Anatomy PathologiesUpper extremity Flashcards by Simi Singh

Dislocated epiphysis of femoral head that occurs in children 10-17 years old can result in what change to the angle of inclination?

Angle of inclination reduces to about 90 degrees, this is called coxa vara

Radiology to confirm dx

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Which arteries can cause bleeding and femoral head necrosis

Injury to the retinacular arteries

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Bone graft using the fibula utilizes what area of the fibula?

middle third where the nutrient foramen is

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what tarsal most likely to fracture?

5th

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Varicose Veins, Thrombosis, Thromboplebitis all cause due to a failure of valves in the perforating vines that are tributaries from the ———— vein.

great saphenous vein

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winged scapula

can’t comb hair
long thoracic injury
serratus anterior not working

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What nerve can be injured during surgery in the shoulder/axilla that leads to the pt not being able to do pull ups or climb or use crutches?

Thoracodorsal Nerve that innverates the lats

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injury to the dorsal scapular nerve would affect the

Levator SCapulae

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Loss of sensation on the lateral side of the proximal arm skin could be caused by a shoulder joint dislocation, humeral surgical neck fracture, intramuscular injection of medication. You should definitely test what muscle function?

Deltoid

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Triangular and quadrangular space formed by the teres major and long head of the triceps. what exits the triangular space and what exits the quadrangular space?

Traingular space contains: circumflex scapular artery

Quadrangular Space:

Posterior circumflex humeral artery
Axillary Nerve

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How would you test for a rotator cuff injury?

ask patient to lower arms (Adduct from 90degrees)

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Why is the supraspinatus the most injured rotator cuff muscle?

It is limited by the acromion and so gets torn and inflamed

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Pain during abduction (50degrees to 130 degrees) is referred to as

Painful arc syndrome

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Painful arc syndrome is a result of

Subacromia bursitis and calcification

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What bursa is affected in Painful arc syndrome?

The bursa that sits between the tendon of the supraspinatus and the acromion, coracoacromial ligament, and deltoid.

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If the axillary vein were blocked, what collateral venous route could be affected?

Thoracoepigastric Vein

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What Axillary lymph node is the first to be enlarged usually as result from infection or cancer of the shoulder and thoracic region

The Humeral Group

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The cephalic vein is obstructed by a lymph node. Which one most likely?

Apical axillary lymph node

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A surgeon completes an axillary lymph node dissection. Which two muscles are at risk because of the nerves that run through the axilla?

The serratus anterior (Long thoracic)

the Latissimus dorsi (Thoracodorsal nerve)

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The Dorsal scapular nerve is injured. You are no longer able to

elevate the scapula because the levator scapulae and rhomboids are innervated by the dorsal scapular nerve

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A swimmer hypertrophies the middle and posterior scalene muscles and all of a sudden isn’t able to comb her hair because

The serratus anterior is innervated by the long thoracic nerve which
rotates inferior angle of the scapula (punching/reaching forward)
-holds scapula against thoracic wall

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The axillary nerve has been damaged when an elderly woman FOOSHd. Even though the arm is stable, what part of the humerus is likely affected?

Surgical neck. Pt probably lost sensation to lateral aspect of the upper arm. can’t abduct past 15 degrees

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You can’t feel the skin on the lateral side of dorsum of the hand and the lateal 3 and a half fingers. What nerve is likely affected?

Superficial branch of the Radial nerve

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You can’t extend your wrist

(deep branch of the) Radial nerve issue

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The proximal posterior aspect of your arm is compressed after sleeping on a table all night. What could this result in

Saturday Night Palsy

What area of the humerus would put the radial nerve and deep arm vessels at risk if fractured?

The Radial groove (mid humeral fracture)

The distal end of the humerus if fractured could result in injury that would affect a patient's ability to

abduct the thumb, flex the first 2 fingers. Because this would affect the median nerve that crosses lateral to the median epicondyle

The medial epicondyle is fractured. The patient can't flex his 5th and part of his 4th fingers. What nerve injury is responsible for this?

ulnar

Shoulder dystocia or falling on the head and neck can cause injury to what cervical level leading to Erb's Palsy

C5, C6 (Erb's Palsy)

What muscles are paralyzed in Erb's palsy?

Deltoid, Biceps, Brachialis, brachioradialis this leads to waiters tip

Klumpke's palsy is injury to what part of the brachial plexus?

The inferior part: C8, T1 possibly from sudden pull of the arm like grabbing a tree branch of grabbing arm during delivery of baby

In Backpacker's palsy, microinjuries to the superior trunk of the brachial plexus can lead to sensory deficits in the distribution of the what 2 nerves

Musculocutaneous and Radial nerve

A man paints his ceiling and experiences pain running down his arm numbness and tingling. What aspect of the brachial plexus is affected?

superior part

You want to operate on someone's upper limb without using general anesthesis. What plexus would you try to anesthetize and where would you inject?

anesthetize the angle between the posterior border of the sternocleidomastoid and the clavicle. It has to go into the axillary sheath containing the cords not into the vessels.

a pt presents with crepitus in the shoulder, she is a softball pitcher and also plays racquetball. The shoulder is tender and has similar pain levels with active and passive movement. What is the insertion, innervation and origin of the presenting tendinitis of this muscle

She has biceps tendinitis which affects the long head of the biceps originates at the supraglenoid tubercle of the scapula and inserts on the radial tuberosity and bicipital aponeurosis. The tendon is in a synovial sheath that travels through the intertubercular groove and can sustain microtrauma from repeated actions like throwing

Dislocation of the long head of the biceps is associated with what other injury 70% of the time

Rotator cuff injuries

If the tendon of the long of the biceps ruptures, where does the detached muscle belly go?

It's pulled distally--- popeye deformity

A kid is playing football and is hit and his arm is fucked up. What's ikely ∂islocated?

the proximal humeral epiphysis

blood pressure cuff blocks circulation in what artery?

The Brachial Artery

What muscles would be affected with occlusion or laceration of the brachial artery?

Forearm flexor muscles affected from the ischemia.

Where would you apply pressure to stop bleeding if someone's forearm were lacerated?

middle of the arm before the deep artery of the arm branches out.

What nerve pierces the coracobrachialis and if injured from a weapon would result in weakened forearm flexion and supination and loss of sensation on the lateral surface of the forearm?

Musculocutaneous nerve

someone can't feel the dorsum of the hand and digits. They also can't extend their elbow or supinate their arm or extend thei MCPs. What nerve injury?

Radial nerve injury

wrist-drop sign is when

someone has sustained a radial nerve injury and they are unable to extend the MCP joints because the extensor muscles are innervated by the deep branch of the radian nerve

What nerve can compress the median nerve and lead to pain and tenderness in the proximal anterior forearm?

Median Nerve. In pronator syndrome the median nerve can be compressed by the heads of the pronator teres muscles.

If someone has pronator syndrome which involves median nerve compression, what will happen when they try to form a fist?

the patient can't flex the PIPs of 1-3 and can't flex the tips of 2 and 3 Pope's benediction

flexor carpi ulnaris compressed what nerve within the cubital tunnel?

Ulnar Nerve presenting with a claw hand wrist is drawn lateral when making a fist

Fracture of the the medial epicondyle puts what nerve at risk?

Ulnar nerve injury

Injury to guyon's canal affects what nerve that travels between the flexor carpi ulnaris and the Flexor digitorum profundus

ulnar nerve

If you can't feel the skin of your posterior forearm, what branch of the radial nerve may be affected?

Posterior Cutaneous Nerve

What does the deep branch of the radial nerve turn into?

the posterior interosseous nerve

Tennis elbow can be from inflammation of the periosteum of the lateral epicondyle of the humerus. what muscles insert here?

extensor carpi radialis brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris also supinator

tennis elbow hurts when?

at rest or opening a door or lifting a glass

Golfer's elbow affects which muscles?

PFPF medial epicondylitis

what branch of the radial nerve would cause wrist drop and what branch would cause anesthesia of the dorsal hand?

Deep branch injury: can't extend the MCPs Superficial Branch Injury: can't feel the back of hand

You look at the palm of someone's hand and it shows progressive shortening, thickening, and fibrosis of the palmar fascia and aponeurosis. Which fingers are mainly perma-flexed

The 4th and 5th are pulled in partial flexion

Someone punctures their common synovial sheath of the flexors, what digit is in communication with that synovial sheath that the infection could spread to?

The 5th digit. This is tenosynovitis

A patient experiences radiating pain when they adduct their thumb and adduct their wrist joint. The synovial sheath of what tendons have likely undergone fibrous thickening?

Abductor Pollicis Longus Extensor Pollicis brevis

Fibrous thickening of the synovial sheath of the Abductor pollicis longus and the extensor pollicis brevis is called?

De Quervain's Tenovaginitis

Fibrous thickening of the Flexor digitorum superficialism and flexor digitorum profundus tendons could cause a snapping sound on passive extension known as

Digital Tenovaginitis Stenosans (trigger finger)

What sort of injections could you try before surgical intervention of trigger finger?

Steroid injections

If the palmar arterial arches are lacerated, why might there be profuse bleeding?

extensive anastamoses. stop bleeding at brachial artery

thenar muscle weakness and atrophy seen in

carpal tunnel syndrome

difficulty opposing thumb

carpal tunnel syndrome possibly

trauma to median nerve could affect the ability of the thumb to flex and abduct

carpal tunnel

Cyclist's palsy involved ulnar nerve damage in what area?

the hand

The superior gluteal nerve on the right side is injured. What side of the hip will drop?

the left side.

sciatic nerve can be injured by

compression (hypertrophy of the piriformis) Sciatica (irritation and inflammation due to chronic pressure

Does the sternoclavicular joint break very often?

no it's super tough

shoulder separation vs dislocation

separation: AC joint dislocation + coracoclavicular ligament borken dislocation: humeral head dislocated from glenoid cavity

AC joint dislocation can happen from?

FOOSH

what part of the glenohumeral joint is most weak and a point for joint dislocation?

inferior glenohumeral joint

If you aren't able to flex your shoulder which muscles are affected (4)

Pec Major Deltoid Coracobrachialis Biceps Brachii

If you can't extend your shoulder which muscles affected? (2)

Latissimus | Deltoid

Shoulder abduction controlled by (?)

Supraspinatus to 15 degrees Deltoid after that

Shoulder Adduction controlled by

Pec Major Latissimus Dorsi Rotator Cuff muscles

Shoulder Medial Rotators controlled by (3)

Subscapularis Teres Major Latissimus Dorsi

Shoulder lateral Rotators

Infraspinatus and Teres Minor

Resist downaward dislocation of the joint

Coracobrachialis Biceps Long head of the triceps Deltoid

what tendon is affected in painful arc syndrome?

Supraspinatus tendon there is also inflammation of the subacromial bursa

Frozen shoulder is from fibrosis that occurs as a result of what injuries?

Painful arc Partial Tearing of rotator cuff Bicipital tendonitis

What is the most common shoulder dislocation?

anterior dislocaiton from a hard blow when shoulder is abducted

What nerve can be affected by glenohumeral joint dislocation?

Axillary nerve

Glenoid Labrum tears happen to what sort of athlete?

pitchers/ baseball throwers

You are flexing your elbow what main muscles are you using?

Brachialis, biceps brachii, brachioradialis

You are extending your elbow what muscles are you using

Triceps

What bursa in the olecranon can become inflamed due to repeated pressure or friction? This is known as Student's elbow

Subcutaneous olecranon bursa

Elbow dislocation can affect what nerve?

Ulnar Nerve

Nursemaid's elbow a dislocation from what ligament

Annular ligament

colles fracture

distal 2cm radial fracture

Anterior dislocation of the lunate

happens to dorsiflexed wrist, lunate is dislocated into the carpal tunnel or the palm pressing the median nerve

Fracture-dislocation of the distal radial epiphysis

happens to children, radial epiphysis is displaced dorsally

gamekeeper's thumb

thumb sprain from a torn collateral ligament

Mallet finger

distal extensor tendon rupture from evulsio of extensor tendon

Jersey finger

distal flexor tendon rupture from ruptured flexor digitorum profundus tendon from attachment on the distal phalanx

Boutonniere deformity

extensor slip rupture of the central tendinous slip of the extensor hood

Anatomy PathologiesUpper extremity Flashcards

(96 cards)