Chap 123 Occupational

Question 1

What occupational vascular syndromes are caused by manual labor?

Answer 1

Hand-arm vibration syndrome

Hypothenar hammer syndrome

Question 2

What are symptoms of HAVS?

Answer 2

intermittent numbness or tingling progressing to extensive blanching
1 hour attack with reactive hyperaemia

Question 3

How is diagnosis made of HAVS?

Answer 3

provocation and history of raynauds with vibration tool

Question 4

What are arteriographic changes in HAVS?

Answer 4

multiple segmental occlusions of digits
corkscrew configuration of vessels in hand
incomplete palmar arch

Question 5

What is HAVS treatment

Answer 5

CCB
IV prostanoids
cervical of digital sympathectomy

Question 6

Where and how does injury occur in HHS?

Answer 6

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

Question 7

What are symptoms in HHS?

Answer 7

raynauds, involves ulanr three digits (not thumb)

Question 8

What are treatments for HHS?

Answer 8

smoking cessation
anticoag
CCB
reconstruction/ligation

Question 9

Name three exposure injuries.

Answer 9

occupation acro-osteolysis
electrical burns
thermal injuries

Question 10

What is acro-osteolysis?

Answer 10

exposure to polyvinyl chloride
raunauds, clubbin
angio–multiple stenosis with hypervascularity adjacent to the bone of reabsorption

Question 11

What is the vascular run jury with electrical burns?

Answer 11

Arterial necorsis, thrombus, bleeding, and gangrene of digits, aneurysm formation

Question 12

What profession get thermal injuries?

Answer 12

exposure to cold, slaughterhouse, canning factories, fisheries

Question 13

What are some injuries that athletes get?

Answer 13

hand ischemia
quadrilateral space syndrome
humeral head compression of axillary artery
TOS

Question 14

What kind of athletes get these injuries and what are the symptoms?

Answer 14

baseball, volleyball, karate, swimming, golf, weightlifting

raynauds, aterial occlusion, embo to digits

Question 15

What is the mechanism of injury in hand ischemia?

Answer 15

digital artery injury

embolization from proximal source

Question 16

What are the mechanisms which cause hand ischemia?

Answer 16

direct injury (baseball catchers)
compression of digital artery by cleland ligament

Question 17

What is treatment for hand ischemia?

Answer 17

IV dextran and pain control
sx–digital sympathectomy, release of clelands ligament
prevention

Question 18

Describe the quadrilateral space. What travels in it?

Answer 18

Bordered by teres minor, humeral shaft, tere minor, and long head of tricpes
Within the space posterior humeral circumflex artery and axillary nerve

Question 19

Who gets QSS? What vascular abnormalities do they get?

Answer 19

pitcher, volleyball (cocked position)
aneurysm with embo (to hand), occlusions
from compression of the posterior circumflex artery

Question 20

What is the aetiology of HHCAA?

Answer 20

compression of third portion of axillary artery by head of humerus

Question 21

What are the symptoms of HHCAA?

Answer 21

numbness of fingers, raynauds, cutaneous embolization

Question 22

What is treatment?

Answer 22

modification of throwing

saphenous vein patch, bypass

Question 23

Name sites or injury and the vessel injured that can digital symptoms.

Answer 23

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

Question 23

How is raynauds with HHS distinguishable from other presentation of raynauds?

Answer 23

Predominance male smokers
Usually lacks reactive hyperaemia
Usually dominant hand
Repetitive trauma to hand