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Flashcards in Anatomy PathologiesUpper extremity Deck (96):
1

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

2

Which arteries can cause bleeding and femoral head necrosis

Injury to the retinacular arteries

3

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

middle third where the nutrient foramen is

4

what tarsal most likely to fracture?

5th

5

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

6

winged scapula

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

7

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

8

injury to the dorsal scapular nerve would affect the

Levator SCapulae

9

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

10

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

11

How would you test for a rotator cuff injury?

ask patient to lower arms (Adduct from 90degrees)

12

Why is the supraspinatus the most injured rotator cuff muscle?

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

13

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

Painful arc syndrome

14

Painful arc syndrome is a result of

Subacromia bursitis and calcification

15

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.

16

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

Thoracoepigastric Vein

17

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

18

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

Apical axillary lymph node

19

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)

20

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

21

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

22

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

23

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

24

You can't extend your wrist

(deep branch of the) Radial nerve issue

25

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

Saturday Night Palsy

26

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

The Radial groove (mid humeral fracture)

27

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

28

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

29

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)

30

What muscles are paralyzed in Erb's palsy?

Deltoid, Biceps, Brachialis, brachioradialis

this leads to waiters tip

31

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

32

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

33

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

34

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.

35

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

36

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

Rotator cuff injuries

37

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

It's pulled distally--- popeye deformity

38

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

the proximal humeral epiphysis

39

blood pressure cuff blocks circulation in what artery?

The Brachial Artery

40

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

Forearm flexor muscles affected from the ischemia.

41

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.

42

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

43

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

44

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

45

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.

46

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

47

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

48

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

Ulnar nerve injury

49

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

ulnar nerve

50

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

Posterior Cutaneous Nerve

51

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

the posterior interosseous nerve

52

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

53

tennis elbow hurts when?

at rest or opening a door or lifting a glass

54

Golfer's elbow affects which muscles?

PFPF

medial epicondylitis

55

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

56

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

57

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

58

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

59

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

De Quervain's Tenovaginitis

60

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)

61

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

Steroid injections

62

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

extensive anastamoses. stop bleeding at brachial artery

63

thenar muscle weakness and atrophy seen in

carpal tunnel syndrome

64

difficulty opposing thumb

carpal tunnel syndrome possibly

65

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

carpal tunnel

66

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

the hand

67

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

the left side.

68

sciatic nerve can be injured by

compression (hypertrophy of the piriformis)

Sciatica (irritation and inflammation due to chronic pressure

69

Does the sternoclavicular joint break very often?

no it's super tough

70

shoulder separation vs dislocation

separation: AC joint dislocation + coracoclavicular ligament borken

dislocation: humeral head dislocated from glenoid cavity

71

AC joint dislocation can happen from?

FOOSH

72

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

inferior glenohumeral joint

73

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

Pec Major
Deltoid
Coracobrachialis
Biceps Brachii

74

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

Latissimus
Deltoid

75

Shoulder abduction controlled by (?)

Supraspinatus to 15 degrees

Deltoid after that

76

Shoulder Adduction controlled by

Pec Major
Latissimus Dorsi
Rotator Cuff muscles

77

Shoulder Medial Rotators controlled by (3)

Subscapularis
Teres Major
Latissimus Dorsi

78

Shoulder lateral Rotators

Infraspinatus and Teres Minor

79

Resist downaward dislocation of the joint

Coracobrachialis
Biceps
Long head of the triceps
Deltoid

80

what tendon is affected in painful arc syndrome?

Supraspinatus tendon

there is also inflammation of the subacromial bursa

81

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

Painful arc

Partial Tearing of rotator cuff

Bicipital tendonitis

82

What is the most common shoulder dislocation?

anterior dislocaiton from a hard blow when shoulder is abducted

83

What nerve can be affected by glenohumeral joint dislocation?

Axillary nerve

84

Glenoid Labrum tears happen to what sort of athlete?

pitchers/ baseball throwers

85

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

Brachialis, biceps brachii, brachioradialis

86

You are extending your elbow what muscles are you using

Triceps

87

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

Subcutaneous olecranon bursa

88

Elbow dislocation can affect what nerve?

Ulnar Nerve

89

Nursemaid's elbow a dislocation from what ligament

Annular ligament

90

colles fracture

distal 2cm radial fracture

91

Anterior dislocation of the lunate

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

92

Fracture-dislocation of the distal radial epiphysis

happens to children, radial epiphysis is displaced dorsally

93

gamekeeper's thumb

thumb sprain from a torn collateral ligament

94

Mallet finger

distal extensor tendon rupture from evulsio of extensor tendon

95

Jersey finger

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

96

Boutonniere deformity

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