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msk 2nd shift > ana of elbow, forearm, wrist and hand > Flashcards

ana of elbow, forearm, wrist and hand Flashcards

1
Q

primary role of the elbow

A

position hand in appropriate location to perform fine motor abilities, gripping, grasping

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2
Q

what are the 3 joints of the elbow complex

A

ulnohumeral
radiohumeral
superior radioulnar

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3
Q

what motions are present in the elbow complex

A

1 deg of freedom - flex-ext

but some rotation in sup RU joint

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4
Q

discuss the stability of the elbow

A

1° stabilized by ligaments hence it does respond well to trauma

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5
Q

most common type of dislocation in the elbow

A

posterolateral dislocation d/t empty back part in RH joint

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6
Q

discuss the congruency of joints in the elbow

A

mostly superficial yung sa trochlea, olecranon and cornoid of UH lng yung deep

and sa RH meron empty back part

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7
Q

what inert structures can be found on the medial elbow

A

MUCL or UCL - on medial side; restricts valgus motion and fan shaped

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8
Q

what ligament is most commonly injured in the elbow

A

MUCL

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9
Q

what can be found in the posterior portion of UCL

A

houses ulnar nerve as it passes by cubital fossa

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10
Q

what inert structures can be found on the lateral elbow

A

radial collateral lig and lateral ulnar collateral lig

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11
Q

what does the LUCL do

A

has to restrict more - d/t to empty space in lateral elbow

stronger than medial ligaments

fan shaped

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12
Q

second most commonly injured ligament in the elbow

A

LUCL

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13
Q

proximal row of carpals

A

scaphoid
lunate
triquetrum
pisiform

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14
Q

distal row of carpals

A

trapezium
trapezoids
capitate
hamate

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15
Q

movements in the DRUJ

A

uniaxial pivot - pronation and supination

and some radial/ulnar dev

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16
Q

rc joint movements

A

biaxial ellipsoid - flex/ext and radial/ulnar deviation

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17
Q

keeps the stability of proximal carpals to radiocarpal bones

A

radioscapholunate ligament

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18
Q

most common injured lig of the wrist

A

radioscapholunate ligament

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19
Q

how is radioscapholunate ligament usually injured

A

pronated FOOSH per pwede din FOOSH tas either ext, ulnar dev and intercarpal supination

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20
Q

second most common injured lig of the wrist

A

Lunotriquetral Ligament

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21
Q

MOI for Lunotriquetral Ligament

A

wrist ext, radial dev and intercarpal sup

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22
Q

what is the TFCC

A

cushion for the triquetrum as it articulates with the ulna

bears the weight of the triquetrum at the proximal carpal bones

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23
Q

weight distrib on wrist

A

60% borne on the radius and 40% on the ulna but mostly on the TFCC

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24
Q

relate tendons to resting pos of hand

A

tendons are in the most ready or most efficient position to contract and to perform its action

no active or passive insufficiencies present in the tendon

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25
relate resting pos of hand and immob
immobilize using cast or orthosis, this is our preferred position to avoid contractures and tightening of the muscular tissue of the hand
26
which is mobile and stable betw proximal and distal transverse arch
proximal arch has to be more stable than your distal transverse arch
27
components of proximal transverse arch
carpal tunnel distal row of carpals CMC of thumb
28
Keystone of the proximal transverse arch
Capitate
29
Keystone of the distal transverse arch and longitudinal arch
2nd and 3rd MCP
30
compare stab and mob of proximal and distal carpal bones
Wrist and proximal carpal bones (RC joint) is geared towards mobility (2o of freedom), whereas the distal carpal bones requires stability
31
compare stab and mob of 2nd and 3rd MTC and distal carpal bones
2nd and 3rd metacarpals as well as distal carpal bones are geared towards stability hypermobility in 2nd or 3rd metacarpal, there is compromise in the hand present hamate/trapezium (basta distal row) is unstable there will be instability in the hand
32
MOI for posterior elbow disloc
FOOSH c extended shoulder, elbow, and wrist + ulnar dev
33
usual presentation of lateral epicondylitis
35 yo or older inflammation of tendons at common extensor origin at elbow d/t overuse or repetitive stress/strain in wrist flexion and extension pain present in motion or even at rest
34
usual presentation of nursemaid's elbow
young children elbow lacks supination and head of radius is dislocated d/t tug on arm the radial head is distracted from anullar ligament
35
discuss effect of repetitive throwing in sports
throwing can create severe valgus force medial side traction = sprain of MCU lateral side compression
36
usual presentation of little leaguer's elnow
concomitant valgus sprain on the medial side of elbow excessive concomitant compression on the lateral side Younger population is more predisposed due to the not fully developed inert stabilizers
37
usual effect if MOI is FOOSH
elbow disloc or wrist fractures consider also clavicle, AC and labrum
38
usual effect if MOI is fall on tip of elbow
Contusions or Displacemens of the Radius and Ulna on the olecranon or on to the humerus
39
common MOI and presentation for MCL or MUCL sprain/tear
audible pop followed by pain and swelling one medial elbow common in throwers, pitchers and racket sports also consider ulnar nerve affectation
40
usual presentation of distal bicep rupture
centralized pop c weakness of elbow flexion
41
normal carrying angle
5-10° for males and 10-15° for females
42
what to consider if swelling is extra-acrticular
bursitis or student’s elbow or repetitive strains
43
what to consider if swelling is intra-acrticular
in triangular space in lat elbow - radial head, olecranon, lat epicondyle
44
usual presentation of gunstock
Decrease in carrying angle sheer stresses on lateral portions of the elbow = lateral sprain and compression on medial usually secondary to severe disloc or trauma
45
usual presentation of cubito valgus
Increase in carrying angle Sprain on medial structures, compression on lateral structures
46
compare loc of heberdens and bochards
usually late stage RA bouchards - DIP heberdens - PIP
47
usual presentation of ulnar drift
Severe ulnar deviation of the MCP, PIP, and DIP = Concomitant zigzag of the metacarpals to radial deviate insufficiency’s of the grip late stage RA
48
usual presentation of dupuytrens
tightness of the anterior fascia of the MCP and DIP fixed flexion in MCP and DIP usually ring and little may cordlike structure na kita genetic and progressive
49
what to consider if pt has spoon shaped nails
Entail fungal, anemic, local injuries, or diabetes
50
what to consider if pt has clubbing of DIP
Entail respiratory compromise and other infection
51
usual presentation of Boutonniere deformity
rupture of the central slip of the extensor hood could be present in RA and due to trauma ext of MCP and DIP but PIP is flexed
52
usual presentation of swan neck
contracture of intrinsic muscles or torn volar plate due to trauma or RA ext PIP but flexed MCP and DIP usually one finger lang
53
usual pres of Benediction’s hand deformity
wasting of the interossei muscles and 2 medial lumbricals d/t ulnar nerve palsy inability to raise the fingers and there is contraction in structures below tightening and they cannot properly extend the fingers because of the weakness and the contractures of the structures of the volar surface
54
usual pres of ape hand
median nerve compromise (neck, shoulder, forearm or anterior interosseous nerve) wasting of thenar eminence - thumb pulled or ext in line na with other fingers = unable to oppose or flex thumb
55
usual pres of Claw hand or Intrinsic minus hand
MCP hyperextension, IP flexion median and ulnar nerve palsy Weak long flexors of the wrist and hand leading to overriding of the radial nerve subserved structures tas strong extensors
56
what to consider in drop wrist
inability to actively extend = radial nerve palsy or saturday night paralyzed extensor muscles
57
usual pres of Zigzag deformity of the thumb
in RA seen in ulnar drift Bowstringing effect with the dislocated CMC, hyperextended MCP and flexed DIP Volar plate avulsion and rupture of the ligaments
58
usual pres of mallet finger
common in sports rupture or avulsion of extensor tendon sa distal phalanx = flexed DIP
59
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msk 2nd shift (6 decks)

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