Week 5 Flashcards

1
Q

What joint of the upper limb is commonly dislocated in rugby players?

A

Acromioclavicular

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2
Q

Name a muscle whioh moves the shoulder girdle?

A

Trapezius

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3
Q

What is the origin, insertion and innervation of trapezius?

A

Origin: spinous processes - T12
Insertions: occiput, spine of scapula
Innervation: accessory nerve XI

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4
Q

What is the function of the trapezius muscle?

A

Elevates and depresses scapula

Retracts scapula

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5
Q

What joint of the upper limb is susceptible to OA, RA, dislocation and adhesive capsulitis?

A

Glenero-humeral joint

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6
Q

What is the role of the labrum in the gleno-humeral joint?

A

Increases capture of humeral head so increasing stability

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7
Q

What occurs where the biceps tendon anchors to the labrum in the upper limb?

A

SLAP tear

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8
Q

What is the origin, insertion and innervation of supraspinatus?

A

Origin: supraspinous fossa
Insertion: greater tuberosity of humerus
Innervation: suprascapular n. (C5,C6)

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9
Q

What function does supraspinatous have?

A

Abducts the arm

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10
Q

What is the origin, insertion and innervation of infraspinatus?

A

Origin: infraspinous fossa
Insertion: greater tuberosity of humerus
Innervation: suprascapular n.

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11
Q

What is the function of infraspinatus?

A

Externally rotates the arm

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12
Q

What is the origin, insertion and innervation of teres minor?

A

Origin: dorsal surface of lateral border of scapula
Insertion: greater tuberosity of humerus
Innervation: axillary n. (C5,C6)

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13
Q

What is the function of teres minor?

A

Externally rotates the arm

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14
Q

What is the origin, insertion and innervation of subscapularis?

A

Origin: anterior surface of scapula
Insertion: lesser tuberosity of humerus/shoulder capsule
Innervation: upper and lower subscapular n.

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15
Q

What is the function of subscapularis?

A

Internally rotates the arm

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16
Q

What is the origin, insertion and innervation of deltoid?

A

Origin: clavicle, acromion and spine of scapula
Insertion: deltoid tuberosity on lateral aspect of humerus
Innervation: axillary n.

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17
Q

What is the function of deltoid?

A

Abducts the arm

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18
Q

What is the origin, insertion and innervation for biceps brachii?

A

Origin: short head - coracoid process. long head - labrum/glenoid
Insertion: tuberosity of radius
Innervation: musculocutaneous n.

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19
Q

What is the function of biceps brachii?

A

Flexes the elbow

Supinates forearm

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20
Q

What is biceps brachii susceptible to?

A

Tendonitis

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21
Q

In the elbow joint - what part are kids likely to fracture?

A

Supracondylar region - bone is thinner

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22
Q

What three ligaments are involved in the elbow joint?

A

Medial collateral, lateral collateral and annular ligaments

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23
Q

What is the site of insertion for all of the extensor muscles of the forearm?

A

Lateral epicondyle

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24
Q

What is the lateral epicondyle susceptible to?

A

Enthesiopathies

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25
What is the site of insertion for all of the flexor muscles of the forearm?
Medial epicondyle
26
What can be said about breaks in the forearm?
If there is a break in one place there will also be a break somewhere else.
27
What type of fracture is described as a dinner fork deformity?
Distal radius fracture
28
What group of muscles move the thumb?
Thenar muscles
29
Name the three thenar muscles?
1. Opponens pollicis 2. Flexor pollicis brevis 3. Abductor pollicis brevis
30
What innervates the thenar muscles?
Median n.
31
What group of muscles move the little finger?
Hypothenar muscles
32
Name the main hypothenar muscle?
Abductor digiti minimi
33
What nerve innervates abductor digiti minimi?
Ulnarn.
34
What group of muscles move the fingers and all flex at MCPJs and extend at IPJs?
Interossei muscles
35
What innervates interossei muscles?
Ulnar nerve
36
What is the function of dorsal interossei?
ABducts the fingers at MCPJs (DAB)
37
What is the function of palmar interossei?
ADucts the fingers at MCPJs (PAD)
38
What innervates the lateral lumbrical muscles?
Median nerve
39
What innervates the medial lumbrical muscles?
Ulnar nerve
40
Name the extrinsic flexor muscle of the fingers which flexes fingers at the proximal interphalangeal joints?
Flexor digitorum superficialis
41
What is the innervation of flexor digitorum superficialis?
Median nerve
42
What flexor tendons pass through the carpal tunnel?
Flexor digitorum superficialis | Flexor digitorum profundus
43
What flexor tendon is the extrinsic flexor muscle of the fingers and flexes the fingers at the distal interphalangeal joints?
Flexor digitorum profundus
44
What innervates flexor digitorum profundus at the 4th and 5th digits?
Median nerve via anterior interosseus
45
What innervates flexor digitorum profundus at the 2nd and 3rd digits?
Ulnar nerve
46
What two annular ligaments in the hand are critical to prevent bowstringing?
A2 and A4
47
What three annular ligaments in the hand overlie the MP, PIP and DIP joints respectively?
A1, A3 and A5
48
What annular ligament in the hand is most commonly involved in trigger finger?
A1
49
What pulley prevents sheath collapse and expansion during digital motion?
Cruciate
50
What separates the palmar muscle bellies and flexor tendons from the skin and is susceptible to hypertrophy and fibrosis (Dupuytren's)?
Palmar fascia
51
What is the muscular test for the median nerve?
Abductor pollicis brevis
52
What is the cutaneous sensation test for median nerve and what does it supply?
Tip of index finger and base of thenar muscles | Supplies radial 3.5 digits
53
What is the muscular test for ulnar nerve?
Adductor digiti minimi | Abductor indicis
54
What cutaneous sensation does ulnar nerve supply and what is its test?
Ulnar 1.5 digits | Dorsum and volar aspects of little finger
55
What are the two tests for radial nerve muscular supply?
Extensor digitorum communis | Extensor indocis
56
What cutaneous sensation does radial nerve supply and what is its test?
Variable portion of dorsum of hand | Dorsum of 1st webspace
57
Where does cubital tunnel syndrome occur?
At the elbow
58
What nerve passes posterior to medial epicondyle, enters an arch formed by two heads of flexor carpi ulnaris and underneath the arcuate ligament?
Ulnar nerve
59
What are the boundaries of carpal tunnel?
Carpal bones which form dorsal, medial and lateral constraints Flexor retinaculum
60
Name two tests which if positive suggest shoulder impingement?
Painful arc | Hawkins Kennedy
61
Frozen shoulder?
Adhesive capsulitis
62
What does a crescendo arc suggest?
Problems related to AC joint - not impingement
63
What is an extremely painful condition related to shoulder impingement that involves crystals?
Calcific tendonitis
64
Give four points about traumatic shoulder instablity?
T - Traumatic U - Unilateral B - Bankart S - Surgery: bankart repair/laterjet
65
Give five features of Atraumatic shoulder instability?
``` A - Atraumatic M - Multidirectional B - Bilateral R - Rehabilitation I - Inferior capsular shift ```
66
What conditions can cause soft tissue leading to multidirectional shoulder instability?
Ehlers-Danlos | Marfans
67
What sign suggests multidirectional shoulder instability?
Sulcus sign
68
What are the three sites involved in cubital tunnel?
1. Cubital tunnel 2. Flexor carpi ulnaris tendon heads 3. Intermuscular fibrous bands
69
For the cervical spine x-ray - what views are taken?
1. AP 2. Lateral 3. Odontoid peg
70
For the scaphoid bone x-ray - what views are taken?
1. AP 2. Lateral 3. Two obliques
71
What fracture fragments are incompletely corticated?
Acute avulsion fractures
72
What do all avulsion fracture mimics have?
A completely corticated contour
73
Where may fat density be seen on normal upper limb x-rays?
Anterior to the distal humerus
74
Explain the posterior fat pad sign?
If an elbow effusion is present a displaced fat pad becomes visible posterior to the distal humerus
75
Give two features of childrens fractures?
1. Bones are soft so bend or bow - buckle fracture and plastic bowing 2. Fractures are often incomplete - greenstick fracture
76
What is the weakest part of a developing bone?
Physis or growth plate
77
What is the Salter-Harris classification used to grade?
Growth plate fractures
78
Name the fracture: elderly with osteoporosis, dorsal angulation of radius, associated ulnar styloid fracture?
Colles fracture
79
Name the fracture: children with soft bones (note un-fused growth plates and non-ossified carpal bones?
Radial buckle fracture
80
Name the fracture: young males, pain in anatomical snuff box, commonly mid-scaphoid (waist)?
Scaphoid fracture
81
Name the fracture: post-menopausal females, sclerosis indicates impaction, often comminuted and can damage axillary nerve?
Surgical neck humerus fracture
82
What fracture involves the articular surface of the first metacarpal base?
Bennett's fracture
83
Name three common shoulder problems?
1. Rotator cuff - especially supraspinatus tendonitis (age 35-65) 2. Subacromial bursitis 3. Acromioclavicular disease
84
Name three less common shoulder conditions?
1. Frozen shoulder - diabetics 2. OA/RA of shoulder 3. Recurrent dislocation
85
What are the basic treatment principles for upper limb arthritis?
Rest, analgesia, splintage, steroid injections, replace, fuse, excise
86
Where in the upper limb can arthritis occur that may be due to trauma - it is also very common?
Acromioclavicular joint
87
What loss of movement is significant in glenohumeral joint OA?
external rotation
88
In what case will an anatomic shoulder replacement fail?
When rotator cuff torn and deltoid pulls head upwards putting forces on gleaned to cause OA
89
If there is a rotator cuff tear and the shoulder joint needs replaced what replacement is suggested?
Reverse geometry shoulder
90
What arthritis is monoarticular, localised, osteophytes/sclerosis, early joint space narrowing, base of thumb and PIP + DIP joints?
Osteoarthritis
91
What arthritis is polyarticular, systemic, erosions, later joint space narrowing, synovitis, tendon rupture, MCP joints and carpus?
Rheumatoid
92
What is the number 1 joint in the body for OA?
DIP joints
93
OA of what joint results in subluxation of CMC joints?
Base of thumb