Chap 123 Occupational Flashcards Preview

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Flashcards in Chap 123 Occupational Deck (24):
1

What occupational vascular syndromes are caused by manual labor?

Hand-arm vibration syndrome
Hypothenar hammer syndrome

2

What are symptoms of HAVS?

intermittent numbness or tingling progressing to extensive blanching
1 hour attack with reactive hyperaemia

3

How is diagnosis made of HAVS?

provocation and history of raynauds with vibration tool

4

What are arteriographic changes in HAVS?

multiple segmental occlusions of digits
corkscrew configuration of vessels in hand
incomplete palmar arch

5

What is HAVS treatment

CCB
IV prostanoids
cervical of digital sympathectomy

6

Where and how does injury occur in HHS?

ulnar travels in guyon's canal bound by pisiform and hamate bones, only covered by skin
repetitive injury to this site
vasospasm and plt aggregation and thrombus with distal embo

7

What are symptoms in HHS?

raynauds, involves ulanr three digits (not thumb)

8

What are treatments for HHS?

smoking cessation
anticoag
CCB
reconstruction/ligation

9

Name three exposure injuries.

occupation acro-osteolysis
electrical burns
thermal injuries

10

What is acro-osteolysis?

exposure to polyvinyl chloride
raunauds, clubbin
angio--multiple stenosis with hypervascularity adjacent to the bone of reabsorption

11

What is the vascular run jury with electrical burns?

Arterial necorsis, thrombus, bleeding, and gangrene of digits, aneurysm formation

12

What profession get thermal injuries?

exposure to cold, slaughterhouse, canning factories, fisheries

13

What are some injuries that athletes get?

hand ischemia
quadrilateral space syndrome
humeral head compression of axillary artery
TOS

14

What kind of athletes get these injuries and what are the symptoms?

baseball, volleyball, karate, swimming, golf, weightlifting

raynauds, aterial occlusion, embo to digits

15

What is the mechanism of injury in hand ischemia?

digital artery injury
embolization from proximal source

16

What are the mechanisms which cause hand ischemia?

direct injury (baseball catchers)
compression of digital artery by cleland ligament

17

What is treatment for hand ischemia?

IV dextran and pain control
sx--digital sympathectomy, release of clelands ligament
prevention

18

Describe the quadrilateral space. What travels in it?

Bordered by teres minor, humeral shaft, tere minor, and long head of tricpes
Within the space posterior humeral circumflex artery and axillary nerve

19

Who gets QSS? What vascular abnormalities do they get?

pitcher, volleyball (cocked position)
aneurysm with embo (to hand), occlusions
from compression of the posterior circumflex artery

20

What is the aetiology of HHCAA?

compression of third portion of axillary artery by head of humerus

21

What are the symptoms of HHCAA?

numbness of fingers, raynauds, cutaneous embolization

22

What is treatment?

modification of throwing
saphenous vein patch, bypass

23

Name sites or injury and the vessel injured that can digital symptoms.

Scalene triangle, subclavian artery
subcoracoid space, axillary artery
cleland ligament, digital artery
direct injury, digital artery
guyon's space, ulnar artery
quadrilateral space, posterior circumflex artery
humeral head, axillary artery

23

How is raynauds with HHS distinguishable from other presentation of raynauds?

Predominance male smokers
Usually lacks reactive hyperaemia
Usually dominant hand
Repetitive trauma to hand