Blue box Flashcards
Weakest part of the clavicle most prone to fracture
The junction of its middle and lateral thirds
What happens after a clavicle fracture
The SCM elevates the medial fragment of the bone. The lateral fragment can’t be held up by the trapezius and the shoulder drops
The clavicle is the first long bone to ______
ossify
What is the most frequently fractured part of the humerus
The surgical neck
What is a humeral fracture more commonly seen in middle aged and elderly people
An occlusion of the greater tubercle.
List the parts of the humerus that are in direct contact with the indicated nerves
Surgical neck - Axillary nerve
Radial groove - radial nerve
Distal end of humerus - median nerve
Medial epicondyle - Ulnar nerve
A UE fracture more commonly seen in women> 50, why?
Fracture of the distal end of the radius. . Due to osteoporosis.
What is a Colles fracture (claim to fame)
A complete transverse fracture of the distal 2cm of the radius. Its the most common fracture of the forearm
What is a dinner fork deformity
occurs with a Colles fracture of the radius, a posterior angulation occurs in the forearm proximal to the wrist. The bending is due to a posterior displacement of the distal fragment of the radius
Most frequently fractured carpal bone. What can happen due to it
the Scaphoid. Due to poor blood supply healing could take 3 months. That could result in bone death and degenerative bone disease
What is boxer’s fracture
Fracture of the 5th metacarpal - from punching something
A wing in the scapula is caused by
Serratus anterior paralysis due to injury to the long thoracic nerve;
What happens due to spinal accessory nerve (CN11) palsy
An ipsilateral weakness in the shoulders when elevated (shrugged) against resistance
What happens with there is an injury to the Thoracodorsal nerve
It supplies the latissimus dorsi. Injury to that would mean paralysis to the lats causing the person to be unable to raise the trunk with the upper limbs (when climbing)
Benefits of collateral circulation
when one artery is occulded the blood can reverse and go in a different direction to get to the needed site
when may compression of the axillary artery be needed (which part should be compressed)
During profuse bleeding (the 3rd part)
Where does the axillary vein lie
Anteriorly and inferiorly to the axillary vein (superficial) and parts of the brachial plexus
Two nerves at risk during axillary node dissection
The long thoracic and the thoracodorsal
What is a prefixed brachial plexus and a post fixed b.p.
Prefixed - When the superior most root is C4 and inferiormost is C8.
Post fixed - when the superior root is C6 and posterior is T2
Injuries to the superior parts of the brachial plexus (C5 and C6) usually result in
an excessive increase in the angle btwn the neack and shoulder. Medial trunk injury can create a ‘waiter’s tip’ position where the limb hangs by the side in medial rotation. It also results In paralysis of delts, bicps and brachialis (adducted sholder, medially rotated arm and extended elbow)
Injuries to the inferior parts of the brachial plexus
Less common but would results in affecting the short muscles of the hand and result in a closed hand.
What is ischemic compartment syndrome
A flexion deformity usually due to occlusion of the brachial artery for more than 6 hours. After a fibrous scar tissue replaces necrotic tissue causes the muscles around to shorten permanently
Classical clinical sign of a radial nerve injury
A wrist drop or inability to extend the wrist and fingers at the metacarpophalangeal joints
Elbow tendonitis is usually due to
strain of the superficial extensor muscles. THe pain is felt over the lateral epicondyle and radiates down the posterior surface of forearm
A ‘fractured elbow’ usually is
a fracture to the olecranon
What happens in a median nerve injury
Loss in finger flexion 1-3 lost, 4-5 weakened . OK sign looks pinched
What happens in an injury to the ulnar nerve
Usually in elbow - numbness in palm and medial 1/2 of fingers . Trouble making fist and claw hand when trying to straighten fingers
Dupuytren Contracture
A disease of the palmar fascia resulting in progressive shortening, thickening and fibrosis of the plamar fascia and apeneurosis. Can’t straighten hand. Usually 50+
Carpal tunnel syndrome
Any lesion that significantly reduces the size of the carpal tunnel or increase the size of some of the 9 structures or their coverings that pass thru it. Median nerve is the most sensitive structure in the tunnel
Dermatoglyphics
the science of studying ridge patterns in the palm (can detect downs syndrome)
Apophyses
Bony projections that lack a secondary ossification center.
Coxa vara and Coxa valga
Concerns the angle of inclination between the long axis of the femoral neck and the femoral shaft. Coxa vara is when the angle of inclination is decreased. Coxa valga is when it is increased
A psoas abscess can result from
A retroperitoneal pyogenic infection maybe with TB
when does the patella ossify
During the 3rd to 6th years
The patellar tendon reflex is testing the intergrity of
the femoral nerve
Saphenous Varix
A localized dilation of the great saphenous vein, it may cause edema in the femoral triangle
Where can the Femoral vein be located
Inferior to the inguinal ligament
Test for gluteal nerve injurty
Trendleburg test - stand on one leg and the pelvis on the unsupported side descends indicated ithe gluteus medius and minimus on supported side are weak
Where is the safe place to do an intraglutal injection
only in the superolateral quadrant of the buttocks (superior to the PSIS)
Best way to find a popliteal pulse
person in prone position with knee flexed to relax the popliteal fascia and hamstrings
