arm clinical conditions Flashcards
what actions are caused by the myotome C5
elbow flexion, shoulder abduction
what actions are caused by the myotome C6
wrist extension, supination
what actions are caused by the myotome C7
elbow extension, pronation
what actions are caused by the myotome C8
finger grip
what actions are caused by the myotome T1
finger abduction
what vein is usually used for venepuncture
median cubital vein
where can the brachial pulse be palpated
in the cubital fossa
what is Volkmann’s ischaemic fracture
where a supracondyle fracture damages the cubital fossa and the brachial artery so the muscles in the forearm are no longer supplied so become fibrotic and short giving flexion
what is a supracondyle fracture
fracture of the distal humerus above the epicondyles
what nerve is most likely to be damaged in a supracondyle fracture
medial nerve
what nerves may be damaged in axially node clearance
long thoracic nerve
what does damage to the long thoracic nerve result in
winged scapula
how do you test for winged scapula
push arms against the wall and the scapula should protrude
what muscle is damaged with winged scapula
serratus anterior
what does the flexor retinaculum attach to
schaphoid, trapezium, hamate and pisiform
what nerve is damaged in carpal tunnel syndrome
median nerve
what is Tinel’s sign
tapping the carpal tunnel to see where the pain distributes
what is Phalens test
holding wrist flexion for 60seconds to show pain distribution
how does axially nerve damage occur
shoulder dislocation and proximal humeral damage
how does median nerve damage occur
carpal tunnel syndrome supracondyle fracture
how does radial nerve damage occur
mid-humeral fractures
how does ulnar nerve damage occur
cubital tunnel syndrome, medial epicondyle fracture
what is damaged in lacerations of the wrist
median and ulnar nerve
what is Erb’s palsy
damage to C5 root due to trauma or during birth giving a waiter tip position
what does Erb’s palsy look like
shoulder abduction, external rotation, elbow flexion
what is hand of benediction
median nerve damage to the elbow making you unable to flex lateral 3 1/2 fingers due to loss of flexors in forearm
what is Klummpke’s palsy
damage to lower brachial plexus giving intrinsic hand deformities
what is a possible consequence of a scaphoid fracture
AVN due to the retrograde blood flow
what is a Boxers fracture
breaking the metacarpals, particularly in the little finger due to punching
what is ulnar claw
damage to the ulnar nerve at the wrist causing hyperextension of MCP and flexion of IP joint of medial 2 fingers due to loss of lumbricals
what is tenosynovitis
inflammation of fluid filled sheath surrounding tendons
what is seen in osteoarthritis
osteophytes, narrowing joint space, pain, sclerosis, cysts
when is rheumatoid arthritis worse
in the mornings
what muscles are affected in carpal tunnel syndrome
L - lateral 2 lumbricals
O - opponens pollicis
A - abductor pollicis
F - flexor pollicis
what is Dupuytrens disease
where the palm tissue becomes fibrotic
what is tennis elbow
overuse of tendons attaching to the lateral epicondyle giving pain and inflammation
what is golfers elbow
over of tendons attaching to medial epicondyle
what is cubital tunnel syndrome
compression of ulnar nerve as it passes through the epicondyles of the humerus giving ulnar paradox
what is ulnar paradox
compression of ulnar nerve at the elbow meaning that the ulnar claw doesn’t look as bad as FDP I now also damaged so theres less flexion
what is pulled elbow
sublaxation/ partial dislocation - where theres a tear in the annular ligament so the radial hea dislocated. mainly seen in children as the ligament strengthens with age
what is a colles fracture
distal radius fracture from a FOOSH giving a dorsal displacement of the hand
what is a smiths fracture
distal radius fracture from falling on a flexed wrist giving ventral displacement
what is a moneteggia fracture
ulna fracture with radius head dislocation
what is a galeazzi fracture
radius fracture with distal radioulnar dislocation
what causes posterior shoulder dislocation
shock or epileptic fit
how is the arm seen in an anterior shoulder dislocation
externally rotated and abducted
what artery is damaged in an anterior shoulder dislocation
anterior circumflex artery
what artery is damaged in a proximal humeral fracture
posterior circumflex artery
in a proximal humeral fracture what is the humeral head at risk of
AVN
in a mid-clavicular fracture how are the fragments displaced
medial end superiorly due to sternocleidomastoid
lateral is inferiorly due to weight of arm and medially due to pec major
what artery is affected in a clavicular fracture
subclavian artery
what is painful arc
where pain is experienced when raising the arm between 60-120 degrees as there is an inflamed supraspinous tendon being impinged in the caracoarcomial arch
how does a supracondyle fracture occur
falling onto a flexed elbow
when is carpal tunnel syndrome worse
in the mornings
what is the treatment for carpal tunnel syndrome
splint to hold the wrist in dorsiflexion, corticosteroid injections and surgical intervention
what nerves may be damaged in a clavicular fracture
suprascapular nerves which supply the lateral rotators
what artery is damaged in a mid humeral fracture
profunda brachii artery
what happens in a mid humeral fracture
wrist drop
what is a Bennett’s fracture
fracture of the 1st metacarpal base
what is the most common cause of accessory nerve damage
due to medical procedure
how do you test for accessory nerve damage
ask the patient to shrug their shoulders
what is the Popeye sign
when the long head of the biceps brachii ruptures giving a bulge when flexing
how is the musculocutaenous nerve damaged
direct injury
what types of bursitis can occur in the elbow
subcutaneous bursitis and subtendinosus bursitis
what is an aneurysm
dilation of a blood vessel to more than twice its original size
