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msk and ct - step > anatomy and physiology - upper limb > Flashcards

anatomy and physiology - upper limb Flashcards

(128 cards)

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1
Q

positive anterior drawer test meansÉ

A

ACL damage

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2
Q

describe how to perform the anterior drawer test

A

patinet supine, knee bet at 90 degress

angerior glindign of tibia

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3
Q

psoterior drawer sign positive

A

pcl damage

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4
Q

describe attachemtn of acl and pcl on tiba

A

anterior on tiba - acl
posterior on tibia - pcl
hurrah

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5
Q

how to assess mcl damage

A

abnormal passive abduction: patinet supie, knee extended or at 30 degress
apply lateral/valgus force - if results in medial space widening of tibia = mcl damage

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6
Q

how to assess lcl damage

A

abnormal passive adduction: patient supine, knee extended or at 30 degrees.
apply medial/varus force - if results in lateral space wideing of tibia - lcl damage

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7
Q

what is the mcmurray test

A

with patine supine and knee internally and externally rotated during motion
external rotation = pain and pop = medial
internal rotation = pain and pop = lateral

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8
Q

what type of trauma causes the unhappy triad

A

common in contact sprots due to lateral force applied to a planted leg

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9
Q

what injuries constitute the unhappy triad

A

damage to the ACL, MCL and medial lemnisucs (but mor ecommonly the laterla mensicus is injuered even though it is not attaced to the mcl)

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10
Q

acute knee pain

signs of joint injuery and instability

A

unhapy triade

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11
Q

list the physical examination positive in the unhappy triad

A

ACL: positive anterior drawer
MCL: medial space widening of tibia/abnormal passive abduction when lateral/valgus force applied
medial menicus: external rotation - pop and pain
laterla meniscus: internal rotation - pop and pain

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12
Q

housemaids kneww

A

prepatellar bursisits

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13
Q

repreated trauam ro pressure from extensive kneelign

A

prepatellar bursitis

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14
Q

popliteal non pulsaltie fliud collection

A

baker cyst

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15
Q

arthritis associated with baker cyst

A

rheumatoid arhtiritis

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16
Q

what are baker cysts usually associated with?

A

chronic joint disease.

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17
Q

list the rotator cuff muscles and their innervation please

A

supraspinatus - suprascapular nerve
infraspinatus - suprascapular nerve
teres minor - axillary nerve
subscapularis - upper and lower subscapular nerves

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18
Q

list the rotator cuff muscels and their function please

A

supraspinatus - 0-15 abduction
infraspinatus - lateral rotation
teres minor - lateral rotation and adduction
subscapularis - medial rotation and adduction

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19
Q

list the rotator cuff muscles and their function please. weak last time :)

A

supraspinatus - 0-15 abdocution
infraspinatus - lateral rotation
teres minor - lateral rotation and adduction
subscapularis - medial rotation and adduction

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20
Q

list the rotator cuff muscles, innvervation, function and common injuries

A

suprascapularis/suprscapular/ abduction 10-15 degrees/most commonly injuered/empty can- full can assessment
infraspinatus/suprascapular/lateral rotation/pitchign injury
teres minor/axiallary nerve/lateral rotation/adduction
subscapularis/upper and lower subscapular nerves/medial rotation and adduction fo arm

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21
Q

what nerve roots primariy innervate teh rotator cuff muscles

A

C5 and C6

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22
Q

golfers elbow aka

A

medial epicondylities

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23
Q

what type of action causes golfers elbow

A

repetitive flexion aka forehand shots

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24
Q

how to reproduce pain in golfers elbow

A

flex hand and supinate arm

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25
tennis elbow aka
lateral epicondylitis
26
what type of action causes tennis elbow
repetitive extension aka backhand shots/hammer and screwdrive repetitive use says glojan...
27
how to reproduce pain in lateral epicondylitis
gripping
28
list the wrist bones please
lateral/proximal: scaphoid - lunate - traquitrum - pisiform | lateral/distal: trapezium - trapexoid - capitate - hamate
29
what bones make up the wrist joint
scaphoid, lunate and radial bone
30
what carpal bone is palpated in the anatomic snuff box
scaphoid
31
what are the borders of the anatomic snuff box
posterior = tendon of extensor pollicus longus anterior: extensor pollicus brevis and abductur pollicis longus proximal: styloid procress of radius distal: apex of trinagle floor: trapezium, scaphoid can be palplated
32
whats the big deal abotu the blood supply of the scaphoid
received it distally. if fractured, proximal portion can become necrotic.
33
what can happen from the lunate becoming dislocated
can cause acute carpal tunnel syndrome
34
what causes acute carpal tunnel syndrome
dislocation of the lunate.
35
fall onto an outstreched hand
can damage the hook of the hamate = ulnar nerve injury
36
what sort of injury can cause distal damage of the unlar nerve
fall onto an outstretched hand - damages the hook of the hamate.
37
entrapment of median nerve in the carpal tunnel
carpal tunnel syndrome
38
how does carpal tunel syndrom present?
paresthesia, pain and numbess in distribution of median nerve - roughly 123.
39
causes of carpal tunnel
pregnancy rheumatoid arhtritis hypothyroidisi repetitive use
40
what can these conditiosn be associated with? pregnancy hypothyroidism rheumatoid arthritis
and repeititve used | carpal tunnel syndrome
41
what is guyon canal syndrome
compression of ulnar nerve at wrist or hand
42
what injury common seen in cyclists (involving wrist)
bucks fascia ;) guyan canal syndrome from pressure in the handle bars compression of ulnar nerve at wrost or hand
43
list the nerve roots: a) axillary b) musculocutaenous c) radial d) median e) ulnar f) recurrent branch of median nerve
a) axially - C56 b) MC - C567 c) radial = C5678T1 d) median = C5678T1 e) ulnar = C8T1 f) recurrent branch of the median nerve = C5678T1
44
fractured surfical neck of humures
axillary nerve
45
anterior dislocation of the humerus
axillary nerve
46
upper trunk compression
musculocutaneous nerve
47
midshaft fracture of the humuros
radial nerve
48
compression of axialla
radial nerve
49
saturday night palsy
compression of axilla @ crutches or sleepign with arm over chair - radial nerve
50
supracondylar fracture of humurus
proximal lesion of median
51
carpal tunnel syndrome
distal lesion of median
52
wrist lacteration
distal lesion of median never
53
fracture of medial epicondyle of humurus
proximal ulnar n lesions | funny bone
54
fracture hook of hamate
distal ulnar lesion
55
superficial laceration of palm
recurrent branch of media nerve | motor only to oaf
56
injurty to axially nerve caused be?
fracture surgical neck of humerus and anterior dislocation of humerus
57
injuery to MC nerce can be caused by
upper trunk compression
58
injurty to radial never can be caused by
compression of axilla | midshaft fracture of huermus
59
injury of median nerve caused be?
proximal - suprcondylar fracture of humerus | distal - carpal tunnel syndrome, wrist laceration
60
injury of ulnar nerve caused by?
proximal - fracture of medial epicondyle of humerus | distal - fractured hook of hamate
61
damage to recurrnet branch of median nerve caused by
superficial laceration of plam
62
axiallry nerve damage rpesentation
loss of deltion and teres minor flattened shoulder no abduction at shoulder above 15 degrees no sensation over deltoid muscla and lateral arm
63
what sensory areas is axillary nerve responsbile for
lateral arm and over deltoid muscle
64
presentation of musculocutaneous nerve damage please
loss of forarm flexion and supination | loss of sensation fo lateral forarm
65
sensory distribution of musculocutaneous nerve pelase
lateral forearm
66
presentation of radial nerve damage
wrist drop - loss of elbon, wrist and finger extesion decreased drop strenght bc wrist extension needed for maximal action fo flexors (think of hanging off a cliff ;) ) loss of senation over psoterior arm and forarm and dorsal hand
67
sensory distribution of radial nerve please
posterior arm posterior forearm dorsum of hand
68
ape hand
recurrent of median and up
69
popes blessing
median nerve
70
presentation of median never damage
loss fo wrist felxisoin, flexion of lateral fingers, thumb opposition, lumibcals fo second and third digits tinel and phalen sign positive - tingling.
71
what is the action of the lumbricals
flex at MCP | extend and DIP and PIP
72
presentation of ulnar nerve damage
ulnar claw on digit extension radial deviation of wrist upon felxion - proxial lesion loss fo wrist flexion, felxion of medial fingers, abduction and adduction fo finers at interossei, action of medial 2 lumbricals - flex MCp and extend DIP and PIP loss of sensation over medial 1/5 fingers including hypthenar eminence
73
what is sensory distribution of ulnar nerve
sensation over medial 1/5 fingers including the hypothenar eminines @ PALMAR sensation over the 5th, 3/4rds of 4th and 1/8th of 3rd finger and all of hand prox to those digits on dorsal side
74
what ise sensory distribution of median nerve
tehnar eminnens and dorsal and plamar aspects of lateral 3/5 fingers with proximal lesion
75
presentation of damage to recurrnet medial nerve
ape hand loss of thenar muscle group - opposition abduction, flexion of thumb no loss of sensation
76
sensory distribution of recurrent medial nerve
none
77
proximal median nerve damage
loss of sensation!! not with distal...
78
proximal ulnar nerve damage
radial deviation fo wrist upon felxsion
79
order of sections of hte brachial plexus
``` randy travis drinks cold beer roots trunks divisions cords branches ```
80
randy travis drinks cold beer
roots - trunks - divisions - cords - beer
81
lesion at upper trunk
c5c6 | erbs palsy/waiters tip
82
lesion at lower trunk
c8T1 | claw hand/klumpke palsy
83
lesion at posteroir cord
wrist drop
84
lesion fo axiallary nerve
deltoid paralsysi
85
lesion at radial nerve
saturday night palsy
86
lesion at mc nerve
difficulty flexing elbow, varibale sensory loss
87
lesion at media nerve
decrease thumb functio and popes blessign
88
lesion at unlar nerve
intrinsic muscles of hand | claw hand
89
list the trunks
upper - middle -lower
90
list the cords
lateral - posterior - medial
91
waht nerves come off the posterior cord
axiallary and radial | the extensors
92
what nerves come off the lateral cord
musculcutaneous and gives to the median nerve the extensors
93
what nerves come off the medial cord
ulnar and gives to medial nerve the extensors
94
list the order of each segmetn of the branchial plexus
randy travis drinsk cold beers | roots - trunks- divisions - cords - branches
95
erbs palsy causes
upper trunk traction ro tear | C5C6 roots
96
erbs palsy muscles lost
axiallary, MC, suprascapular no deltoid and supraspinatus: abduction lost = arm hands at side no infraspinatus = no lateral rotation, arm will be medially rotated no biceps brachia = bo flexion, arm will be extended
97
trauma that occurs to cause erbs palsy
infants - lateral traction on neck in delivery | adults - traummaa
98
what causes klumpke palsy
traction or tear of lower trunk | C8T1
99
what causes klumpke palsy
infants = upward force on arm during delivery | adults - trauma (trying to catch self on branch fallign out of tree)
100
what muscels are los in klumpke palsy
loss of ulnar nerve - intrinsic hand muscles, lumbricals, interossei, thenar and hypthenar
101
how does klumpke palsy present
total calwa hand lumbicla normally flex MCP joints and extend DIP and PIP joints so in totaly claw hand get extension of MPC and flexion fo DIP and PIP
102
what causes throacic outlet syndrome
crevical rib pancoast tumor spastic anterior sclaene muscles
103
what part of brachial plexus compressed in thoracic otulet syndrome
lower trunk AND subclavina vessles **look for vascular symptoms in presentaiton
104
what muscles are lost in thoracic outlet syndrome
intrinsic muscles of hand: lumbricals, interossei, thenar, hypthenar
105
how does trhoacic outlet sydnroem rpesent
***vascular symptoms = atrophy of intrinsic hand muscles, ischaemia, pain, oedema
106
what is damaged in winged scapula
long thoracic nerve | roots fo c5678t1
107
what causes windged scapula
axiallary node dissection after mastectomy | stb wounds
108
what msucels is lost in winged scapula
serratus anterior
109
how does winged scapula present
inability to anchor scapular to thoracic cage
110
old lady cant lift arm above horizontal position to get stuff from cupoboard
``` dr curry first term long thoaric winged scapula cant hold sacpula to thoarcic cage cant abduct arm above horizontal position - serartus anterior n=requried to rotate scapula to move arm up ```
111
describe the actions of hte hand muscles at rest
balance between teh extrinsic fexors and etensors of the hand and the intrinsic muscles of the hand
112
who wins at rest in the hands
lumbricals -extend mcp and flex dip and pip
113
when is ''clawign'' most prominent?
distal lesions of ulnar and median nerves
114
what happens when the lumbricals are lost
the other extrinsic flexors of the digiets exagerate the loss = lmubrical normally extend the mcp and flex the dip and pip == so will see flexion of mcp and extension of dip and pip
115
describe when the ulnar claw presents
failure to extend fingers with nerve damage
116
proximal or distal lesions cause ''clawing''
distal lesions
117
what muscles fail in clawing
lumbricals from distal lesions @ extension | pope and ok at flexion
118
describe when popes blessing occurs
failure to mak a fist with fingers with nerve damage
119
proximal or distal lesions cause ''benedicte''
proximal cause benedicted - failrure to flex
120
name the nerve damage: when asked to flex the hand fourth and fifth flex secnod and third do not
failure of flexion = proximal lesion @ second and third = median nerve benedicte
121
name the nerve damage: when asked to flex the hand fourth and fifth do not flex second and third flex
failure of flexion = proximal lesion @ foruth and fifty = ulnar nerve ok gesture
122
name the nerve damage: when asked to extend fingers second and third extend fourth and fifth do not
failure of extension = distal lesion @ fourth and fifth = median nerve median clawing
123
name the nerve damage when asked to extend fingers second and third do not extend foruth and fith extend
extension = clawing and distal | secnd and third = ulnar
124
list the thenar muscles
``` opponens poliicis abductor pollicis brecis flexor pollicis brecis superfial head (deep head by ulnar nerve) MEDIAN NERVE (recurrent) ```
125
list the hypothenar muscles
opponens digiti minimi abductor digiti minimi flexor digiti minimi brevis ULNAR NERVE
126
what abducts the fingers
DAB - dorsal interossei | ULNAR NERVE
127
what adducts the fingers
PAD - palmar interossei | ULNAR NERVE
128
what do the lumbricals do
extend the dip and pip arise from tendon of flexor digitorum profundus two and three - MEDIAN NERVE four and five - ULNAR NERVE

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