Blue Boxes 1: Arm and Cubital Fossa/Forearm/Hand Flashcards
What does the biceps reflex test?
Musculocutaneous nerve and the C5 and C6 spinal cord segments
What is biceps tendinitis?
Inflammation of the tendon of the long head of the biceps that moves back and forth withing the bicipital groove inside its synovial sheath
Where is the common place for the biceps tendon to tear?
From its attachment to the supraglenoid tubercle of the scapula
What is the clinical term for stopping bleeding through manual or surgical control of blood flow?
hemosatsis
Where is the best place to compress the brachial artery to control hemorrhage?
Medial to the humerus near the middle of the arm
How long can muscles and nerves tolerate ischemia?
Up to 6 hours
What is ischemic compartment syndrome?
When scar tissue replaces necrotic tissue and causes the involved muscles to shorten permanently
A midhumeral fracture may injure what nerve?
Radial going through the radial groove
Will a lesion of the radial nerve in the redial groove paralyze the triceps?
No because of the high origin of the nerves to two of its three heads, only medial head is affected
A musculocutaneous nerve injury results in the paralysis of what muscles?
coracobrachialis, biceps, and brachialis
What is the cutaneous innervation of the musculocutaneous nerve
the lateral antebrachial cutaneous nerve
What is the characteristic clinical sign of radial nerve injury?
wrist drop
What vein is most commonlyy selected for venus punctures?
Median cubital
What provides some protection during venus blood draws in the cubital fossa region?
bicipital aponeurosis
It separates the median cubital vein from the underlying brachial artery and median nerve
Where is tennis elbow pain felt?
Over the lateral epicondyle, they often feel pain when they open a door or lift a glass
Tennis elbow is a problem with tendons
What tendon usually causes the pain in tennis elbow?
ECRB
What is mallet finger?
The extensor tendon is torn off the distal ip joint
Why is a fracture of the olecranon common?
Because the olecranon is subcutaneous and protrusive
Why is pinning usually required to repair a fractured olecranon?
The fractured olecranon is pulled away by the active and tonic contraction of the triceps.
Where on the hand are synovial cysts usually found?
Dorsum of the wrist
The distal attachment of ECRB tendon to the base of the 3rd metacarpal
Where is the common place to measure pulse rate?
Where the radial artery lies on the anterior surface of the distal end of the radius, lateral to the tendon of the FCR
Why shouldn’t you use the pulp of the thumb when measuring the radial pulse rate?
Because the thumb has its own pulse
When a superficial vessel is pulsating near the wrist, it is probably a superficial what?
Radial artery
Is FDP affected when the median nerve is severed in the elbow?
Only the lateral head of FDP would be affected, the medial part is innervated by the ulnar
What lesion produces the hand of benediction?
Median nerve lesion
When the anterior interosseous nerve is injured, what is affected?
The thenar muscles are unaffected, by partial paralysis of the flexor digitorumm profundus and flexor pollicis longus occurs
Anterior interosseous syndrome is characterized by what hand position?
Abnormal “pinch” sign rather than a normal “ok” sign
Can’t flex the distal IP joint of first finger (FDP) and the IP of the thumb (FPL)
What nerve is compressed in pronator syndrome?
The median nerve is compressed between the heads of the pronator teres.
Often caused by activities that require consistent pronation
Communication between median and ulnar nerves is uncommon. What clinical challenge does it provide?
Even if there is a complete lesion of one nerve, some muscles may not be paralyzed
Where are the common places for the ulnar nerve to become entraped?
Posterior to the medial epicondyle of the hmerus
In the cubital tunnel between the humeral and ulnar heads of the FCU
In the hand
In Guyon’s Canal
What nerve is responsible for the “funny bone”
ulnar
What clinical hand sign is the result of a distal lesion of the ulnar nerve?
Claw hand
What is cubital tunnel syndrome?
compresson of the ulnar nerve between the two heads of FCU
Does loss of sensation occur in a deep branch of the radial nerve lesion?
No, the deep radial nerve is entirely muscular
How do you test the integrity of the deep branch of the radial nerve?
Ask the person to extend the MP joints while the examiner provides resistance. If the nerve is intact the long extensor tendons should appear prominently on the dorsum of the hand.
