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MSS - MSK Exam 2 > Clinical Correlations of the Upper Limb > Flashcards

Clinical Correlations of the Upper Limb Flashcards

(72 cards)

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1
Q

dermatomes of upper limb

A

C4 - T3

cervical plexus
brachial plexus
intercostal nerve

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2
Q

GSA

A

pain fiber (exteroreceptive)

comes to dorsal root ganglia to dorsal root

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3
Q

angina pectoris

A

radiation of pain from thorax down left upper limb
-pain fibers assiciated with sympathetics T1-T4
T1 - T3 dermatomes of upper limb

visceral afferent interpretation present on skin

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4
Q

C345?

A

subdiaphragmatic irritaiton due to peritonitis, gall bladder inflammation, hepatic abscess, pleurisy, or accumulation of CO2 following laser surgery

pain at tip of shoulder
-phrenic nerve C345, supraclavicular nerve C34

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5
Q

p’eau d’orange

A

skin of orange
-dimpling of breast skin bc of tightening of suspensory ligaments

outward sign of tumor growth

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6
Q

dupuytrens contracture

A

thickening/contraction of longitudinal connective tissue bundles of palmar aponeurosis

draws fingers into palm

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7
Q

subacromial/subdeltoid bursitis

A

inflammation accompanied by pain and swelling within confined synovial space

-bursa surrounding glenohumeral or shoulder joint

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8
Q

olecranon bursitis

A

same as subacromial but in elbow

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9
Q

ganglion cyst

A

same as dupuytren for thendon sheaths of extensor surface of wrist

synovial inflammation

under extensor retinaculum

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10
Q

dequervains disease

A

inflammation of synovial sheath surrounding extensor pollicis brevis and abductor pollicis longus tendons

lots of trouble using thumb**

tenosynovitis - inflammation of tendon and synovial

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11
Q

trigger finger

A

same as olecranon bursitis but for flexor tendon sheaths in hand

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12
Q

axilla pathology?

A

stretching of cords of brachial plexus

  • humeral dislocation
  • tumor (pancoast or lymphoma)

compression of axillary artery
-stop bleeding distally, location of neoplastic lymph nodes toe to breast carcinoma metastasis

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13
Q

cubital fossa contents?

A

biceps tendon, brachial artery, median nerve

-lateral to medial

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14
Q

pathology of cubital fossa?

A

care during venapuncture

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15
Q

carpal tunnel

A

bound by flexor retinaculum

has 9 tendons and 1 nerve

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16
Q

carpal tunnel syndrome

A

irritation and inflammation in carpal fluid

-lots of pressure on median nerve

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17
Q

radial bursa

A

flexor pollicis longus sheath

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18
Q

ulnar bursa

A

common flexor

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19
Q

palmar aponeurosis

A

different septa branch down to carpal bone to define the compartments

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20
Q

midpalmar and thenar space

A

between the top compartments of hand and the adductor-interosseous compartment

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21
Q

clavicle

A

last bone to completely ossify
-strut for all of shoulder

used in autopsy to determine age

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22
Q

most commonly broken bond in body?

A

clavicle

-will often greenstick

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23
Q

medial clavicular dislocation

A

pressure on carotid sheath

  • vagus nerve damage also possible
  • stimulation can result in decrease in heart rate and contractility (heart PS innervation)
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24
Q

AC separation?

A

acromioclavicular separation

-strongest are conoid and trapezoid

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25
grading of AC separation
1 - stretched AC ligaments 2 - tear AC, CC intact 3 - torn AC and CC, 3-5x increase in coracoclavicular distance 4/5 - samea s 3 with increased coracoclavicular distance 6 - complete rupture of both ligaments with inferior clavicular displacement
26
adhesive capsulitis
frozen shoulder - thickened fibrotic, inflamed and shrunken capsule - decreased ROM all range, ACTIVE and PASSIVE - arthritis, bursitis, tendonitis, inactivity, postsurgical complications get scapular motion -not glenohumeral
27
rotator cuff
traverse majority of GH capsule en rough to humeral attachments
28
what is most often injured of rotator cuff?
supraspinatus torn while trying to life too much or catching a heavy falling object through repetitive overhead motion activities
29
calcific tendonitis
erosion and inflammation of supraspinatus via osteophyte growth in AC joint -tendon becomes calcified (less elastic) and more brittle
30
posterior glenohumeral dislocation
5% dislocations posterior prominence of humeral head -prominent coracoid process -arm held in adduction with inability to laterally rotate humerus
31
anterior glenohumeral dislocation
95% of dislocations loww of normal shoulder contour muscles pull head of humerus into axilla, humerus slightly abducted humeral head prominent anteriorly symptoms - paresthesia in distribution of axilalry and musculocutaneous nerves
32
humero-ulnar dislocation
movement of ulna and radius posteriorly relative to humerus, may be associated with fractures
33
radial head subluxation
distal movement of radial head from undercover of annular ligament of the radius -occurs more often in children - suddenly lifted
34
youth - fall on outstretched hand?
displacement of distal radial epiphysis
35
adolescent fall on outstretched hand
clavicular fracture
36
elderly fall on outstretched hand?
colle' fracture
37
colle's fracture
fracture of distal radius approximately 1 inch proxmial to radiocarpal joint, prsents silver fork deformity
38
most often fractured carpal bone?
scaphoid | -avascular necrosis
39
most often dislocated carpal bone?
lunate bone | -can impinge on carpal tunnel
40
if you put pressure on digit 3?
lunate dislocation
41
game-keepers thumb
rupture of ulnar collateral ligament | -of metacarpophalangeal joint of thumb
42
compression at axillary artery?
proximal humerus, medial surface
43
compression of brachial artery?
medial to anterior humerus from above downward
44
compression of ulnar artery?
distal anterior wrist lateral to pisiform
45
compression of radial artery?
distal anterior radius, snuff box, 1st dorsal digital space
46
avascular necrosis of scaphoid bone
non-union of distal fragment of scaphoid with proximal fragment -distal portion contains nutrient artery entrance site and therefore, fracture may leave proximal fragment without a blood supply
47
raynauds syndrome
increased sympathetic innervation to distal blood vessels results in increased vasoconstruction with concomitant decrease in vascular flow fingertips are cold and limb warm proximal danger lies in necrosis in fingers cervicodorsla preganglionic sympathectomy can be performed
48
superficial veins?
access for venapuncture, transfusion, catheterization
49
deep veins
thrombosis - clot in deep vein | -trauma, fracture, deep contusion
50
lymphangitis
inflammation of lymph vessels -visible as red streaks those which extend proximally from thumb and index finger follow course of cephalic vein to inferior clavicular nodes those which originate in the medial three fingers follow the course of the basilic vein to cubital and lateral axillary lymph nodes
51
lymphadenitis
inflammation of lymph nodes
52
breast lymphatics
75 % lateral to nodes axillary (can palpate) 25% to parasternal nodes (deep) cannot palpate
53
contralateral drainage?
between the breasts
54
biceps tendon reflexes
biceps C56
55
triceps tendon reflexes
biceps C78
56
erb-duchennes palsy
injury to C5 C6 and nerve roots or upper trunk due to traction on neck loss of flexors of forearm and lateral rotators of humerus medial rotation takes over - limb held in waiters tip location
57
klumpkes palsy
injury to C8 T1 nerve roots of lower trunk catch in hanging position while falling results in total claw hand -no balance between extensor and flexor muscles (lumbrical and interossei)
58
long thoracic nerve injury?
serratus anterior innervation C567 results in winged scapula - decreased ability to fully abduct limb - loss of integrity of platform of upper limb from which it operates
59
axillary nerve damage
C56 injury to nerve as it passes around quadrangular space poor crutch placement, downward glenohumeral dislocation, fracture of surgical neck of humerus
60
radial nerve damage
C5-T1 injury can occur as it exits axilla or winds around spiral groove due to poor crutch placement, falling asleep with arm over back of chair, fracture of upper humerus results in WRIST DROP loss causes flexion contractures
61
innervation of triceps?
happens before the radial gets to the radial groove therefore, damage to the radial groove won't cause decreased in triceps innervation
62
musculocutaneous nerve damage?
C567 rarely injured -loss of forearm flexion and supination, loss of cutaneous sensation to lateral forearm
63
median nerve damage
C678 T1, sometimes C5 injuries at elbow due to medial supracondylar humeral fracture results in ape hand - decreased wrist flexion, supination, thumb neutral, wasting thenar eminence
64
carpal tunnel syndrome
inflammation impinges median nerve -paresthesia lateral 3.5 fingers paresis wasting of thenar eminence
65
ulnar nerve nerve
C8 T1 injury within canal of struthers occurs posterior to medial humeral epicondyle -symptoms - weakness upon flexion and adduction of wrist with paresthesia to ring and little finger
66
injury in struthers canal
posterior to medial humeral epicondyle
67
injury in guyons tunnel
at wrist medial to flexor retinaculum beneath pisohamate ligament cuts or falls on outstretched palms
68
major contributor to hand?
ulnar nerve
69
ulnar claw
partial ulnar claw - 4 5 digits
70
partial median claw
digits 2 and 3
71
ulnar nerve lesion?
need to pinch
72
frohments sign
if you pinch grab instead of adduct grab with thumb -indicates ulnar nerve damage

MSS - MSK Exam 2 (13 decks)

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