Blue boxes Flashcards
Excision and pathologic analysis of axillary lymph nodes are often necessary for what?
Staging and determining appropriate treatment for cancer (ex. breast cancer)
Why is it important to remove and evaluate axillary lymph nodes in a specific order?
Axillary lymph nodes are arranged and recieve lymph in a specific order, important to remove in this order to determine progression of cancer
What is a sentinel lymph node biopsy?
Only nodes with potential of draining the tumor site are removed/examined for less chance of injury to surrounding tissues
What could cause lymphedema (swelling of accumulated lymph) in the subcutaneous tissue?
Impaired lymphatic drainage due to removal/radiation of lymph nodes
Which nerves are at risk for injury during an axillary node dissection?
Long thoracic nerve and thoracodorsal nerve
If the long thoracic nerve is cut during surgery, what could happen?
Winged scapula
If the thoracodorsal nerve is cut during surgery, what could happen?
Medial rotation and adduction of the arm are weakened
In a case of a tumor around the long thoracic nerve and the thoracodorsal nerve, would you remove the tumor or spare the nerves?
Remove the tumor cells, nerve may have to be sacrificed to remove malignancy
What is dupuytren contracture?
A disease of the palmar fascia that results in progressive shortening/thickening/fibrosis of the palmar aponeurosis
If the palmar aponeurosis is shortened/thickened on the medial side of the hand, what would happen?
The 4th and 5th fingers (ring finger and pinky finger) will be pulled into partial flexion at the MCP and PI joints
Is dupuytren contracture unilateral or bilateral?
Commonly bilateral
Who is dupuytren contracture most commonly seen in?
Men over 50
What is the cause of dupuytren contracture?
Unknown but could be hereditary
How does dupuytren contracture first manifest?
Painless nodular thickening of the palmar aponeurosis that adhere to skin
How does dupuytren contracture progress?
Contracture of longitudinal bands of palmar aponeurosis causes raised ridges in palmar skin
The raised ridges of the palmar aponeurosis during dupuytren contracture extend from which areas of the hand?
From the proximal part of the hand to the base of the 4th and 5th digits (ring finger and pinky)
What is the treatment for dupuytren contracture?
Usually surgery to remove the fibrotic tissue of the palmar fascia to free fingers
Fractures of the radius and ulna are often inncomplete in which age population?
Children, “greenstick fractures”
Fractures of both the radius and ulna in adults are often due to what?
Severe injury
Direct injury will result in transverse fractures at what levels of the radius and ulna?
Usually at the same levels (middle third of the bones)
Do isolated fractures of the radius and ulna ever occur?
Yes
Due to the radius and ulna being held together by the interosseous membrane, what does a fracture of these bones usually involve?
Dislocation of the nearest joint
What fracture is common in adults 50 years and over? Who is more prone to these?
Fracture of the distal end of the radius, women with osteoporosis more prone
What is a colles fracture?
A complete transverse fracture of the distal 2cm of the radius *most common fracture of the forearm
During a colles fracture, how is the distal fragment of the radius affected?
Distal fragment is displaced dorsally and often comminuted (broken into pieces)
How do colles fractures often occur?
Forced extension of the hand, usually from bracing a fall
What is often broken off (avulsed) during a colles fracture?
Radial styloid process
What happens to the radial styloid and ulnar styloid relationship during a colles fracture?
It is reversed, the ulnar syloid now projects more distally than the radial styloid caused by shortening of the radius
What is a dinner fork deformity (from colles fracture)?
Posterior angulation/bending occurs in the forearm just proximal to the wrist due to the posterior displacement of the distal fragment of the radius
When the distal end of the radius fractures in children, the fracture line may extend through what?
The distal epiphyseal plate *may result in malalignment of the plate/disturb radial growth
Who are distal epiphyseal plate injuries more common in?
Older children because of their frequent falls
