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COMLEX - OMED > Chapter 7 - Upper Extremity > Flashcards

Chapter 7 - Upper Extremity Flashcards

1
Q

Only bone connecting the UE & axial skeleton

A

clavicle

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2
Q

Shoulder joints

A

acromioclavicular, sternoclavicular, glenohumeral, scapulothoracic (pseudo-joint)

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3
Q

4 muscles of the rotator cuff

A

SITS (supraspinatus, infraspinatus, teres minor, subscapularis)

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4
Q

supraspinatus action

A

abduction of arm

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5
Q

infraspinatus action

A

external rotation of arm

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6
Q

teres minor action

A

external rotation of arm

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7
Q

subscapularis action

A

internal rotation of arm

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8
Q

Deltoid action

A

primary flexor (Ant) & abductor (middle) & primary extensor (Post)

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9
Q

Latissimus dorsi action

A

Extensor & Adductor

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10
Q

Teres major action

A

Extensor

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11
Q

Pectoralis major action

A

Adductor

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12
Q

Subclavian a. passes b/w which muscles?

A

anterior & middle scalenes

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13
Q

Subclavian v. passes

A

anterior to the anterior sclene

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14
Q

Subclavian a. becomes the _____________ at the ______________

A

Axillary a. at the lateral border of the first rib

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15
Q

Axillary a. becomes the _____________ at the ______________

A

brachial a. at the inferior border of the teres minor mm

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16
Q

1st major branch of the brachial a.?

A

profunda brachial a.

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17
Q

profunda brachial a. accompanies which nerve?

A

radial n. as it passes posteriorly

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18
Q

Brachial a. divides into _________&___________ at the

A

ulnar a. & radial a. at the bicipital aponeurosis

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19
Q

Which artery supplies the lateral forearm & forms the deep palmar arterial arch?

A

Radial a.

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20
Q

Which artery supplies the medial forearm & forms the superficial palmar arterial arch?

A

Ulnar a.

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21
Q

OMT for lymph congestion of UE

A

thoracic inlet, re-dome diaphragm, & posterior axillary fold

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22
Q

Surgical neck of humerus fracture -> inability to abduct arm from 15-90 -> which nerve is injured?

A

Axillary n.

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23
Q

Which branch of the median n. supplies the thenar eminence?

A

recurrent branch of median n.

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24
Q

Median n. injury causes

A

carpal tunnel syndrome, lunate dislocation, supracondylar fracture of the humerus

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25
Q

Distal median claw hand would look like

A

on opening hand, pts 2-3 digits remain flexed (d/t loss of lateral lumbricals)

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26
Q

Proximal median claw hand would look like

A

inability to flex digits 1-3, while digits 4-5 are flexed (d/t loss of forearm flexors & lateral lumbricals)

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27
Q

Carpal Tunnel Syndrome

A

overuse of Flexor Retinaculum -> median n. entrapment

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28
Q

Causes of Carpal Tunnel Syndrome

A

“MEDIAN TRAP”

Myxedema, Edema, Diabetes, Idiopathic, Acromegaly, Neoplasm, Trauma, RA, Amyloidosis, Pregnancy

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29
Q

Radial n. injury causes

A

fracture to the body of the humerus, compression of nerve in axilla (Saturday night palsy), improper use of crutches -> wrist drop

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30
Q

Ulnar n. injury causes

A

medial epicondyle injury & hook of hamate fracture

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31
Q

Ulnar n. injury results in

A

the inability to abduct/adduct fingers, hypothenar eminence atrophy (on opening hand, digits 4-5 remain flexed d/t loss of median lumbricals)

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32
Q

How can you tell the difference b/w ulnar n. injury & a proximal median n. injury

A

ability to flex thumb - proximal median n. injury cannot flex thumb

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33
Q

Erb Duchenne Palsy

A

Lesion to C5-C6 (Upper trunk) - Most common brachial plexus injury; pulling superiorly on arm

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34
Q

Normal abduction of arm: ____ degrees

A

180

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35
Q

The normal 180 degree abduction, _____________ is accountable for 120 degrees

A

glenohumeral joint

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36
Q

The normal 180 degree abduction, _____________ is accountable for 60 degrees

A

scapulothoracic motion

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37
Q

Most common SD of the shoulder

A

restriction of IR/ER

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38
Q

2nd most common SD of the shoulder

A

restriction of abduction

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39
Q

Lest common SD of the shoulder

A

restriction of extension

40
Q

Most common SD of sternoclavicular joint

A

anterior/superior clavicle on the sternum

41
Q

Motion of the clavicle

A

the ends move in opposite directions & rotation around transverse axis

42
Q

Most common SD of acromioclavicular joint

A

superior/lateral clavicle on the acromion

43
Q

superior/lateral clavicle on the acromion - findings

A

“Step off” at AC joint

44
Q

Ligaments of the acromioclavicular joint

A

acromioclavicular, coracoacromial, coracoclavicular ligaments

45
Q

Thoracic Outlet Syndrome

A

compression of the subclavian a./v. & brachial plexus

46
Q

Thoracic Outlet Syndrome - Compression occurs in what 3 places

A

b/w anterior & middle scaliness, b/w clavicle & rib 1, b/w pec minor & upper ribs

47
Q

Thoracic Outlet Syndrome - S/S

A

neck pain radiating down arm, paresthesias, +Adsons

48
Q

Supraspinatus tendinitis

A

impingement of the greater tuberosity against the acromion when arm is flexed + IR

49
Q

Supraspinatus tendinitis - S/S

A

pain exacerbated by abduction, esp 60-120 “painful arc” may lead to calcification of mm

50
Q

Bicipital tenosynovitis

A

inflammation of tendon & sheath of biceps long head d/t overuse, physiologic wear/tear, causing adhesions to bind tendon to bicipital groove

51
Q

Bicipital tenosynovitis - S/S

A

anterior shoulder pain radiating to biceps + worsens w/ resisted flexion & supination

52
Q

Rotator cuff tear

A

tear at insertion of 1 of the rotator cuff tendons

53
Q

Rotator cuff tear - most common tendon torn

A

supraspinatus

54
Q

supraspinatus tear - S/S

A

weakness in abduction +Droparm test, atrophy

55
Q

Adhesive Capsulitis

A

pain & restriction of shoulder motion that worsens over a year

56
Q

Adhesive Capsulitis - S/S

A

decreased ROM, extension is typically preserved

57
Q

Adhesive Capsulitis etiology

A

prolonged immobility

58
Q

What nerve is most commonly injured in shoulder dislocations?

A

Axillary n

59
Q

Shoulder dislocations most commonly occur in which direction

A

Anterior & inferior dislocations

60
Q

What nerve injury can cause winging of the scapula?

A

Long thoracic n. injury -> serratus anterior weakness

61
Q

Erb-Duchenne palsy results in paralysis to which mm?

A

deltoid, external rotators, biceps, brachioradialis, supinators

62
Q

Klumpke’s palsy

A

C8-T1 lesions -> paralysis of intrinsic mm of the hand

63
Q

List the Carpal bones starting from the lateral side

A

Scaphoid, Lunate, Triquetral, Pisiform, Trapezium, Trapezoid, Capate, Hamate

64
Q

Most flexors of the wrist/hand originate from _______________ & are innervated by ___________

A

Medial epicondyle; Median n.

65
Q

Most extensors of the wrist/hand originate from _______________ & are innervated by ___________

A

Lateral epicondyle; Radial n.

66
Q

Supinators of the forearm

A

biceps (musculocutaneous n) & supinator (radial n)

67
Q

Pronators of the forearm

A

pronator teres & pronator quadratus (median n)

68
Q

Innervation to hypothenar eminence

A

ulnar n.

69
Q

Innervation to thenar eminence

A

median n.

70
Q

Innervation to 1-2 lumbricals

A

median n.

71
Q

Innervation to 3-4 lumbricals

A

ulnar n.

72
Q

Flexor digitorum profundus attaches to

A

DIPs

73
Q

Flexor digitorum superficialis attaches to

A

PIPs

74
Q

Normal carrying angle for males

A

5 degrees

75
Q

Normal carrying angle for females

A

10-15

76
Q

Carrying angle >15 is

A

abduction of the ulna (cubitus valgus)

77
Q

Carrying angle < 3 is

A

adduction of the ulna (cubitus varus)

78
Q

Abducted ulna will cause what motion at the wrist

A

adduction of the wrist

79
Q

Adducted ulna will cause what motion at the wrist

A

abduction of the wrist

80
Q

Radial head glides ______ with forearm supination

A

anterior

81
Q

Radial head glides ______ with forearm pronation

A

posterior

82
Q

Posterior radial head causes

A

falling forward on a pronated forearm

83
Q

Anterior radial head causes

A

falling Backward on a supinated forearm

84
Q

Carpal Tunnel Syndrome S/S

A

paresthesia of thumb & first 2.5 digits, +Tinels, +Phalen

85
Q

Lateral epicondylitis

A

“Tennis elbow” - overuse of extensors & supinators

86
Q

Medial epicondylitis

A

“Golfer’s elbow” - overuse of flexors & pronators

87
Q

Swan Neck Deformity

A

MCP/PIP/DIP = Flexed/Extended/Flexed d/t contracture of intrinsic mm of the hand

88
Q

Boutonniere Deformity

A

MCP/PIP/DIP = Extended/Flexed/Extended d/t rupture of hood of the extensor tendon at PIP

89
Q

Swan Neck Deformity & Boutonniere Deformity are associated w/

A

RA

90
Q

Claw hand

A

MCP/PIP/DIP = Extended/Flexed/Flexed d/t median or ulnar n injury

91
Q

Ape hand

A

Claw hand + thenar atrophy & thumb adduction d/t median n injury

92
Q

Bishops deformity

A

contraction of the last 2 digits d/t ulnar n injury

93
Q

Dupuytren’s Contracture

A

MCP/PIP flexion contracture seen w/ flexion of the last 2 digits d/t contracture of the palmar fascia

94
Q

Drop-wrist deformity

A

radial n injury -> paralysis of extensor m.

95
Q

Which nerve only carries fibers from C5 root?

A

Dorsal scapular n.

COMLEX - OMED (20 decks)

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