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Gross Anatomy 1 > Exam II (UE) Pathologies > Flashcards

Exam II (UE) Pathologies Flashcards

1
Q

Shoulder Complex Grade I

A

AC ligament sprain
CC ligaments and Deltotrapezial facia intact
Nondisplaced

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2
Q

Shoulder Complex Grade II

A

AC Ligament complete tear
CC ligaments sprain
Delto-trapezial fascia intact
<25% Superior displacement

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3
Q

Shoulder Complex Grade III

A

AC and CC ligaments complete tear
Delto-trapezial fascia injuried
25-200% superior displacement

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4
Q

Shoulder Complete Grade IV-VI

A

AC & CC ligaments complete tear
Delto-trapezial fascia detached
All displaced
Generally requires surgery

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5
Q

What is it called when clavicle separates from acromion?

A

acromioclavicular (AC) separation

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6
Q

What is it called when the humerus separates from the glenohumeral capsule?

A

Glenohumeral dislocation

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7
Q

Where can a shoulder impingement be?

A

Supraspinatus or biceps LH

Subacromial bursa

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8
Q

What can shoulder impingement be caused by?

A

Chronic tendonitis of supraspinatus or biceps LH,
Subacromial bursa
Weakness of rotator cuff
Abnormal movement of scapula (Anterior tipping)
Type 3 acromion
Posture
Capsule (tightness, requires joint mobz)

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9
Q

Pathologies of glenohumeral joint

A

Subluxation

Adhesive capsulitis

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10
Q

What is GH joint subluxation and what is it caused by?

A

When humerus comes out of joint but does not dislocate
Common in stroke patients; no mm tone to counteract weight of arm
Connective tissue is decreased, so there is increased motion

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11
Q

What is GH adhesive capsulitis?

A

AKA Frozen Shoulder

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12
Q

How does adhesive capsulitis/frozen shoulder occur?

A

Intact MM
Fibrosis of capsule
Connective tissue (collagen) increases causing decreased motion

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13
Q

What is the most lost motion in adhesive capsulitis?

A

ER is the primary motion lost, which will affect shoulder flexion

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14
Q

What are the causes (primary & secondary) of adhesive capsulitis?

A

Primary: insidious; unknown reasons
Secondary: arthritis, RC tear, trauma, cardiac, neurology, pulmonary disease, diabetes, thyroid disease

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15
Q

What is a bankart lesion and how does it happen?

A

anterior inferior lesion to the labrum of GH capsule

Occurs at 90 flexion, 90 abduction

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16
Q

What is the most common result of a shoulder dislocation?

A

Bankart lesion

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17
Q

What is a Hill-Sachs leison and how does it occur?

A

Dislocation of humeral head causes muscles to spasm and push head into the edge of GH cavity causing a gouge in humeral head

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18
Q

How are Hill-sachs leisons treated?

A

it is left alone if the gouge in humeral head is less than 20% of the surface, if more can be filled with bone graph

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19
Q

What is a SLAP Tear and how does it happen?

A

Minor subluxation causing a tear in the superior labrum anterior to posterior, extreme forces causing LH of bicep tendon pull on the labrum

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20
Q

Who commonly gets SLAP tears?

A

Overhead athletes eg. baseball players 90-90

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21
Q

What causes winging of the inferior angle of the scapula?

A

Weakness of serratus anterior

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22
Q

What plane does scapula winging occur in?

A

coronal plane

abduction/protraction

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23
Q

Damage to what peripheral nerve causes scapula winging?

A

Long Thoracic N.

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24
Q

Damage to what cranial nerve causes scapula winging?

A

C5-C7

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25
Q

What occurs when there is damage to the spinal accessory nerve?

A

scapula is elevated and entire medial boarder of scapula is lifted/winged

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26
Q

What motions are limited with damage to CNXI (spinal accessory)

A

Shoulder flexion to 90 degrees

Abduction to 20-30 degrees

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27
Q

If pectoralis minor is tight, what motion is limited?

A

Shoulder flexion since shoulder is anteriorly tilted…

Coracoacromial ligament hits the greater tubercle

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28
Q

Where can suprascapular nerve get compressed and what muscles become weak at that location?

A

Suprascapular notch: Supraspinatus and Infraspinatus

Spinoglenoid notch: Infraspinatus

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29
Q

What would swelling within the quadrangular space compress?

A

Axillary n. (deltoid & teres minor)

Posterior humeral circumflex a.

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30
Q

What would swelling within the triangular space compress?

A

Scapular circumflex a.

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31
Q

What would swelling within the triangular interval compress?

A

Profunda Brachial A.

Radial N. (Triceps, brachioradialis, anconeous, APL, Supinator, all wrist extensors)

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32
Q

What is the most common clavicular fracture?

A

Middle third of clavicle
Medial fragment displaced upward by pull of sternocleidomastoid, lateral fragment displaced downward by weight of shoulder

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33
Q

If C5 spinal nerve was damaged, what would not work?

A

Elbow flexion (biceps)

34
Q

If C6 spinal nerve was damaged, what would not work?

A

Wrist extension (eg. extensor carpi radialis)

35
Q

If C7 spinal nerve was damaged, what would not work?

A

Elbow extension(eg. triceps)

36
Q

If C8 spinal nerve was damaged, what would not work?

A

Finger flexion (eg. flexor digitorum profundus)

37
Q

If T1 spinal nerve was damaged, what would not work?

A

Small finger abductors (eg. abductor digiti minimi)

38
Q

How does UCL (Ulna Collateral Ligament) tears occur?

A

Typically in baseball players due to decreased internal rotation. Damage to the anterior band

39
Q

What muscle weaknesses contribute to UCL tears?

A

Primarily flexor digitorum superficialis, but also pronator teres and flexor carpi ulnaris

40
Q

Damage to the common flexor tendon affects what muscles?

A

Pronator teres, flexor capri radialis, palmaris longus, flexor carpi ulnaris, and flexor digitorum superficialis
wich would affect: pronation, flexion of wrist, ulnar and radial deviation weakness, and PIP flexion

41
Q

What is Nursemaid’s elbow?

A

Subluxation of radial head; tear distal part of annular ligament
Proximal part of ligament is trapped between radial head and capitulum (blocking motion)

42
Q

How does nursemaid’s elbow occur?

A

Axial traction is the most common
Can happy from a fall
Infants can get it after being assisted to roll over

43
Q

What is a common elbow injury from children falling?

A

Supracondylar fx, from hyper extension

44
Q

Typical clinical manifestation from nursemaid’s elbow

A

Child protective of arm
Anxiety is greater than pain
Elbow flexed 15-20 degrees
No warmth or swilling
distal circulation, sensation and motor activity are normal
Tenderness at radial head
Pt resists pronation, supination, flex, and ext

45
Q

What is an elbow complex dislocation

A

Dislocation with fracture

Pts almost never get full ROM in the future

46
Q

What are the 4 bursaes in the elbow?

A

Olecranon (2-subcutatneous and subtendinous)
Bicipital
Radioulnar

47
Q

What bursitis in the elbow would not be painful?

A

Subcutatneous; superficial between skin and olecranon

48
Q

Damage to the musculocutaneous nerve would cause weakness in what muscles?

A

coracobrachialis C6-7
biceps brachii C5-6
brachialis C5-6

49
Q

Damage to the musculocutaneous nerve would cause sensory loss to what?

A

Lateral forearm (lateral antebrachial cutaneous)

50
Q

Damage to the median nerve would cause weakness in what muscles?

A

Anterior compartment of forearm, and palmar hand

51
Q

Damage to the median nerve would cause sensory loss to what?

A

anterior hand and posterior digits 2-4

52
Q

Damage to the ulnar nerve would cause weakness to what?

A

anterior compartment forearm and palmer hand

53
Q

Damage to ulnar nerve would cause sensory loss to what?

A

Little finger, lateral half of digit IV, and hypothenar

54
Q

Damage to the radial nerve would cause weakness in what muscles?

A 
Triceps
Anconeus
Brachioradialis
Supinator
Wrist extensors
55
Q

Damage to the radial nerve would cause sensory loss in what?

A

posterior arm, forearm, and hand

56
Q

What is myositis ossificans?

A

Bone growing within the muscle

Typically happens with bleeding

57
Q

What are heterotropic ossification commonly seen with?

A

supracondylar fractures
posterior dislocation of elbow
aggressive stretching of elbow flexors

58
Q

Examples of injuries that can damage the radial nerve

A

humeral fractures at radial groove

direct trauma

59
Q

Radial head fracture dislocation can damage what nerve?

A

Deep radial nerve

  • Superficial (all sensory)
  • Deep (posterior interosseous nerve)
60
Q

Damage to the common extensor tendon would effect what muscles?

A

Extensor carpi radialis brevis, extensor digitorum, extensor carpi ulnaris, extensor digiti minimi

61
Q

What is a common area the axillary nerve would be damaged?

A

quadrangular space

62
Q

How is the musculocutaneous nerve commonly damaged?

A

entrapment by coracoprachialis

63
Q

What are common ways to damage the ulnar nerve?

A

Honeymooner’s palsy, cubital tunnel, tunnel guyon

64
Q

How would the ulnar nerve get damaged at the cubital tunnel?

A

Compression against medial epicondyle, repetitive pressure, stretching, trauma

65
Q

What are common ways to damage median nerve?

A

pronator teres entrapment, anterior interosseous syndrome, carpal tunnel, honeymooner’s palsy

66
Q

Anterior interosseous syndrome (from the median nerve) affects what muscles?

A

Flexor digitorum profundus I&II
Flexor pollicis longus
pronator quadratus

67
Q

What is the cause of honeymooner’s palsy

A

Pressure on the upper arm from head lying on the arm

68
Q

What type of occupation could have entrapment of their median nerve?

A

Carpenters, anyone with repetitive pronation (pronator teres entraps nerve)

69
Q

Who would get nerve damage at the tunnel of guyon?

A

long distance bikers, mma

anyone with excess pressure or force on hypothenar

70
Q

What are common ways to damage the radial nerve?

A 
compression in triangular interval
Radial groove (saturday night palsy)
Radial head dislocations
supinator syndrome
posterior interosseous syndrome
superficial radial n.
71
Q

What nerve damage causes wrist drop

A

Compression to radial nerve at spiral groove

AKA Saturday night palsy

72
Q

What is affected with Saturday Night Palsy?

A

branch to triceps are spared
long extensor of forearm paralyzed
small loss of sensation over the dorsal surface of the hand and lateral 3 fingers

73
Q

What is Wartenberg’s syndrome?

A

Compression of superficial radial nerve?

74
Q

Is there loss of motor, sensory, or both with Watenberg’s syndrome

A

Sensory only (back of the hand)

75
Q

How does Watenberg’s Syndrome happen?

A

Superficial radial nerve compressed by scissoring of brachioradialis and extensor carpi radialis longus during pronation

76
Q

What test could be performed to assess for anterior interosseous nerve palsy?

A

Ask patient to make an O with index and thumb

FDP II&III, FPL, PQ

77
Q

Rule of dislocations with fractures of forearm

A

dislocation of the head, fx of bone near by

78
Q

What is a Monteggia Fracture?

A

fx of proximal 1/3 of ulna

Anterior dislocation of radial head

79
Q

What is a Galeazzi Fracture?

A

Fx of radial shaft

Ulnar head dislocation at distal radioulnar joint

80
Q

What is a Smith Fracture?

A

fracture of radial head

Gross Anatomy 1 (7 decks)

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