Chap 123 Occupational Flashcards
What occupational vascular syndromes are caused by manual labor?
Hand-arm vibration syndrome
Hypothenar hammer syndrome
What are symptoms of HAVS?
intermittent numbness or tingling progressing to extensive blanching
1 hour attack with reactive hyperaemia
How is diagnosis made of HAVS?
provocation and history of raynauds with vibration tool
What are arteriographic changes in HAVS?
multiple segmental occlusions of digits
corkscrew configuration of vessels in hand
incomplete palmar arch
What is HAVS treatment
CCB
IV prostanoids
cervical of digital sympathectomy
Where and how does injury occur in HHS?
ulnar travels in guyon’s canal bound by pisiform and hamate bones, only covered by skin
repetitive injury to this site
vasospasm and plt aggregation and thrombus with distal embo
What are symptoms in HHS?
raynauds, involves ulanr three digits (not thumb)
What are treatments for HHS?
smoking cessation
anticoag
CCB
reconstruction/ligation
Name three exposure injuries.
occupation acro-osteolysis
electrical burns
thermal injuries
What is acro-osteolysis?
exposure to polyvinyl chloride
raunauds, clubbin
angio–multiple stenosis with hypervascularity adjacent to the bone of reabsorption
What is the vascular run jury with electrical burns?
Arterial necorsis, thrombus, bleeding, and gangrene of digits, aneurysm formation
What profession get thermal injuries?
exposure to cold, slaughterhouse, canning factories, fisheries
What are some injuries that athletes get?
hand ischemia
quadrilateral space syndrome
humeral head compression of axillary artery
TOS
What kind of athletes get these injuries and what are the symptoms?
baseball, volleyball, karate, swimming, golf, weightlifting
raynauds, aterial occlusion, embo to digits
What is the mechanism of injury in hand ischemia?
digital artery injury
embolization from proximal source
What are the mechanisms which cause hand ischemia?
direct injury (baseball catchers) compression of digital artery by cleland ligament
What is treatment for hand ischemia?
IV dextran and pain control
sx–digital sympathectomy, release of clelands ligament
prevention
Describe the quadrilateral space. What travels in it?
Bordered by teres minor, humeral shaft, tere minor, and long head of tricpes
Within the space posterior humeral circumflex artery and axillary nerve
Who gets QSS? What vascular abnormalities do they get?
pitcher, volleyball (cocked position)
aneurysm with embo (to hand), occlusions
from compression of the posterior circumflex artery
What is the aetiology of HHCAA?
compression of third portion of axillary artery by head of humerus
What are the symptoms of HHCAA?
numbness of fingers, raynauds, cutaneous embolization
What is treatment?
modification of throwing
saphenous vein patch, bypass
Name sites or injury and the vessel injured that can digital symptoms.
Scalene triangle, subclavian artery subcoracoid space, axillary artery cleland ligament, digital artery direct injury, digital artery guyon's space, ulnar artery quadrilateral space, posterior circumflex artery humeral head, axillary artery
How is raynauds with HHS distinguishable from other presentation of raynauds?
Predominance male smokers
Usually lacks reactive hyperaemia
Usually dominant hand
Repetitive trauma to hand
