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MSK > Clinical Correlation > Flashcards

Clinical Correlation Flashcards

1
Q

dermatome testing

A
  • integrity of ascending neuronal system
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2
Q

referred pain

A
  • brain misinterprets inside pain to outside because there is only axon tract for pain leading to brain
  • GVA that parallel sympathetic splanchnic nn. return to the identical spinal cord levels of visceral efferent innervation
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3
Q

angina pectoris

A
  • radiation of pain from thorax down left upper limb
  • pain fibers associated with sympathetics from T1-T4
  • T1-T3 dermatomes
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4
Q

Subdiaphragmatic irritation

A
  • due to peritonitis, gall bladder inflammation, hepatic abscess, pleurisy, or accumulatons of CO2 aftery surgery
  • pain referred to tip of shoulder
  • phrenic nerve C3, C4, C5
  • supraclavicular nerve C3, C4
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5
Q

Peau d’orange

A
  • dimpling of skin over breast

- due to tightening of suspensory ligament bc of tumor growth

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6
Q

dupuytren’s contracture

A
  • thickening and contraction of longitudinal connective tissue of palmar aponeurosis
  • draws finger into palm
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7
Q

subacromial/subdeltoid bursitis

A
  • inflammation with pain and swelling within synovial space of bursa surrounding glenohumeral joint or shoulder joint
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8
Q

olecranon bursitis

A
  • inflammation of bursa surrounding olecranon
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9
Q

ganglion cyst

A
  • contraction and thickening of tendons sheath at extensor surface of wrist
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10
Q

dequervian’ disease

A

inflammation of synovial sheath (ganglion cyst) surrounding extensor pollicis brevis
- abductor pollicis longus (inflammed in 1st compartment)

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11
Q

trigger finger

A
  • inflammation of bursa and swelling in synovial membrane

- ganglion cyst on tendon can’t extend finger

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12
Q

Axilla injuries

A
  1. stretching brachial plexus nerves due to humeral dislocation
  2. tumor (lymphoma, panacost)
  3. compression of axillary artery to stop distal profuse bleaeding
  4. location of neoplastic nodules
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13
Q

Cubital fossa

A
  1. TAN (lateral to medial)
    - tendon of biceps, brachial artery, median nerve
    - take care during venapuncture
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14
Q

carpal tunnel syndrome

A
  • inflammation compresses median nerve as it passes through cubital fossa
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15
Q

radial (flexor pollicis longus sheath)
ulnar (common flexor- profundus and superificalis) bursa
tenosynovitis

A
  • inflammation of synovial tendon sheaths

- distension with pus

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16
Q

deep palmar spaces

A

thenar and medial space can spread infection

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17
Q

clavicle

A
  • 1st bone to start ossifying; last bone to complete
  • used in autopsy to analyze age at death
  • most commonly broken bone
  • greenstick fracture
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18
Q

medial clavicular dislocation

A
  • can place press on carotid sheath
  • compromise arterial supply
  • mechanical stimulation of vagus nerve causes deceased heart rate and contractility (parasympathetic innervation to heart)
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19
Q

acromioclavicular separation

A
  • stretching or rupture of acromioclavicular or coracoclavicular ligaments
  • graded:
    1- stretched ligaments
    2- torn AC logs with stretch CC ligs
    3- torn AC and CC with increase in clavicular space (3-5 X)
    4&5- torn AC and CC with increase in clavicular space ( greater increase in space)
    6- rupture AC and CC ligaments with inferior clavicular dislocation
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20
Q

adhesive capsulitis

A
  • frozen shoulder
  • thickened, fibrotic, inflamed, and shrunken capsule
  • decreased range of motion (active and passive)
  • cause by arthritis, bursitis, tendonitis, inactivity, post surgical complications
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21
Q

Rotator cuff

A
  • erosion of tearing of SITS muscles
  • most often supraspinatus
  • lifting to much or catching heavy falling object
  • erosion by osteophytes from arthritic AC joint that grow downwards
22
Q

calcific tendinosis of supraspinatus tendon

A
  • erosion and inflammation of supraspiantus tendon via osteophyes
  • inflammation causes tendon calcification
  • results in less elasticity and brittle tendon
    = prone to rupture
    ** can see in xray
23
Q

rupture of long head of biceps

A
  • intracapsular tendon becomes inflamed and erodes over time
24
Q

bicipital tendonitis

A
  • inflammation of synovial sheath surrounding tendon of long head of biceps within intratubercular groove
  • can lead to dislocation of long head of biceps from inter tubercular groove
25
Q

posterior shoulder dislocation

A
  • 5% (less common)

- arm held in adduction; inability to laterally rotate humerus

26
Q

anterior shoulder dislocation

A
  • 95% (most commone)
  • loss of normal shoulder contour
  • muslces pull head of humerus into axilla
  • prominent humeral head anterior
  • parathesis in axillary and musculocutaneous nerve distribution
27
Q

humero-ulnar dislocation

A
  • movement of ulnar and radius posteriorly

- can cause stretching within fibroosseous canal of strutters

28
Q

Radial head subluxation

A
  • movement of radial head from annular ligament of radius

- occurs more often in children when jerked off ground when forearm pronated

29
Q

displacement of distal radial epiphysis

A
  • youth most often

- occurs when falling on outstretched hand

30
Q

clavicular fracture

A
  • most often in adolescents

- occurs when falling on outstretched hand

31
Q

colle’s fracture

A
  • occurs in elderly most often
  • when falling on outstretched hand
  • fracture to distal radius approx 1 in proximal to radiocarpal joint
  • *silver fork deformity
32
Q

scaphoid fracture

A
  • most often fracture carpal bone
  • can get avascular necrosis
  • distal portion contains artery entrance site proximal won’t get nutirents
33
Q

lunate dislocation

A
  • most often dislocated carpal bone

- can impinge carpal tunnel

34
Q

skier’s thumb (game keeps thumb)

A
  • rupture ulnar collateral ligament of metacarpophalangeal joint of thumb
35
Q

collateral anastomosis

A
  • shoulder (circumflex scapular etc)
  • elbow (collaterals and recurrents)
  • hand (arches superficial and deep)
36
Q

compression site

A
  • axillary- proximal humerus
  • brachial- medial to anterior humerus
  • ulnar- distal wrist lateral to pisiform
  • radial- distal anterior radius, snuff box and 1 dorsal digit
37
Q

raynaud’s disease

A
  • increased sympathetic innervation to blood vessels
  • increased vasoconstriction causes decreed flow
  • cold/ blue finger tips
  • can cause necrosis of fingers due to reduced profusion
  • cervicodorsal preganglionic sympathectomy
38
Q

deep vein thrombosis

A
  • clots that forms within vessel
  • can travel to heart, lungs, brain
  • due to reduced physical activity
  • weakened muscular fascia
39
Q

lymphangitis

A
  • inflammation of lymph vessels

- visible red streaks

40
Q

lymphadenitis

A
  • inflamed lymph nodes as a result of lymphagitis
41
Q

tendon reflex

A
  • biceps- C5 and C6

- triceps- C7 and C8

42
Q

erb- duchenne’s palsy

A
  • injury to C5 and C6 roots or upper trunk
  • due to falling on shoulder and head
  • loss of flexors of forearm and lateral rotators
  • medial rotators take over
  • limb held in “waiter’s tip” position
  • can also get it from delivery*
43
Q

Klumpke’s palsy

A
  • injury to C8 and T1 at nerve roots or lower trunk
  • happens when catching one’s self in hanging position while falling
  • lose of intrinsic hand muscles (interosseous, lumbricles- lose balance between flexors and extensor)
  • causes claw hand- due to loss of muscle balance
44
Q

winged scapula

A
  • long thoracic nerve
  • superficial to serratus anterior
  • can’t abduct limb
  • loss of scapular fixation
45
Q

axillary nerve injury

A
  • most common as it passes around humerus in quadrangular space
  • due to poor crutch placement, downward glenohumeral dislocation, fracture to surgical neck of humerus)
    results in:
    -wasting of deltoid contour
    -decreased abduction and flexion of arm
  • loss of cutaneous sensation over lower 1/2 deltoid
46
Q

Radial nerve injury

A
  • injury to nerve as it exits axilla and winds around radial groove
  • poor crutch placement, falling asleep with arm over back of chair, fracture to upper humerus, downward dislocation of glenohumeral joint
  • results in wrist drop due to loss of innervation of extensors
  • chronic- get flexor contractures
47
Q

Musculocutaneous nerve injury

A
  • can be caused by traumatic rupture of coracobrachialis
  • loss of forearm flexion and supination
  • loss of cutaneous sensation to lateral forearm
48
Q

median nerve injury

A
  • injurie at elbow due to medial supracondylar humeral fracture or humero-ulnar dislocation
  • results in APE HAND
  • decreased wrist flexion, supinaiton of hand, thumb in neutral position and wasting of thenar eminence
49
Q

carpal tunnel syndrome

A
  • increased activity of wrist results in edema, compression, and inflammation of median nerve
  • Symptoms:
  • parathesis 3.5 fingers
  • paresis upon flexion, abduction, and opposition of thumb
  • wasting thenar eminence
  • loss of fine motor control 2 and 3 digits due to paralysis of 1 and 2 lumbricals (median claw)
  • loss of opposition- loss of grasp reflex

**falls on outstretched hand can injury recurrent branch of median nerve

50
Q

ulnar nerve injury

A
  1. injury to canal of struthers
  2. ## injury to guyons tunnel
51
Q

injury to canal of struthers

A

-caused by medial epicondyle fracture or dislocation
-SX:
weakness with flexion and adduction of wrist
parathesias to ring finger and little finger

52
Q

Injury to guyons tunnel

A
  • occurs at wrist medial to flexor retinaculum beneath pisohamate ligament
  • results from cuts of falls on outstretched palm

Deficits:

  • parathesias to ring and little finger
  • wasting of hypothenar eminence and interosseous spaces
  • ulnar claw appearance of hand
  • loss of adduction and flexion

MSK (13 decks)

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