Anatomy and clinical implications Flashcards by HARRY RICHARDSON

Complications of a clavicle fracture

malunion , neuro- vascular damage and Pneumothorax, sternocleidomastoid muscle will elevate the middle third creating a shoulder drop at the distal third.

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Damage to the Long thoracic nerve which innervates the Serratus anterior muscle causes what?

Winged scapula , middle and inferior borders are protruded

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ipsilateral wrist drop caused by damage to what nerve

Radial nerve damage - in the humerus spinal groove

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Fracture to the distal radius, pushed anteriorly

Smiths fracture

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Fracture to the distal radius , distal fragment pushed posteriorly

Colles fracture

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supraspinatus

abduction of arm for first 15 degrees

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infraspinatus

external rotation of shoulder

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subscapularis

internal rotation of shoulder and adduction

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Teres minor

external rotation

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How do you test the rotator cuff muscles

lower a fully abducted arm - a positive result is when the arm drops uncontrollably from 30 degrees

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inflammation of base of flexor tendons , and pain when flexing

medial epicondylitis and golfers elbow

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Tennis elbow

lateral epicondylitis

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Nursemaids elbow

Subluxation (partial dislocation) of the annular ligament or radial head
to relocate 90 degrees flex arm in a supine position then push in

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Axillary nerve
Nerve roots
motor
sensory

C5,C6
motor - deltoid and teres minor
sensory- skin over the lower deltoid

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Ulna nerve
nerve roots
motor
sensory

C8,T1
motor to the flexor carpi ulnaris, flexor digitorum profundus and flexors of the hand
sensory - little finger and half of the ring finger - claw hand

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Radial nerve
nerve roots
motor
sensory

all nerve roots
motor to extensors of arm, forearm and hand
sensory to posterior forearm and posterior hand ( not little finger or tips of fingers)
this can be compressed by crutches in the axilla , loss o finger extension

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Musculocutaneous nerve
nerve roots
motor
sensory

C5,C6,C7
motor to the arm flexors ( BCB)
sensory to the lateral cutaneous nerve which runs with the cephalic vein

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Median nerve
nerve roots
motor
sensory

all nerve roots
motor to flexors of the forearm and hand muscles
sensory to lateral palm and lateral 3 half finger on palmar surface

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carpel tunnels syndrome is caused by damage to which nerve and what test can diagnose this

compression of the median nerve - test called Tinels test - tap it and fingers tingle - hand of benediction

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Cubital tunnel syndrome caused by damage to which nerve

ulna nerve ,

wrist adduction is lost if damage to medial epicondyle

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Guyans canal damage to what nerve

Ulnar nerve causing numbness in little finger and half orf ring finger , no dysfunction of movement in her hand likely to be this.
ulnar artery goes through here too

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What is Erbs palsy

severing of upper trunk of brachial plexus so C5 and C6

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What is klumpkes palsy

severing of lower trunk of brachial plexus C8 and T1

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Dermatome

an area of skin innervated by a single spinal nerve

Myotome

a group of muscles innervated by a single spinal nerve

How is compartment syndrome relieved?

Fasciotomy - release of fascia around the muscles so blood vessels aren't compressed

What is a sign of lack of blood to the arm causing a claw like hand

Volkmans ischemic contracture

Complications of a humeral head fracture

axillary nerve damage causing atrophy and loss of sensation to the deltoid muscle,

Complications of an olecranon fracture

avulsion of triceps ligaments , ulnar nerve injury | radial nerve innervates triceps muscles that connects onto the olecranon process

What nerve supplies the dorsal interossi and palmar interossi muscles?

Ulnar nerve dorsal interossi - 4 muscles back of hand abduct the fingers away from midline and assist in flexion palmaar interossi muscles - adduct the fingers in between consist of 4 or 3

Two muscles that extend the forearm and attach to the olecranon are .. .....

Triceps brachia and anconeus innervated by the radial nerve

A 58-year-old male presents to the GP six weeks following a motor bike accident where he sustained a fracture of his right distal radius. Today he complains of a two-day history of an inability to fully extend his right thumb at both the metacarpophalangeal and interphalangeal joints. Rupture of which muscle is likely to have caused his presentation?

Extensor pollicis longus - extends the thumb at the MCPJ and IPJ also with in synergy with the extensor policies brevis muscle

What are the borders of the anatomical snuff box?

extensor pollicis longus, extensor pollicis brevis and abductor pollicis longus

Boutonnieres deformity is caused by what?

Injury to the tendons characterised by PIP flexion and DIP extension - extensor digitorum tendon

Which carpal bone is involved in osteoarthritis of the base of the thumb?

Trapezium

What nerve supplies the muscles that pulls on the radial tuberosity?

Musculocutaneous nerve supplies biceps brachii muscle that attaches

What are the borders of the axilla?

Anterior border - pectorals major and minor Medial border - serratus anterior and thoracic wall (ribs) lateral border - intertubecular sulcus posterior border - scapularis , teres major , latissimus dorsi superior most anterior - clavicle

on x-ray the left wrist. What x-ray findings of the left radius distal metaphysis would be consistent with a diagnosis of a Smith’s fracture?

Extra- articular fracture with solar angulation

Nathan presents to the emergency department after falling from a ladder. He is most tender just proximal to the first metacarpal and in between the extensor pollicis longus and the extensor pollicis brevis tendons. A: What bone has Nathan fractured to give this presentation?

scaphoid bone - awn

difficulty opposing the thumb to the index finger is damage to what nerve?

Anterior Interosseous nerve is branch of median nerve, supplies opponens pollicis

What muscle at the interphalangeal joint is required for the opposition of the thumb?

Flexor Pollicis Longus

How would you test for the biceps brachia muscle?

Resist elbow flexion or forearm supination while palpating the muscle bulk on the anterior surface of the arm.

Besides adipose tissue, what separates the olecranon from the skin?

The olecranon bursa

Problems with a humeral shaft fracture

radial nerve - in posterior groove between the two triceps heads , wrist drop

What common paediatric injury at the elbow means that the humerus dose not line up with the capitellum ( narrowest point of the humerus) FOOSH

supracondylar fracture

What is elbow joint effusion?

This is where intra-articular fracture occurs presenting a convex anterior fat pad

What is a fracture of the 5th metacarpal neck called?

Boxer fracture

Gamekeepers thumb is when?- I did this fucking remember

avulsion or rupture of UCL of 1st MCPJ , hyperabduction of the pole

What FOOSH injury presents a risk of AVN and the bone that has a retrograde blood supply ?

Scaphoid

What nerve is thenar atrophy associated with?

Median nerve

What nerve is hypothenar atrophy associated with?

Ulnar nerve

what is the cascade sign(positive)

when all fingers point to scaphoid

frozen shoulder

inflammation of ligaments resisting abduction

Popeye sign

caused by rheumatoid arthritis as tendons fragile

what muscle supinates the elbow

bicep brachaii

what is de quervains tenosynovitis and how to diagnose it

tendons on the thumb affected | diagnosed by frinklesteins test , around thumb then ulnar deviation

Symptoms of de Quervain's tenosynovitis include what test

Pain near the base of your thumb. Swelling near the base of your thumb. Difficulty moving your thumb and wrist when you're doing something that involves grasping or pinching. A "sticking" or "stop-and-go" sensation in your thumb when moving it. frinklesteins test inflammation of the synovium

features of acromegaly

Increased sweating, coarsening or thickening of facial features, increased prominence of jaw +/- forehead