading to pain around medial epicondyle Treatment for medial epicondylitis? Treatment: cryotherapy or heat through the application of an ultrasound, anti-inflammatories, counterforce brace, severe cases may have splinting for 7-10 days How is lateral epicondylitis ("tennis elbow") caused? stems from a backhand strike involving repetitive overextension of the wrist; Irritation & inflammation of the insertion of the extensor muscle of lateral epicondyle Pain during activity with weakness What is the treatment for lateral epicondylitis?
Treatment: PRICE & anti-inflammatory drugs & rehabilitation with ROM exercises, stretching What is one of the most common problems of the elbow in sports? lateral epicondylitis What is the most commonly broken bone in the hand? scaphoid b/c of extension of wrist (FOOSH) How are the lunate & scaphoid fractured? FOOSH How can you tell if someone broke their scaphoid? press the anatomical snuff box and if it's fractured, they'll scream What is the most commonly dislocated bone in the hand? lunate & is caused by a fall in either direction (flexion & extension)
Where does the median nerve track? under retinaculum ~ carpal tunnel syndrome What is colles fracture? Occurs at the distal radius leading to dorsal displacement of radius because of hyperextension *Always check circulation: - radial/ulnar pulse, color, temp, capillary refill and innervation (dermatomes and wiggling fingers slightly) What is smith's fracture? Occurs at distal radius leading to palmar displacement of the radius typically because of hyperflexion **always check circulation: - radial/ulnar pulse, color, temp, capillary refill and innervation (dermatomes and wiggling fingers slightly)
What is bennett's fracture? fracture of the 1st metacarpal at Intra-articular (carpal-metacarapal joint), which typically needs fixation What type of injury usually happens to the phalanges? dislocations at PIP jiont, but sometimes fractures Cause: "jammed" or caught in jersey, net, etc. Often associated with fracture Can be open dislocation What does an avulsion fracture of the extensor digitorum produce? "mallet finger" happens when the finger is straight and there is a force on the end putting it in hyperflexion that leads to popping the extensor tendon out of place. You must splint the distal interphalangeal joint (DIP) straight immediately- put something underneath it and tape it so it stays straight. If you don't, there may not be reattachment. What does an avulsion fracture of the flexor digitorum profundus create? "jersey finger" b/c finger is usually caught it in a jersey. It will just hang there. To tell if someone has jersey finger: ask them to flex their finger and they won't be able to.
How do you treat a jammed finger? Try and see if finger goes side to side (if can't, jammed finger) First aid for jammed finger: splint finger, ice it, light compression, get it looked at What is subungual hematoma? How do you treat it? Blood pooling pushes up on the nerve under the nail The pressure causes pain You need to release the blood if they have a really bad contusion- send them to hospital to aspirate. What is carpal tunnel syndrome? Compression on the median nerve at the wrist Very common in 30-50 y.o. females Usually in dominant hand Can be caused from direct trauma (hyperextension) or overuse (laptop usage) Causes a lot of fluid in the tunnel, which causes pressure to impinge the nerve What is ulnar neuropathy or "cyclist's palsy?"
Overuse/Compression/direct trauma of the ulnar nerve in the hypothenar eminence (squishy part of hand under pinky to wrist)
- The little finger and half of ring finger will start to go tingly or numb or both! What are ganglion cysts? Ganglion cysts are benign collections of tissues (too much tissue plus fluid), not cancerous Generally caused by a herniation- weak area of a structure, something bulges out because of the weakened area (inner tube, a weak area of the tube causes the sides to bubble through) What organs are in the right upper quadrant? Right lobe of liver, gallbladder, right kidney, portions of stomach, small and large intestine What organs are in the left upper quadrant?
*They don't collapse when impacted because they are not hollow organs What are the hollow organs? Hollow organs: stomach, small and large intestines, gallbladder, fallopian tubes, ureters, and uniary bladder, Where is liver/gallbladder pain region? liver area on front and back & right shoulder/neck below right scapula Where is small intestine pain region? belly button Where is appendix pain point? appendix area
Where is ureter pain point? groin Where is lung and diaphragm pain region? left shoulder
