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MM Test 1 > B6.003 Upper & Lower Extremity Bones > Flashcards

B6.003 Upper & Lower Extremity Bones Flashcards

1
Q

flexion

A

bending or decreasing the angle between bones or body parts

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2
Q

extension

A

straightening or increasing the angle between bones or body parts

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3
Q

abduction

A

moving away from median plane, spreading apart

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4
Q

adduction

A

moving toward median plane, repositioning spread body parts

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5
Q

circumduction

A

circular movement combining flexion, extension, abduction, and adduction

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6
Q

rotation

A

turning or revolving body part around longitudinal axis

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7
Q

thumb abduction

A

moving out of plane of palm perpendicularly

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8
Q

thumb adduction

A

moving into plane of palm

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9
Q

thumb extension

A

moving out from palm, parallel

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10
Q

thumb flexion

A

moving into palm, parallel

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11
Q

pronation

A

rotational movement of forearm/hand

moving radius medially around longitudinal axis

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12
Q

supination

A

opposes pronation

hold a bowl of soup

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13
Q

opposition

A

moving pad of first digit to contact pads of other digits

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14
Q

ankle inversion

A

moving sole toward medial plane

85% of ankle sprains

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15
Q

ankle eversion

A

moving sole away from medial plane

15% of ankle sprains

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16
Q

4 segments of upper extremity

A
  1. pectoral girdle (shoulder)- clavicles, scapula
  2. arm- humerus
  3. forearm- radius, ulna
  4. hand- 8 carpals, 5 metacarpals, 14 phalanges
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17
Q

how are segments connected?

A

joints

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18
Q

joints of upper extemity

A 
sternoclavicular
acromioclavicular
glenohumeral
elbow (humeroulnar/ humeroradial)
proximal/distal radioulnar
radiocarpal
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19
Q

sternoclavicular joint

A

sternal end of clavicle + manubrium articulation

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20
Q

acromioclavicular joint

A

acromial (lateral) end of clavicle + acromion of scapula articulation

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21
Q

superior surface of clavicle

A

shaft

deltoid tubercle at lateral end

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22
Q

ligaments of the clavicle

A

coracoclavicular @ lateral end

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23
Q

clavicle functions

A

only bone support for upper limb to the body trump
allows mobility/flexibility
transmits shock from upper limb to axial skeleton

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24
Q

frequency of clavicle fractures

A

most frequently broken bone in body
due to FOOSH
peak 14-18, 19-40, and 60+
1/3 in males 13-20

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25
Q

cause of clavicle fractures

A

indirect forces transmitted through bones of arm and forearm

falls directly onto shoulder

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26
Q

location of clavicle fractures

A

often in weakest part:
middle 1/3 : 70%
distal 1/3: 30%
medial 1/3: <3%

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27
Q

deformity due to complete clavicular fracture

A

RARE
medial fragment elevates due to sternocleidomastoid
lateral fragment depresses due to weight of the arm
shoulder drops
clavicle may appear shortened due to pulling force from adductor muscles of the arm

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28
Q

how can you get a complete clavicle fracture

A

high force injury
amt of fracture correlates to amt of force
may require plating for optimal repair

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29
Q

how to stabilize greenstick fractures

A

figure of 8 splints

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30
Q

what is unique about the ossification of the clavicle

A

primary ossification center in diaphysis vs secondary ossification center in the epiphysis
fuse at age 25-31, last in the body

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31
Q

how do avoid misdiagnosis of clavicle fracture

A

cartilaginous region can be mistaken as a fracture

do a bilateral radiograph to compare

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32
Q

description of the scapula

A

shoulder bone
triangular, flat bone on posterolateral aspect of thorax
overlies 2-7 ribs on posterior wall of thorax

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33
Q

acromion

A

highest portion of the scapula

continuation of the spine of the scapula, hooks to meet the clavicle

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34
Q

coracoid process

A

origin/insertion for 3 muscles on scapula:
pectoralis minor
short head of biceps brachii
coracobrachialis

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35
Q

glenoid cavity

A

cavity under coracoid process
articulates with head of humerus
shallow, concave, oval
faces slightly anterior and superior

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36
Q

functions of scapula

A

forms the shoulder
allows attachment of muscles from axial skeleton and the upper limb
enables free movement of the arm

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37
Q

epidemiology of fractures of the scapula

A

RARE, typically due to high speed auto accidents
mean age 35-40
usually accompanied by another pathology (85% of the time rib, thorax or clavicle injuries)

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38
Q

management of scapula fractures

A

local tenderness and crepitus

90% not significant, don’t require surgery

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39
Q

humerus deltoid tuberosity

A

lateral side

attachment of deltoid

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40
Q

humerus radial groove

A

posterior

contains radial nerve and deep artery

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41
Q

humerus anatomical neck

A

groove circumscribing head and separating it from greater and lesser tubercles

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42
Q

humerus surgical neck

A

narrow part distal to tubercles and crests

common site for fracture

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43
Q

humerus medial supracondylar ridge and medial epicondyle (large)

A

muscle attachment for forearm flexors

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44
Q

humerus lateral supracondylar ridge and lateral epicondyle (smaller)

A

muscle attachment for forearm extensors

45
Q

humerus capitulum

A

articulate with radial head

46
Q

humerus trochlea

A

articulate with trochlear notch of ulna

47
Q

humerus olecranon

A

elbow

posterior and superior to trochlea

48
Q

nerve and vessel injuries related to humerus fractures

A

surgical neck - axillary nerve
mid humeral shaft (radial groove) - radial nerve and deep arm vessels
distal end of humerus - median nerve (rare)
medial epicondyle - ulnar nerve

49
Q

components of proximal ulna

A 
olecranon (elbow)
trochlear notch ( C shape area that articulates with humerus)
coronoid process (hook on bottom of trochlear notch)
radial notch (articulates w radius)
50
Q

components of distal ulna

A

head of ulna

ulnar styloid process (bump on pinky side of wrist)

51
Q

ulnar styloid process

A

site of attachment of triangular fibrocartilage attaching to distal radial bone

52
Q

components of proximal radius

A

head of radius (articulates with capitulum of humerus and radial notch of ulna)
neck of radius
radial tuberosity

53
Q

radial tuberosity

A

attachment for biceps brachii

54
Q

body of the radius

A

convexes laterally

progressively enlarges distally

55
Q

distal end of radius

A 
ulna notch (articulates with head of ulna)
radial styloid process (extends more distally than ulnar styloid)
56
Q

interosseous membrane between ulna and radius

A

ties bones together
flexible for pronation and supination
attachment for some deep forearm muscles
separates forearms into two compartments

57
Q

joints at the elbow

A
  1. between trochlea of humerus and trochlear notch of ulna (hinge joint) - flexion and extension
  2. capitulum of humerus and head of radius on lateral side - flexion and extension
  3. radial notch of ulna and head of radius - pronation and supination of radius around ulna
58
Q

subluxation and dislocation of the radial head

A

pulled elbow
common in preschool aged children, esp girls
sudden lifting of child’s body by pulling arm
head of radius pulled out of anular ligament (ligament by be torn)

59
Q

cause of olecranon fracture

A

direct fall on elbow, while elbow joint is flexed

60
Q

appearance of olecranon fracture

A

olecranon pulled upward by the triceps

61
Q

treatment of olecranon fracture

A

orthopedic surgical intervention required

pinning or plating

62
Q

Colles Fracture description

A

complete transverse fracture within distal 2 cm of the radius
may involve distal ulna as well

63
Q

Colles fracture epidemiology

A

most common fracture of forearm

common in adults over 50 due to osteoporosis

64
Q

cause of colles fracture

A

forced dorsiflexion of hand due to FOOSH and landing on outstretch limb with forearm and hand pronated

65
Q

deformity associated with Colles fractures

A

dinner for appearance
distal fragment is displaced dorsally and proximally
radial styloid process moved proximally

66
Q

types of hand bones

A

carpal (wrist)
metacarpal (hand)
phalanges (fingies)

67
Q

orientation of carpal bones

A

8 total

2 rows, 4 in each

68
Q

orientation of metacarpals

A

5 total

thumb (1) to pinky (5)

69
Q

orientation of phalanges

A

14 total
3 rows: proximal, middle, distal
thumb only has proximal and distal

70
Q

proximal row of carpals

A

~anterior (palmar) radial to ulnar orientation~
scaphoid
lunate
triquetrum
pisiform (on palmar surface of triquetrum)

71
Q

distal row of carpals

A 
~anterior (palmar) radial to ulnar orientation~
trapezium
trapezoid
capitate
hamate
72
Q

mnemonic for carpals

A 
some (scaphoid)
lovers (lunate)
try (triquetrum)
positions (pisiform)
that (trapezium)
they (trapezoid)
cant (capitate)
handle (hamate)
73
Q

structure of metacarpals

A

base at proximal end
body
head at distal end

74
Q

structure of phalanges

A

proximal base, body, distal head
proximal is larges, middle is intermediate, distal is smallest
distal phalanx is flattened and expanded at distal end to form nail bed on distal surface

75
Q

scaphoid fracture epidemiology

A

most frequently fractured bone of the wrist (70% of all carpal fractures)
results from FOOSH

76
Q

pain associated with scaphoid fracture

A

radial/lateral side of wrist, worsens with dorsiflexion and abduction
more pain generated when you press into the anatomical snuff box

77
Q

appearance of scaphoid fracture

A

line hard to see at beginning, shows 1-2 weeks after bone reabsorption
poor blood supply to proximal part of scaphoid results in slow bone union and avascular necrosis of proximal fragment (degenerative joint disease at wrist)

78
Q

nonunion in scaphoid fracture

A

may occur in 5-10% of cases

79
Q

imaging for scaphoid fracture

A

MRI provides most info about soft tissue injuries

CT faster and more cost effective

80
Q

boxers fracture

A

distal end of 5th metacarpal

punching objects

81
Q

mallet finger

A

avulsion of extensor digitorum tendon (pulling of extensor tendon off of DIP)
needs pins or sutures

82
Q

jersey finger

A

avulsion of flexor digitorum profundus tendon into distal phalanx

83
Q

4 segments of lower extremity

A
  1. pelvic girdle (hip)- ilium, ischium, pubis
  2. thigh - femus
  3. leg - tibia and fibula
  4. foot- tarsal, metatarsals, phalanges
84
Q

joints of lower extremity

A 
sacroiliac
hip
knee
ankle
foot: subtalar, transverse tarsal, tarsometatarsal, intermetatarsal, metatarsophalangeal, inter-phalangeal
85
Q

components of proximal femur

A 
head and neck
greater trochanter
lesser trochanter
intertrochanteric line (anterior)/ ridge(posterior)
gluteal tuberosity
86
Q

components of middle femur

A

on posterior:
linea aspera
-lateral lip (lateral supracondylar line)
-medial lip (medial supracondylar line)

87
Q

linea aspera

A

insertion point for medial and lateral intermuscular septa of thigh

88
Q

components of distal femur

A 
lateral epicondyle/ condyle (smaller)
medial epicondyle/ condyle (larger)
patellar surface (anterior)
adductor tubercle
intercondylar notch
intercondylar line
popliteal surface (posterior)
89
Q

angle of inclination of femur

A

angle decreases with age
145 - child
126- adult
120 - elderly

90
Q

overview of femoral fractures

A

femoral neck (hip) fractures are more frequent femoral fracture
happen in elderly
injure the retinacular arteries causing bleeding and femoral head necrosis

91
Q

retinaculum

A

band or band like structure that holds and organ or a part in place

92
Q

significance of retinacular arteries

A

when injured, blood supply to femoral head is largely cut off
run along femoral neck to head

93
Q

epidemiology of patellar fracture

A

1% of all fractures
males > females
direct force applied to kneecap

94
Q

treatment of patellar fracture

A

if fragments significantly displaced, pinning and wiring is generally required
minimal displacement can be treated with bracing

95
Q

tibia

A

shin bone

96
Q

is the fibula a part of the knee joint?

A

no

97
Q

common tibial fractures

A

most caused by direct force at middle to distal 1/3 junction

easily become compound fracture (break through skin)

98
Q

tibial plateau fracture

A

due to landing on ones feet from a significant height, or from an automobile accident
need surgery for repair
result in arthritic knee joint

99
Q

fibular/lateral malleolar fractures

A

commonly occur 2-6 cm proximal to distal end of the lateral malleolus (end of fibula)
associated with inversion of ankle joint

100
Q

fibular fractures due to excessive eversion

A

fracture of lateral plus medial malleoli (bimalleolar fractures)
omen over 60 most likely

101
Q

bones of the foot

A

talus- ankle
calcaneus - heel
navicular- top of foot
cuneiform (medial, intermediate, lateral) - row below navicular
cuboid- lateral side of foot, lateral to navicular and cuneiforms
5 metatarsals
14 phalanges

102
Q

ligaments that make up the arch of the foot

A

plantar aponeurosis
long plantar ligament
plantar calcaneonavicular ligament

103
Q

what is the posterior malleolus

A

a misnomer

posterior portion of the tibia

104
Q

what is a trimalleolar fracture

A

a misnomer

lateral malleolar + medial malleolar + “posterior malleolar” fracture from severe ankle injury

105
Q

what are the Ottawa ankle rules for

A

determine whether an xray is needed in an ankle injury

106
Q

what are the Ottawa ankle rules

A

needs xray if:
-unable to bear weight immediately and in ED for 4 steps
PLUS ONE:
-tender lateral malleolar tip or posterior aspect of lateral malleolus
-tenderness over base of the 5th metatarsal
-tender on medial malleolar tip or posterior aspect of medial malleolus
-tenderness over navicular bone

107
Q

calcaneal fracture cause

A

person landing on feet following a fall or during a motor vehicle collision

108
Q

jones fracture location

A

base of 5th metacarpal

109
Q

jones fracture cause

A

sudden inversion of the foot (tendon avulsion or direct pressure on proximal head of bone) or overuse

MM Test 1 (20 decks)

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