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MSK Exam II > Clinical Correlations > Flashcards

Clinical Correlations Flashcards

1
Q

What is dermatome testing

A

integrity of ascending neuronal system

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2
Q

what are 2 examples of refferred pain

A

under diaphragm irritation causing pain tip of shoulder. from phrenis C3-5 and supraclavicular nn C3 C4
angina pectoris

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3
Q

what is angina pectoris

A

radiation from thorax to upper left limb

sympathetic T1-T4 and T1-T3 are the dermatomes of upper limb

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4
Q

P’eau d’orange

A

orange skin. dimpling of skin overlaying breast due to tightening of the suspensory ligaments-tumor growth

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5
Q

Dupuytren’s contracture

A

pathological thickening and contracture of the longitudinal CT bundles of palmar aponeurosis. draws fingers into palm

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6
Q

Subacromial/subdeltoid bursitis

A

inflammation accompanied by pain and swelling within a confined synovial space, in this case the bursa around glenhumeral joint

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7
Q

olecranon bursitis

A

inflammation of elbow

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8
Q

ganglion cyst

A

thickening and contracture of tendon sheaths at extensor surface of wrist

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9
Q

DeQuervain’s disease

A

inflammation of the synovial sheath surrounding extensor pollicis brevis and abductor pollicis longus tendons

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10
Q

Trigger finger

A

inflammation of flexor tendons of the hand

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11
Q

clinical correlations go radial and ulnar bursae

A

tenosynovitis inflammation and distension of synovial tendon sheaths

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12
Q

what could happen in the deep palmar spaces

A

spread of infection thorugh deep spaces

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13
Q

What bone is used to determine age of badly decomposed bones

A

clavicle- last to ossify early 2nd-3rd decade

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14
Q

what is the typical fracture of clavicle

A

in the middle because of natural curve. “green stick” fracture

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15
Q

results of medial calvicular dislocation

A

pressure on carotid sheath. CNX= decrease HR and contractility

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16
Q

AC separation

A

stretching or rupturing the acromioclavicular and coracoclavicular ligaments

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17
Q

Grades of AC joint

A

1: stretch
2: torn AC stretch CC
3: torn AC CC and 3-5X increase of space
4/5: greater increase in separation
6: complete rupture of both ligaments with inferior clavicle displacement

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18
Q

adhesive capsulitis

A

thickend fibrotic inflammed capsule decreasing all ROM active and passively

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19
Q

what can cause adhesive capsulitis

A

arthritis, bursitis, tendonitis, inactivity, postsurgical complication

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20
Q

scneario of tearing supraspinatus tendon

A

trying to lift too much or catchin heavy object.

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21
Q

calcific tendinosis of supraspinatus tendon

A

osteophytes growing inferiorly from arthritic AC joint

tendon becomes calcific so less elastic and more brittle- prone to rupture

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22
Q

What can cause a ruptured tendone of long head biceps

A

intracapsular tendon becomes inflammed and erodes over time

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23
Q

what is bicipital tendonitis

A

inflammtion of the synovial sheath surrouding the tendon of the long head of the biceps within inter tubercular groove.
can lead to dislocation of long head biceps

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24
Q

describe posterior shoulder dislocations

A

5% shoulder dislocations
posterior prominence of humeral head, prominent coracoid process and the arm is in adduction without being able to laterally rotate

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25
Q

describe anterior shoulder dislocations

A

95% shoulder dislocations
loss of normal contour
pull head of humerus into axilla- slight abduction
humeral head is prominent anteriorly
Sx include paresthesias in distribution of axillary and musculocutaneous nn

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26
Q

describe humero-ulnar dislocation

A

movement of ulna and radios posteriorly relative to the distal end of humerus- can stretch ulna n

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27
Q

Radial head subluxation

A

distal movement of the radial head from undercover of the annular lig- children when yanked

28
Q

If a youth falls on outstretched hand what usually happens

A

dislocation of radial epiphysis

29
Q

if an adolescent falls on outstretched hand what usually happends

A

clavicular fracture

30
Q

if an elderly person falls on outstretched hand what usually happens

A

colles’ fracture. distal radius fracture 1 in proximal to joint- “silver fork” deformity

31
Q

what carpal bones can be affected in falling on outstretched hand

A

scaphoid- most common

lunate- most often dislocated

32
Q

What is Game Keeper’s or skiiers thumb

A

rupture of ulnar collateral log of metacarpophalangeal joint of thumb

33
Q

what arteries are in compression sites

A

axillary- proximal humerus medial surface
brachial- medial to anterior humerus from above downward
ulnar- distal anterior wrist lateral to pisiform
radial- distal anterior radius “snuff box”

34
Q

what is avascular neccrosis of scaphoid bone

A

when distal and proximal scaphoid fracture apart. distal contains nutrient a import, so proximal has no blood supply

35
Q

Raynaud’s syndrome

A

increased sympathetic inn to distal blood vessels causing increased vasoconstriction with concomitant decrease in vascular flow. fingertips coldest.
can cause necrosis distally

36
Q

Tx for Raynauds’ syndrome

A

cervicodorsal preganglionic sypathectomy- induce vasodilation

37
Q

how are superficial vv used clinically

A

access for surgical procedures: venapunctures, transfusions, cardiac catheterization

38
Q

what causes thrombosis

A

trauma, fracture or deep contusions. deep vein clot

spntaneous- reduced physical activity for prolonged time and weakened muscular fascia- weak musculovenous pump

39
Q

Lymphangitis

A

inflammation of lymph vessels “red streaks”

40
Q

lymphangitis that extend proximally from thumb and index finger go where

A

follow course of cephalic v to inferoir clavicular nodes

41
Q

lymphangitis that originate in medial 3 fingers follow course of what

A

basilic v to cubital and lateral axillary lymph nodes

42
Q

why do infections on fingers of palm lead to inflammatory edema or abcess on dorsume of hand

A

lymph drains to dorsum

43
Q

lymphadenitis

A

inflamed lymph nodes as a direct result of lymphangitis

44
Q

What segmental regions do the bicep and tricep tendon reflexes check

A

biceps: C5,C6
triceps: C7C8

45
Q

Erb-Duchenne’s palsy

A

Injury to C5 C6 nerve roots or upper trunk to traction placed on neck (falling on shoulder)
loss of flexors of forearm and lateral rotators of humerus
medial rotators take over and the limb looks like waiter tip

46
Q

Klumpke’s palsy

A

Injury to C8 T1 nerve roots or lower trunk; catching one’s self in a hanging positions while falling
loss of hand intrinsic mm
claw hand- loss of lumbricals and interossei

47
Q

Damage to long thoracic n C5-C7 causes what

A

winged scapula because lose serratus anterior

lose scapular portion of abduction

48
Q

Where is axillary n usually damaged? what cord levels is this?

A

passes around humerus in quadrangular space.

C5 C6 C7

49
Q

what can cause axillary n damage and results in what?

A

poor crutch placement, downward glenohumeral dislocation, fracture of 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

50
Q

where is radial n usually damaged? What cord levels is this?

A

injury as it exits axilla or winds around humerus in the “spiral” groove
C5-T1

51
Q

what can cause radial n damage?

A

poor crutch placement, falling asleep with arm over back of chair or fracture of upper humerus, downward dislocation of glenohumeral joint

52
Q

what are the Sx of acute and chronic radial n damage

A

acute: wrist drop- loss of all extensors
chronic: flexion contractures of flexors of upper limb with complete loss of limb function

53
Q

what can cause musculocutaneous damage? and what levels?

A

traumatic rupture of coracobrachialis

C5 C6 C7

54
Q

what is the resulting injury of Musculocutaneous

A

loss of forearm flexion and supination; loss of cutaneous sensation to lateral forearm

55
Q

What are the 2 common syndromes involving MEdian N

A

ape hand and carpal tunnel

56
Q

What can cause ape hand

A

medial supracondylar humeral fracture or humeroulnar dislocation

57
Q

what is ape hand

A

appearance due to decreased wrist flexion, supination of hand(both pronators paralyzed), thumb in neutral position(laterally rotated and adducted) and wasting of thenar eminence

58
Q

what causes carpal tunnel syndrome

A

increased activity of wrist resulting in edema, compression and inflammation of median n

59
Q

Sx of carpal tunnel syndrome

A

paresthesias of lateral 3.5 fingers
paresis upon flexion abduction and opposition of thumb
wasting thenar eminence
loss of fine motor control 2n3 and 3rd digits due to paralysis of 1st and 2nd lumbricals “median claw”
loss of opposition and grasp reflex

60
Q

what can injure the recurrent branch of median n

A

falling on outstretched palm

61
Q

What n gets injured if the psterior medial humeral epicondyle is fractured or dislocated

A

canal of Struther’s, Ulnar n C8 T1

62
Q

Sx of ulnar n damage from strutter canal compression

A

weakness during flexion and adduction of the wrist with paresthesias to ring and little finger

63
Q

Where is the guyon’s tunnel

A

wrist medial to flexor retinaculum beneath pisohamate ligament

64
Q

what causes injury to ulnar n within guyons tunnel

A

falling on outstreched palms

65
Q

deficits seen with ulnar damage in guyon’s canal

A

paresthesias to ring and little finger
wasting of hypothenar eminence and interosseous spaces
ulnar claw of 4th and 5th fingers
loss of adduction of the thumb (Froment’s sign)

MSK Exam II (10 decks)

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