Clinical Correlations ch. 17 Flashcards
Pain in tip of shoulder: C4/C3
- subdiaphragmatic irritation due to peritonitis, gall bladder inflammation, hepatic abscess, pleurisy or accumulations of CO2
- due to phrenic nerve (C3,4,5) or supraclavicular nn. C3,4
Pain from the left chest, down the left lower limb
Angina pectoris, due to heart pain. Pain fibers associated with sympathetics from T1-T4: T1-T3 dermatomes of upper limb
P’eau d’orange
- dimpling of skin overlying the breast due to tighetning of suspensory “coopers ligaments” via tumor growth
Dupuytren’s Contracture
pathological thickening and contracture of longitudinal connective tissue bundles of palmar aponeurosis
- draws fingers into palm by tugging on digital sheaths - so that they become useless
Subacromail/subdeltoid bursitis
inflammation/pain/swelling within synovial space of bursa surrounding glenohumeral/shoulder joint
- results in grating of shoulder joint
olecranon bursitis
inflammation/pain/swelling within synovial space of bursa surrounding elbow joint
ganglion cyst
- distention of a weakened portion of a tendon sheath at the extensor surface of the wrist
DeQuervain’s Disease
- inflammation of synovial sheath surrounding the extensor pollicis brevis and abductor policis longus tendons
- results in trouble using the thumb
DeQuervain’s Disease
- inflammation of synovial sheath surrounding the extensor pollicis brevis and abductor policis longus tendons
- results in trouble using the thumb
Trigger Finger
Bursitis for flexor tendon sheats in hand.
- the node forms in sheath and it can’t pass through the fibrous tendon sheath pully - thus the finger stays in a flexed position.
Pressure on Axilla compartment
- stretching of cords of brachial plexus
- could be due to humeral dislocation, tumor
- could compress axillary artery to stop profuse bleeding distally
- could be due to neoplastic lymph nodes due to breast carcinoma metastasis
Cubital Fossa Compartmental damage
could damage TAN (tendon of biceps, brachial artery, median nerve)
- must take care during venapuncture not to go too deep
Carpal Tunnel Syndrom
- increased activity of wrist results in edema, compression and inflammation of median n.
Symptoms:
1. parasthesias of lateral 31/2 fingers
2. Paresis (weakness) upon flexion, abduction, and opposition of thumb
3. wasting of thenar eminence
4. loss of fine motor control of 2nd/3rd digits due to paralysis of 1st and 2nd lumbricals (may result in median claw)
5. loss of opposition/grasp reflex
NOTE: falls on outstretched palm can injure the recurrent branch of the median n.
infection in deep palmar spaces
- if get infections in the deep spaces of palm (through maybe a deep puncture wound) - can fester and cause large amounts of pain in palm
infection in deep palmar spaces
- if get infcetions in the deep spaces of palm (through maybe a deep puncture wound) - can fester and cause large amounts of pain in palm
Clavicle
- first to start, last to end ossifying (2nd-3rd decade)
- most commonly broken bone in body: b/c of architecture of shoulder joint and natural curve of clavicle it will often “green stick” fracture in its middle 1/3rd
- medial posterior clavicular dislocation –> pressure on carotid sheath
- dislocation –> mechanical stimulation to vagus n. (CN X) from pressure placed on it by medial end of clavicle –> decreased heart rate and contractility
acromioclavicular separation
- torn AC joint: often happens when someone falls on their shoulder
Graded 1-6:
1: stretched AC ligs
2: torn AC ligs with stretched CC ligs
3: torn AC and CC with 3-5x increase in CC space (everything is free)
Rotator Cuff
- supraspinatus, infraspinatus, teres minor, subscap
- supraspinatus is most often torn b/c of “over the top”position –> due to lifting too much or catching a heavy falling object, or repetitive overhead motion activities
- also susceptible to erosion via osteophytes which grow down from an arthritic AC joint
Rotator Cuff
- supraspinatus, infraspinatus, teres minor, subscap
- supraspinatus is most often torn b/c of “over the top”position –> due to lifting too much or catching a heavy falling object, or repetitive overhead motion activities
- also susceptible to erosion via osteophytes which grow down from an arthritic AC joint
Ruptured tendon of long head of biceps
intracapsular tendon becomes inflamed and erodes over time
Ruptured tendon of long head of biceps
intracapsular tendon becomes inflamed and erodes over time
bicipital tendonitis
inflammation of synovial sheath around tendon of long head of biceps within the intertubercular (bicipital) groove; can lead to dislocation of long head of biceps from intertubercular groove
- this happens due to overuse and throwing sometimes
Anterior Glenohumeral dislocation
- 95% of dislocations: b/c glenohumeral ligaments are on posterior side
- loss of normal shoulder contour: appears flat
- subcoracoid is most common
- muscles “pull” head of humerus into axilla, humerus is slightly abducted
- humeral head is prominent anteriorly
- symptoms include parestheisas in C5 axillary (skin shoulder patch) and musculocutaneous nerve (forearm)
Anterior Glenohumeral dislocation
- 95% of dislocations: b/c glenohumeral ligaments are on posterior side
- loss of normal shoulder contour: appears flat
- subcoracoid is most common
- muscles “pull” head of humerus into axilla, humerus is slightly abducted
- humeral head is prominent anteriorly
- symptoms include parestheisas in C5 axillary (skin shoulder patch) and musculocutaneous nerve (forearm)