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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
cause of clavicle fractures
indirect forces transmitted through bones of arm and forearm | falls directly onto shoulder
26
location of clavicle fractures
often in weakest part: middle 1/3 : 70% distal 1/3: 30% medial 1/3: <3%
27
deformity due to complete clavicular fracture
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
28
how can you get a complete clavicle fracture
high force injury amt of fracture correlates to amt of force may require plating for optimal repair
29
how to stabilize greenstick fractures
figure of 8 splints
30
what is unique about the ossification of the clavicle
primary ossification center in diaphysis vs secondary ossification center in the epiphysis fuse at age 25-31, last in the body
31
how do avoid misdiagnosis of clavicle fracture
cartilaginous region can be mistaken as a fracture | do a bilateral radiograph to compare
32
description of the scapula
shoulder bone triangular, flat bone on posterolateral aspect of thorax overlies 2-7 ribs on posterior wall of thorax
33
acromion
highest portion of the scapula | continuation of the spine of the scapula, hooks to meet the clavicle
34
coracoid process
origin/insertion for 3 muscles on scapula: pectoralis minor short head of biceps brachii coracobrachialis
35
glenoid cavity
cavity under coracoid process articulates with head of humerus shallow, concave, oval faces slightly anterior and superior
36
functions of scapula
forms the shoulder allows attachment of muscles from axial skeleton and the upper limb enables free movement of the arm
37
epidemiology of fractures of the scapula
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)
38
management of scapula fractures
local tenderness and crepitus | 90% not significant, don't require surgery
39
humerus deltoid tuberosity
lateral side | attachment of deltoid
40
humerus radial groove
posterior | contains radial nerve and deep artery
41
humerus anatomical neck
groove circumscribing head and separating it from greater and lesser tubercles
42
humerus surgical neck
narrow part distal to tubercles and crests | common site for fracture
43
humerus medial supracondylar ridge and medial epicondyle (large)
muscle attachment for forearm flexors
44
humerus lateral supracondylar ridge and lateral epicondyle (smaller)
muscle attachment for forearm extensors
45
humerus capitulum
articulate with radial head
46
humerus trochlea
articulate with trochlear notch of ulna
47
humerus olecranon
elbow | posterior and superior to trochlea
48
nerve and vessel injuries related to humerus fractures
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
components of proximal ulna
``` 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
components of distal ulna
head of ulna | ulnar styloid process (bump on pinky side of wrist)
51
ulnar styloid process
site of attachment of triangular fibrocartilage attaching to distal radial bone
52
components of proximal radius
head of radius (articulates with capitulum of humerus and radial notch of ulna) neck of radius radial tuberosity
53
radial tuberosity
attachment for biceps brachii
54
body of the radius
convexes laterally | progressively enlarges distally
55
distal end of radius
``` ulna notch (articulates with head of ulna) radial styloid process (extends more distally than ulnar styloid) ```
56
interosseous membrane between ulna and radius
ties bones together flexible for pronation and supination attachment for some deep forearm muscles separates forearms into two compartments
57
joints at the elbow
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
subluxation and dislocation of the radial head
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
cause of olecranon fracture
direct fall on elbow, while elbow joint is flexed
60
appearance of olecranon fracture
olecranon pulled upward by the triceps
61
treatment of olecranon fracture
orthopedic surgical intervention required | pinning or plating
62
Colles Fracture description
complete transverse fracture within distal 2 cm of the radius may involve distal ulna as well
63
Colles fracture epidemiology
most common fracture of forearm | common in adults over 50 due to osteoporosis
64
cause of colles fracture
forced dorsiflexion of hand due to FOOSH and landing on outstretch limb with forearm and hand pronated
65
deformity associated with Colles fractures
dinner for appearance distal fragment is displaced dorsally and proximally radial styloid process moved proximally
66
types of hand bones
carpal (wrist) metacarpal (hand) phalanges (fingies)
67
orientation of carpal bones
8 total | 2 rows, 4 in each
68
orientation of metacarpals
5 total | thumb (1) to pinky (5)
69
orientation of phalanges
14 total 3 rows: proximal, middle, distal thumb only has proximal and distal
70
proximal row of carpals
~anterior (palmar) radial to ulnar orientation~ scaphoid lunate triquetrum pisiform (on palmar surface of triquetrum)
71
distal row of carpals
``` ~anterior (palmar) radial to ulnar orientation~ trapezium trapezoid capitate hamate ```
72
mnemonic for carpals
``` some (scaphoid) lovers (lunate) try (triquetrum) positions (pisiform) that (trapezium) they (trapezoid) cant (capitate) handle (hamate) ```
73
structure of metacarpals
base at proximal end body head at distal end
74
structure of phalanges
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
scaphoid fracture epidemiology
most frequently fractured bone of the wrist (70% of all carpal fractures) results from FOOSH
76
pain associated with scaphoid fracture
radial/lateral side of wrist, worsens with dorsiflexion and abduction more pain generated when you press into the anatomical snuff box
77
appearance of scaphoid fracture
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
nonunion in scaphoid fracture
may occur in 5-10% of cases
79
imaging for scaphoid fracture
MRI provides most info about soft tissue injuries | CT faster and more cost effective
80
boxers fracture
distal end of 5th metacarpal | punching objects
81
mallet finger
avulsion of extensor digitorum tendon (pulling of extensor tendon off of DIP) needs pins or sutures
82
jersey finger
avulsion of flexor digitorum profundus tendon into distal phalanx
83
4 segments of lower extremity
1. pelvic girdle (hip)- ilium, ischium, pubis 2. thigh - femus 3. leg - tibia and fibula 4. foot- tarsal, metatarsals, phalanges
84
joints of lower extremity
``` sacroiliac hip knee ankle foot: subtalar, transverse tarsal, tarsometatarsal, intermetatarsal, metatarsophalangeal, inter-phalangeal ```
85
components of proximal femur
``` head and neck greater trochanter lesser trochanter intertrochanteric line (anterior)/ ridge(posterior) gluteal tuberosity ```
86
components of middle femur
on posterior: linea aspera -lateral lip (lateral supracondylar line) -medial lip (medial supracondylar line)
87
linea aspera
insertion point for medial and lateral intermuscular septa of thigh
88
components of distal femur
``` lateral epicondyle/ condyle (smaller) medial epicondyle/ condyle (larger) patellar surface (anterior) adductor tubercle intercondylar notch intercondylar line popliteal surface (posterior) ```
89
angle of inclination of femur
angle decreases with age 145 - child 126- adult 120 - elderly
90
overview of femoral fractures
femoral neck (hip) fractures are more frequent femoral fracture happen in elderly injure the retinacular arteries causing bleeding and femoral head necrosis
91
retinaculum
band or band like structure that holds and organ or a part in place
92
significance of retinacular arteries
when injured, blood supply to femoral head is largely cut off run along femoral neck to head
93
epidemiology of patellar fracture
1% of all fractures males > females direct force applied to kneecap
94
treatment of patellar fracture
if fragments significantly displaced, pinning and wiring is generally required minimal displacement can be treated with bracing
95
tibia
shin bone
96
is the fibula a part of the knee joint?
no
97
common tibial fractures
most caused by direct force at middle to distal 1/3 junction | easily become compound fracture (break through skin)
98
tibial plateau fracture
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
fibular/lateral malleolar fractures
commonly occur 2-6 cm proximal to distal end of the lateral malleolus (end of fibula) associated with inversion of ankle joint
100
fibular fractures due to excessive eversion
fracture of lateral plus medial malleoli (bimalleolar fractures) omen over 60 most likely
101
bones of the foot
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
ligaments that make up the arch of the foot
plantar aponeurosis long plantar ligament plantar calcaneonavicular ligament
103
what is the posterior malleolus
a misnomer | posterior portion of the tibia
104
what is a trimalleolar fracture
a misnomer | lateral malleolar + medial malleolar + "posterior malleolar" fracture from severe ankle injury
105
what are the Ottawa ankle rules for
determine whether an xray is needed in an ankle injury
106
what are the Ottawa ankle rules
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
calcaneal fracture cause
person landing on feet following a fall or during a motor vehicle collision
108
jones fracture location
base of 5th metacarpal
109
jones fracture cause
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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