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MSK I > Upper Extremity Clinical Notes > Flashcards

Upper Extremity Clinical Notes Flashcards

1
Q

Greenstick fracture

  • where
  • what causes it
A

incomplete fractures in the clavicle

  • most common in young children
  • occur from falling
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2
Q

most common fracture site on humerus

A

surgical neck

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3
Q

cause of “funny bone” pain

A

compression of the ulnar nerve in the groove for the ulnar nerve in the humerus

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4
Q

avulsion of the medial humeral epicondyle

A

small break in the humerus bone; caused by severe abduction of the extended elbow

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5
Q

“fractured elbow”

A

fracture of the olecranon; commonly caused from falling; considered an avulsion fracture because of the forceful nature of the triceps brachii m.

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6
Q

Colle’s fracture

A

fracture of the distal end of the radius from breaking a fall
- styloid process of ulna is often avulsed in this situation as well

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7
Q

most commonly fractured carpal bone

- mechanism

A

the scaphoid; usually the result of trying to break a fall

- often the fracture is not visible on x-ray and misdiagnosed as severe sprain

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8
Q

carpal tunnel syndrome

A

swelling in the tendons which causes the median nerve to become compressed in the carpal tunnel
- produces parasthesia, anesthesia, and pain

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9
Q

the passage anterior to the carpal bones posterior to the flexor retinaculum is knows as the

A

carpal tunnel

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10
Q

compression in the guyon tunnel causes _____

A

loss of sensation and muscular weakness due to compression of the ulnar nerve

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11
Q

guyon tunnel (ulnar canal)

A

the depression between the pisiform and the hamulus of the hamate

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12
Q

boxer’s fracture

A

fracture of the head of the 5th metacarpal; caused when an individual punches something with a closed fist

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13
Q

closing fingers in a door can cause _____

A

fractures in the distal phalanges; bone fragments must be realigned carefully to maintain function

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14
Q

what injury can occur in individuals who repeatedly throw balls, such as pitchers

A

glenoid labrum tear; in response to sudden contraction of the biceps brachii muscle in the anterosuperior part of the labrum

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15
Q

“shoulder separation”

A

injury and separation of the acromioclavicular joint

- is capable of separating w/ or w/o rupture of coracoclavicular ligament

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16
Q

glenohumeral joint dislocations

  • why is it susceptible to dislocation
  • how does it most commonly occur
A

the joint is suceptible to dislocation due to its mobility and relative instability
- most commonly occurs anteriorly or inferiorly

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17
Q

elbow dislocations

- how does it occur

A

occurs posteriorly in response to force transmitted along the long axis of the forearm
- usually involves tear in ulnar collateral ligament

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18
Q

“student’s elbow”
“dart thrower’s elbow”
“miner’s elbow”

A

subcutaneous olecranon bursitis (inflammation of the subcutaneous olecranon bursa)
- results from excessive friction between skin and olecranon

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19
Q

“Nursemaid’s elbow”

“Pulled elbow”

A

when the radial head is dislocated out of the annular ligament
- typically occurs from pulling on the arm of a child

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20
Q

“skier’s thumb”

“game-keeper’s thumb”

A

laxity or rupture of both collateral ligaments of the 1st metacarpophalangeal joint which results in a hyperabduction of that joint

21
Q

“Baseball finger”

“mallet finger”

A

sudden hyperflexion of the distal interphalangeal joint

- causes avulsion of the attachment of the long extensor tendon with the tendon away from the distal phalanx

22
Q

“bull-rider’s thumb”

A

sprain of the lateral collateral ligament and avulsion of the lateral part of the proximal phalanx of the thumb

23
Q

Synovial cyst

ganglion cyst

A

when the synovial sheaths are irritated and an accumulation of mucopolysaccharide fluid occurs
- infections can cause swelling

24
Q

Dupuytren contracture

A

thortening, thickening, and fibrosis of the palmar aponeurosis and palmar fascia which results in a partial flexion of the 4th and 5th digits

25
Q

“winged” scapula

A

paralysis of the serratus anterior muscle usually as a result of injury to the long thoracic nerve

26
Q

rotator cuff injuries

A

trauma results in instability of the glenohumeral joint

- supraspinatus is most commonly injured

27
Q

bicipital myotactic reflex failure indicates injury to what

A

musculocutaneous nerve or C5 and C6 anterior rami

28
Q

bicipital myotactic reflex

A

is produced when striking the thumb placed over the bicipital tendon with a reflex hammer
- tendon will tighten up and forearm will flex

29
Q

biceps tendinitis

A

inflammation to the biceps tendon secondary to repetitive movement of the long head of the tendon through the intertubercular groove

30
Q

popeye deformity

A

muscle balling up in the mid arm secondary to the biceps tendon dislocating out of the intertubercular groove or separating entirely from the supraglenoid tubercle

31
Q

tennis elbow

A

results from repetitive use of the superficial extensor muscles of the forearm
- involves pain over the lateral epicondyle and down the posterior forearm

32
Q

lateral epicondylitis

A

results from repeated flexion and extension of the wrist which strains the periostium of the later humeral epicondyle

33
Q

injuries to the median nerve can cause what in the thumb

A

inability to oppose the thumb

recurrent branch of median n.

34
Q

Erb-Duchenne Palsy

“Waiter’s tip position”

A

upper plexus injury; affects C5 and C6 anterior rami; individuals will have an adducted and medially rotated arm and an extended elbow; caused by dramatically increasing the angle between neck and shoulder

35
Q

“claw hand”

Klumpke paralysis

A

inferior brachial plexus injury; affects the short muscles of the hand; individuals make a claw when they try to make a fist

36
Q

Compression of the cords of the brachial plexus

  • result from
  • clinical findings
A

results from prolonged periods of working with the upper limb extended over the head
- results in pain radiating down the arm, loss of sensation, tingling of arms, and weakness of the hands

37
Q

injury to the musculocutaneous nerve

A

renders the anterior brachial muscles paralyzed

- rare but possible with blunt force trauma

38
Q

injury to the axillary nerve

A

results in atrophy of the deltoid muscle and loss of sensation over the superolateral arm

39
Q

injury to the median nerve

  • “Ape’s Hand”
  • “Hand of Benediction”
A

results in adducted thumb and thenar eminence atrophy (ape’s hand)

inhibits flexion of 2nd and 3rd digits (hand of benediction)

40
Q

injury of the ulnar nerve normally occurs in what four places

A
  1. posterior to the medial humeral epicondyle
  2. between ulnar and humeral heads of flexor carpi ulnaris muslces
  3. at the wrist
  4. in the hand
41
Q

handlebar neuropathy

A

sensory loss on medial side of hand and weakness of intrinsic hand muscles
- result of ulnar nerve compression when pressure is placed on the hamulus of the hamate bone, like when riding a bike

42
Q

wrist drop

A

injury of the radial nerve

- impairment of elbow extension and thumb adduction and extension

43
Q

why is the distal fragment of bone susceptible to avascular necrosis in scaphoid fractures

A

it is usually separated from its blood supply in the fracture

44
Q

what is the carpal tunnel

  • contents
  • anterior and posterior borders
A
  • the tendons of flexor digitorum profundus and superficialis tendon of flexor carpi radialis, and median nerve
  • passing anterior to carpal bones and posterior to flexor retinaculum
45
Q

Guyon Canal (Ulnar Canal)

A

the depression between the pisiform and hamulus of the hamate where the ulnar n. passes through

46
Q

muscles of the rotator cuff

A

supraspinatus m.
infraspinatus m.
teres minor m.
subscapularis m.

47
Q

3 borders of the snuff box and contents

A

abductor pollicis longus m., extensor pollicis brevis m., and
extensor pollicis longus m.
contents: radial a. and superficial radial n.

48
Q

which region of the axillary a. is susceptible to aneurysm and in what patients

A

region 1

  • patients who have experienced repeated rapid arm movements (baseball pitchers)
  • can compress brachial plexus resulting in pain and loss of sensation
49
Q

most common site of venipuncture and why

A

medial cubital vein

- its superficial location and the protection of underlying deep structures by the bicipital aponeurosis

MSK I (15 decks)

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