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Musculoskeletal and Soft-Tissue Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Sudden traction on the arm may tear the muscles that make up the rotator cuff. The onset may be insidious, but a traumatic incident may complete a tear causing sudden severe pain and reduced shoulder function.
Musculoskeletal Ultrasound
Published in John McCafferty, James M Forsyth, Point of Care Ultrasound Made Easy, 2020
The shoulder is a ball-and-socket joint, with a supportive girdle of tendons and muscles allowing multi-directional movement (see Figure 7.10). Arguably the most important group of muscles at the shoulder are those of the rotator cuff. These muscles and tendons cross from the scapula to the bones of the forearm to support and facilitate movement at the shoulder. The supra- and infraspinatus muscles arise from the posterior surface of the scapula, extending across the glenohumeral joint to the humeral head. Teres minor is a smaller muscle, which passes inferior to the infraspinatus muscle from the lower border of the scapula to the humeral head. Finally, subscapularis arises from the anterior surface of the scapula and passes beneath the coracoid process to attach on the anterior surface of the humeral head. Together, these muscles and tendons make up the rotator cuff. Another important muscle of the arm is the biceps, whose tendons are an important part of shoulder movement. The tendon of the long head of the biceps attaches to the coracoid process, while the short head of the biceps tendon attaches to the anterior humeral head. Overlying all of these is a large superficial muscle, the deltoid. This muscle gives the shoulder its rounded shape, but is less often involved in pathology of the shoulder joint.
The practice of metaphor
Published in Alan Bleakley, Routledge handbook of the medical humanities, 2019
“Why can’t you make it easier for me to breathe? And the nurses are stupid. Why can’t they bring me my pills on time? They’re always late, and you know that don’t you? Well of course you do. You see them. And you don’t do anything about it.” The old lady’s left hand flew about like a conductor’s. Her right arm was splinted from a pathologic fracture.
Analysis of common shoulder injuries in collegiate baseball players
Published in The Physician and Sportsmedicine, 2022
Luilly Vargas, Daniel Charen, Hsin-Hui Huang, Jashvant Poeran, Alexis Colvin
In this study, pitching and throwing were the most common mechanisms of injury for biceps related pathology, including biceps tendinitis (70%) and SLAP tears (87.5%). As compared to rotator cuff injuries, which are mostly due to the high forces on the glenohumeral joint during arm deceleration, biceps injuries tend to occur during the late cocking phase of throwing [10]. Late cocking causes high compressive forces, anteriorly directed forces, grinding moments on the labrum and tension on the long head of the biceps tendon [10,15]. Furthermore, improper pitching mechanics can also lead to increased forces on the biceps tendon [10]. These findings of repetitive microtrauma to the biceps and superior labrum are supported by the results of our study, which demonstrate that biceps tendinitis (PR 3.9, P = 0.024) and SLAP tears (PR 6.4, P = 0.0078) were significantly more likely to be chronic injuries. SLAP tears were also significantly more likely to be recurrent rather than new injuries (PR 5.5, P = 0.010), and biceps tendinitis was significantly more likely to occur in upperclassmen compared to underclassmen (PR 5.5, P = 0.028).
Prevalence of lateral epicondylosis in veteran manual wheelchair users participating in adaptive sports
Published in The Journal of Spinal Cord Medicine, 2022
Andrea K. Cyr, Berdale S. Colorado, Michael J. Uihlein, Kristin L. Garlanger, Sergey S. Tarima, Kenneth Lee
Lateral epicondylosis (LE) or “tennis elbow” is a degenerative process related to the repetitive wrist and arm motions.1,2 Prior studies estimate that the prevalence of LE in the general population is about 1.3%, but the prevalence of LE is in manual wheelchair users in generally unknown.3 Biomechanically, the extensor carpi radialis brevis tendon that inserts at the lateral epicondyle is under maximal force during forearm pronation, wrist flexion and ulnar deviation.2 Widely accepted physical exam maneuvers for LE include the Cozen’s test and Mill’s test.2 A previous study validated these tests with comparisons to ultrasonographic findings suggestive of LE, concluding that Cozen’s test was effective at ruling out LE (sensitivity 84%, specificity 0%) whereas Mill’s test was an appropriate maneuver to rule-in LE (sensitivity 53%, specificity 100%).2
Normal parents: Trans pregnancy and the production of reproducers
Published in International Journal of Transgender Health, 2020
Reproductive institutions do, however, exceptionalize trans reproduction. “Trans broken arm syndrome” is a phenomenon coined to describe the ways that healthcare professionals connect any health concern (broken arms are the eponymous stand-in for all possible ailments unrelated to gender identity and transition) to their patients’ trans identity (Knutson et al., 2016; Payton, 2015). This phenomenon has been widely documented in the popular and scholarly literature as it relates to the kinds of emergent concerns that bring people to the doctor’s office. It often results in mis- or under-treatment by physicians who claim not to know how to treat trans people or who worry that standard therapies will work differently in the presence of hormone replacement. It is less explicitly well documented as it pertains to pregnancy, though it can be found by turning to the framing of professional society guidance on trans pregnancy, such as that released by the American Society for Reproductive Medicine’s (ASRM) Ethics Committee opinion on “access to fertility services by transgender persons” (Ethics Committee of the ASRM, 2015). In it, ASRM opens by rightly asserting that “Transgender persons have the same interests as other persons in having children and in accessing fertility services for fertility preservation and reproduction,” and goes on to note that “programs should treat all requests for assisted reproduction without regard to gender identity status.”