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Gross Anatomy 1 > Exam II (UE) Pathologies > Flashcards

Exam II (UE) Pathologies Flashcards

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1
Q

Shoulder Complex Grade I

A

AC ligament sprain
CC ligaments and Deltotrapezial facia intact
Nondisplaced

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2
Q

Shoulder Complex Grade II

A

AC Ligament complete tear
CC ligaments sprain
Delto-trapezial fascia intact
<25% Superior displacement

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3
Q

Shoulder Complex Grade III

A

AC and CC ligaments complete tear
Delto-trapezial fascia injuried
25-200% superior displacement

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4
Q

Shoulder Complete Grade IV-VI

A

AC & CC ligaments complete tear
Delto-trapezial fascia detached
All displaced
Generally requires surgery

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5
Q

What is it called when clavicle separates from acromion?

A

acromioclavicular (AC) separation

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6
Q

What is it called when the humerus separates from the glenohumeral capsule?

A

Glenohumeral dislocation

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7
Q

Where can a shoulder impingement be?

A

Supraspinatus or biceps LH

Subacromial bursa

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8
Q

What can shoulder impingement be caused by?

A

Chronic tendonitis of supraspinatus or biceps LH,
Subacromial bursa
Weakness of rotator cuff
Abnormal movement of scapula (Anterior tipping)
Type 3 acromion
Posture
Capsule (tightness, requires joint mobz)

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9
Q

Pathologies of glenohumeral joint

A

Subluxation

Adhesive capsulitis

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10
Q

What is GH joint subluxation and what is it caused by?

A

When humerus comes out of joint but does not dislocate
Common in stroke patients; no mm tone to counteract weight of arm
Connective tissue is decreased, so there is increased motion

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11
Q

What is GH adhesive capsulitis?

A

AKA Frozen Shoulder

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12
Q

How does adhesive capsulitis/frozen shoulder occur?

A

Intact MM
Fibrosis of capsule
Connective tissue (collagen) increases causing decreased motion

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13
Q

What is the most lost motion in adhesive capsulitis?

A

ER is the primary motion lost, which will affect shoulder flexion

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14
Q

What are the causes (primary & secondary) of adhesive capsulitis?

A

Primary: insidious; unknown reasons
Secondary: arthritis, RC tear, trauma, cardiac, neurology, pulmonary disease, diabetes, thyroid disease

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15
Q

What is a bankart lesion and how does it happen?

A

anterior inferior lesion to the labrum of GH capsule

Occurs at 90 flexion, 90 abduction

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16
Q

What is the most common result of a shoulder dislocation?

A

Bankart lesion

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17
Q

What is a Hill-Sachs leison and how does it occur?

A

Dislocation of humeral head causes muscles to spasm and push head into the edge of GH cavity causing a gouge in humeral head

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18
Q

How are Hill-sachs leisons treated?

A

it is left alone if the gouge in humeral head is less than 20% of the surface, if more can be filled with bone graph

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19
Q

What is a SLAP Tear and how does it happen?

A

Minor subluxation causing a tear in the superior labrum anterior to posterior, extreme forces causing LH of bicep tendon pull on the labrum

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20
Q

Who commonly gets SLAP tears?

A

Overhead athletes eg. baseball players 90-90

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21
Q

What causes winging of the inferior angle of the scapula?

A

Weakness of serratus anterior

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22
Q

What plane does scapula winging occur in?

A

coronal plane

abduction/protraction

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23
Q

Damage to what peripheral nerve causes scapula winging?

A

Long Thoracic N.

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24
Q

Damage to what cranial nerve causes scapula winging?

A

C5-C7

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25
What occurs when there is damage to the spinal accessory nerve?
scapula is elevated and entire medial boarder of scapula is lifted/winged
26
What motions are limited with damage to CNXI (spinal accessory)
Shoulder flexion to 90 degrees | Abduction to 20-30 degrees
27
If pectoralis minor is tight, what motion is limited?
Shoulder flexion since shoulder is anteriorly tilted... | Coracoacromial ligament hits the greater tubercle
28
Where can suprascapular nerve get compressed and what muscles become weak at that location?
Suprascapular notch: Supraspinatus and Infraspinatus | Spinoglenoid notch: Infraspinatus
29
What would swelling within the quadrangular space compress?
Axillary n. (deltoid & teres minor) | Posterior humeral circumflex a.
30
What would swelling within the triangular space compress?
Scapular circumflex a.
31
What would swelling within the triangular interval compress?
Profunda Brachial A. | Radial N. (Triceps, brachioradialis, anconeous, APL, Supinator, all wrist extensors)
32
What is the most common clavicular fracture?
Middle third of clavicle Medial fragment displaced upward by pull of sternocleidomastoid, lateral fragment displaced downward by weight of shoulder
33
If C5 spinal nerve was damaged, what would not work?
Elbow flexion (biceps)
34
If C6 spinal nerve was damaged, what would not work?
Wrist extension (eg. extensor carpi radialis)
35
If C7 spinal nerve was damaged, what would not work?
Elbow extension(eg. triceps)
36
If C8 spinal nerve was damaged, what would not work?
Finger flexion (eg. flexor digitorum profundus)
37
If T1 spinal nerve was damaged, what would not work?
Small finger abductors (eg. abductor digiti minimi)
38
How does UCL (Ulna Collateral Ligament) tears occur?
Typically in baseball players due to decreased internal rotation. Damage to the anterior band
39
What muscle weaknesses contribute to UCL tears?
Primarily flexor digitorum superficialis, but also pronator teres and flexor carpi ulnaris
40
Damage to the common flexor tendon affects what muscles?
Pronator teres, flexor capri radialis, palmaris longus, flexor carpi ulnaris, and flexor digitorum superficialis wich would affect: pronation, flexion of wrist, ulnar and radial deviation weakness, and PIP flexion
41
What is Nursemaid's elbow?
Subluxation of radial head; tear distal part of annular ligament Proximal part of ligament is trapped between radial head and capitulum (blocking motion)
42
How does nursemaid's elbow occur?
Axial traction is the most common Can happy from a fall Infants can get it after being assisted to roll over
43
What is a common elbow injury from children falling?
Supracondylar fx, from hyper extension
44
Typical clinical manifestation from nursemaid's elbow
Child protective of arm Anxiety is greater than pain Elbow flexed 15-20 degrees No warmth or swilling distal circulation, sensation and motor activity are normal Tenderness at radial head Pt resists pronation, supination, flex, and ext
45
What is an elbow complex dislocation
Dislocation with fracture | Pts almost never get full ROM in the future
46
What are the 4 bursaes in the elbow?
Olecranon (2-subcutatneous and subtendinous) Bicipital Radioulnar
47
What bursitis in the elbow would not be painful?
Subcutatneous; superficial between skin and olecranon
48
Damage to the musculocutaneous nerve would cause weakness in what muscles?
coracobrachialis C6-7 biceps brachii C5-6 brachialis C5-6
49
Damage to the musculocutaneous nerve would cause sensory loss to what?
Lateral forearm (lateral antebrachial cutaneous)
50
Damage to the median nerve would cause weakness in what muscles?
Anterior compartment of forearm, and palmar hand
51
Damage to the median nerve would cause sensory loss to what?
anterior hand and posterior digits 2-4
52
Damage to the ulnar nerve would cause weakness to what?
anterior compartment forearm and palmer hand
53
Damage to ulnar nerve would cause sensory loss to what?
Little finger, lateral half of digit IV, and hypothenar
54
Damage to the radial nerve would cause weakness in what muscles?
``` Triceps Anconeus Brachioradialis Supinator Wrist extensors ```
55
Damage to the radial nerve would cause sensory loss in what?
posterior arm, forearm, and hand
56
What is myositis ossificans?
Bone growing within the muscle | Typically happens with bleeding
57
What are heterotropic ossification commonly seen with?
supracondylar fractures posterior dislocation of elbow aggressive stretching of elbow flexors
58
Examples of injuries that can damage the radial nerve
humeral fractures at radial groove | direct trauma
59
Radial head fracture dislocation can damage what nerve?
Deep radial nerve - Superficial (all sensory) - Deep (posterior interosseous nerve)
60
Damage to the common extensor tendon would effect what muscles?
Extensor carpi radialis brevis, extensor digitorum, extensor carpi ulnaris, extensor digiti minimi
61
What is a common area the axillary nerve would be damaged?
quadrangular space
62
How is the musculocutaneous nerve commonly damaged?
entrapment by coracoprachialis
63
What are common ways to damage the ulnar nerve?
Honeymooner's palsy, cubital tunnel, tunnel guyon
64
How would the ulnar nerve get damaged at the cubital tunnel?
Compression against medial epicondyle, repetitive pressure, stretching, trauma
65
What are common ways to damage median nerve?
pronator teres entrapment, anterior interosseous syndrome, carpal tunnel, honeymooner's palsy
66
Anterior interosseous syndrome (from the median nerve) affects what muscles?
Flexor digitorum profundus I&II Flexor pollicis longus pronator quadratus
67
What is the cause of honeymooner's palsy
Pressure on the upper arm from head lying on the arm
68
What type of occupation could have entrapment of their median nerve?
Carpenters, anyone with repetitive pronation (pronator teres entraps nerve)
69
Who would get nerve damage at the tunnel of guyon?
long distance bikers, mma | anyone with excess pressure or force on hypothenar
70
What are common ways to damage the radial nerve?
``` compression in triangular interval Radial groove (saturday night palsy) Radial head dislocations supinator syndrome posterior interosseous syndrome superficial radial n. ```
71
What nerve damage causes wrist drop
Compression to radial nerve at spiral groove | AKA Saturday night palsy
72
What is affected with Saturday Night Palsy?
branch to triceps are spared long extensor of forearm paralyzed small loss of sensation over the dorsal surface of the hand and lateral 3 fingers
73
What is Wartenberg's syndrome?
Compression of superficial radial nerve?
74
Is there loss of motor, sensory, or both with Watenberg's syndrome
Sensory only (back of the hand)
75
How does Watenberg's Syndrome happen?
Superficial radial nerve compressed by scissoring of brachioradialis and extensor carpi radialis longus during pronation
76
What test could be performed to assess for anterior interosseous nerve palsy?
Ask patient to make an O with index and thumb | FDP II&III, FPL, PQ
77
Rule of dislocations with fractures of forearm
dislocation of the head, fx of bone near by
78
What is a Monteggia Fracture?
fx of proximal 1/3 of ulna | Anterior dislocation of radial head
79
What is a Galeazzi Fracture?
Fx of radial shaft | Ulnar head dislocation at distal radioulnar joint
80
What is a Smith Fracture?
fracture of radial head

Gross Anatomy 1 (7 decks)

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