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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
Distal median claw hand would look like
on opening hand, pts 2-3 digits remain flexed (d/t loss of lateral lumbricals)
26
Proximal median claw hand would look like
inability to flex digits 1-3, while digits 4-5 are flexed (d/t loss of forearm flexors & lateral lumbricals)
27
Carpal Tunnel Syndrome
overuse of Flexor Retinaculum -> median n. entrapment
28
Causes of Carpal Tunnel Syndrome
"MEDIAN TRAP" | Myxedema, Edema, Diabetes, Idiopathic, Acromegaly, Neoplasm, Trauma, RA, Amyloidosis, Pregnancy
29
Radial n. injury causes
fracture to the body of the humerus, compression of nerve in axilla (Saturday night palsy), improper use of crutches -> wrist drop
30
Ulnar n. injury causes
medial epicondyle injury & hook of hamate fracture
31
Ulnar n. injury results in
the inability to abduct/adduct fingers, hypothenar eminence atrophy (on opening hand, digits 4-5 remain flexed d/t loss of median lumbricals)
32
How can you tell the difference b/w ulnar n. injury & a proximal median n. injury
ability to flex thumb - proximal median n. injury cannot flex thumb
33
Erb Duchenne Palsy
Lesion to C5-C6 (Upper trunk) - Most common brachial plexus injury; pulling superiorly on arm
34
Normal abduction of arm: ____ degrees
180
35
The normal 180 degree abduction, _____________ is accountable for 120 degrees
glenohumeral joint
36
The normal 180 degree abduction, _____________ is accountable for 60 degrees
scapulothoracic motion
37
Most common SD of the shoulder
restriction of IR/ER
38
2nd most common SD of the shoulder
restriction of abduction
39
Lest common SD of the shoulder
restriction of extension
40
Most common SD of sternoclavicular joint
anterior/superior clavicle on the sternum
41
Motion of the clavicle
the ends move in opposite directions & rotation around transverse axis
42
Most common SD of acromioclavicular joint
superior/lateral clavicle on the acromion
43
superior/lateral clavicle on the acromion - findings
"Step off" at AC joint
44
Ligaments of the acromioclavicular joint
acromioclavicular, coracoacromial, coracoclavicular ligaments
45
Thoracic Outlet Syndrome
compression of the subclavian a./v. & brachial plexus
46
Thoracic Outlet Syndrome - Compression occurs in what 3 places
b/w anterior & middle scaliness, b/w clavicle & rib 1, b/w pec minor & upper ribs
47
Thoracic Outlet Syndrome - S/S
neck pain radiating down arm, paresthesias, +Adsons
48
Supraspinatus tendinitis
impingement of the greater tuberosity against the acromion when arm is flexed + IR
49
Supraspinatus tendinitis - S/S
pain exacerbated by abduction, esp 60-120 "painful arc" may lead to calcification of mm
50
Bicipital tenosynovitis
inflammation of tendon & sheath of biceps long head d/t overuse, physiologic wear/tear, causing adhesions to bind tendon to bicipital groove
51
Bicipital tenosynovitis - S/S
anterior shoulder pain radiating to biceps + worsens w/ resisted flexion & supination
52
Rotator cuff tear
tear at insertion of 1 of the rotator cuff tendons
53
Rotator cuff tear - most common tendon torn
supraspinatus
54
supraspinatus tear - S/S
weakness in abduction +Droparm test, atrophy
55
Adhesive Capsulitis
pain & restriction of shoulder motion that worsens over a year
56
Adhesive Capsulitis - S/S
decreased ROM, extension is typically preserved
57
Adhesive Capsulitis etiology
prolonged immobility
58
What nerve is most commonly injured in shoulder dislocations?
Axillary n
59
Shoulder dislocations most commonly occur in which direction
Anterior & inferior dislocations
60
What nerve injury can cause winging of the scapula?
Long thoracic n. injury -> serratus anterior weakness
61
Erb-Duchenne palsy results in paralysis to which mm?
deltoid, external rotators, biceps, brachioradialis, supinators
62
Klumpke's palsy
C8-T1 lesions -> paralysis of intrinsic mm of the hand
63
List the Carpal bones starting from the lateral side
Scaphoid, Lunate, Triquetral, Pisiform, Trapezium, Trapezoid, Capate, Hamate
64
Most flexors of the wrist/hand originate from _______________ & are innervated by ___________
Medial epicondyle; Median n.
65
Most extensors of the wrist/hand originate from _______________ & are innervated by ___________
Lateral epicondyle; Radial n.
66
Supinators of the forearm
biceps (musculocutaneous n) & supinator (radial n)
67
Pronators of the forearm
pronator teres & pronator quadratus (median n)
68
Innervation to hypothenar eminence
ulnar n.
69
Innervation to thenar eminence
median n.
70
Innervation to 1-2 lumbricals
median n.
71
Innervation to 3-4 lumbricals
ulnar n.
72
Flexor digitorum profundus attaches to
DIPs
73
Flexor digitorum superficialis attaches to
PIPs
74
Normal carrying angle for males
5 degrees
75
Normal carrying angle for females
10-15
76
Carrying angle >15 is
abduction of the ulna (cubitus valgus)
77
Carrying angle < 3 is
adduction of the ulna (cubitus varus)
78
Abducted ulna will cause what motion at the wrist
adduction of the wrist
79
Adducted ulna will cause what motion at the wrist
abduction of the wrist
80
Radial head glides ______ with forearm supination
anterior
81
Radial head glides ______ with forearm pronation
posterior
82
Posterior radial head causes
falling forward on a pronated forearm
83
Anterior radial head causes
falling Backward on a supinated forearm
84
Carpal Tunnel Syndrome S/S
paresthesia of thumb & first 2.5 digits, +Tinels, +Phalen
85
Lateral epicondylitis
"Tennis elbow" - overuse of extensors & supinators
86
Medial epicondylitis
"Golfer's elbow" - overuse of flexors & pronators
87
Swan Neck Deformity
MCP/PIP/DIP = Flexed/Extended/Flexed d/t contracture of intrinsic mm of the hand
88
Boutonniere Deformity
MCP/PIP/DIP = Extended/Flexed/Extended d/t rupture of hood of the extensor tendon at PIP
89
Swan Neck Deformity & Boutonniere Deformity are associated w/
RA
90
Claw hand
MCP/PIP/DIP = Extended/Flexed/Flexed d/t median or ulnar n injury
91
Ape hand
Claw hand + thenar atrophy & thumb adduction d/t median n injury
92
Bishops deformity
contraction of the last 2 digits d/t ulnar n injury
93
Dupuytren's Contracture
MCP/PIP flexion contracture seen w/ flexion of the last 2 digits d/t contracture of the palmar fascia
94
Drop-wrist deformity
radial n injury -> paralysis of extensor m.
95
Which nerve only carries fibers from C5 root?
Dorsal scapular n.

COMLEX - OMED (20 decks)

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