Mehlman Brachial plexus + upper limb 11-04 (1) Flashcards
What 2 can be caused in neonates by breech/traumatic labor.
Can also be caused by injuries such as grabbing onto tree branch while falling.
Erb-Duchenne and Klumpke
Erb-Duchenne. what nerves injury?
Upper brachial plexus injury (C5-C6)
Upper brachial plexus injury (C5-C6)?
Erb-Duchenne.
Erb-Duchenne. CP of arm?
Arm is adducted, pronated, and wrist flexed
Arm is adducted, pronated, and wrist flexed?
Erb-Duchenne.
Erb-Duchenne. How is called deformity?
Waiter’s tip
Waiter’s tip deformity in what injury?
Erb-Duchenne.
Klumpke. what nerves injury?
Lower brachial plexus injury (C8-T1).
Lower brachial plexus injury (C8-T1)?
Klumpke.
Klumpke. CP of hand?
,,Claw-hand”
,,Claw-hand”?
Klumpke.
DeQuervain tenosynovitis.
what is tenosynovitis?
inflammation of tendon sheats.
DeQuervain tenosynovitis. classic in what population?
breastfeeding women
DeQuervain tenosynovitis. worsened by what test?
Finkelstein
test (HY)
DeQuervain tenosynovitis.
Finkelstein test:
1) thumb is placed in palm;
2) 2nd-5th fingers are wrapped over the palm.
3) Patient ulnar deviates the wrist –> this causes pain = positive test
DeQuervain tenosynovitis.
Finkelstein test how performed?
Finkelstein test:
1) thumb is placed in palm;
2) 2nd-5th fingers are wrapped over the palm.
3) Patient ulnar deviates the wrist –> this causes pain = positive test
Finkelstein test in what pathology?
DeQuervain tenosynovitis.
DeQuervain tenosynovitis. Tx?
Patient should avoid offending activity, but since this is often breastfeeding,
steroid injection can provide immediate relief.
splinting, NSAIDs, and steroid injection are all acceptable as first-line treatments.
Pain along the radial aspect of the wrist caused by thickening of the tendon sheaths of extensor pollicis brevis and abductor pollicis longus –> classically seen in breastfeeding women due to long periods of keeping the wrist in a cocked position?
DeQuervain tenosynovitis.
Ganglion cyst. definition?
Gelatinous collection of joint fluid;
Ganglion cyst. can occur in what parts?
on ankles and flexor areas as well, but classic location is dorsum of hand/wrist.
Can occur on ankles and flexor areas as well, but classic location is dorsum of hand/wrist?
Ganglion cyst.
Ganglion cyst.
Q: most likely trajectory if untreated?
spontaneous regression
Ganglion cyst.
Tx?
Tx is needle drainage if disturbing to the patient
Ganglion cyst.
why recurrence is common?
recurrence common because the root opening to the tendon sheath is not removed.
Lateral epicondylitis. in what sport?
Tennis elbow
Tennis elbow? what pathology
Lateral epicondylitis.
Lateral epicondylitis. CP?
Lateral elbow pain worsened when patient extends wrist against resistance.
Lateral elbow pain worsened when patient extends wrist against resistance.?
Lateral epicondylitis.
Lateral epicondylitis.
NBME: extensor carpi radialis brevis = answer for site of inflammation
.
Lateral epicondylitis.
Tx?
,,forearm strap”
inflammation of extensor carpi radialis brevis?
Lateral epicondylitis.
Medial epicondylitis.
what sport?
Golfer elbow
Golfer elbow?
Medial epicondylitis.
Medial epicondylitis.
Inflammation at flexor carpi radialis and pronator teres.
.
Inflammation at flexor carpi radialis and pronator teres.?
Medial epicondylitis.
Medial epicondylitis. CP?
Medial elbow pain worsened when patient flexes wrist against resistance.
Medial elbow pain worsened when patient flexes wrist against resistance.?
Medial epicondylitis.
Medial epicondylitis. Tx?
forearm strap
Radial head subluxation. in children. how is called?
aka ,,Nursemaid elbow”
,,Nursemaid elbow”?
Radial head subluxation.
Radial head subluxation.
CP in children?
Child stops using arm + arm pronated and partially flexed
Child stops using arm + arm pronated and partially flexed?
Radial head subluxation.
Radial head subluxation.
Hx of child having arm pulled/yanked, or child holding hands and running with older sibling + the child falls, resulting in elbow pull.
.
Radial head subluxation. Tx?
Tx = hyper-pronation, OR supination when arm partially flexed. Either is correct.
Both will not be listed at the same time as answers.
Olecranon bursitis. CP?
Elbow pain, usually following contact injury.
Elbow pain, usually following contact injury?
Olecranon bursitis.
Olecranon bursitis. Tx? 2
Tx = compression bandage + NSAIDs. Steroid injection is wrong answer on USMLE
Olecranon bursitis. what is wrong answer for Tx?
Steroid injection is wrong answer on USMLE
UW. Lateral epicondylitis. what two muscles?
as in M - extensor carpi radialis brevis
+ in UW: Extensor digitorum communis
as in M - extensor carpi radialis brevis
+ in UW: Extensor digitorum communis?
UW. Lateral epicondylitis
UW. Lateral epicondylitis. CP?
Pain:
passive wrist flexion
pain with wrist extension against resistance.
UW. Lateral epicondylitis. cause?
repetitive or forceful wrist extension
UW. Olecranon bursitis. Cause?
repetitive pressure or friction
UW. Olecranon bursitis. Dx?
xray - if suspect fracture
apiration (+gram and culture) in selected cases
UW. Olecranon bursitis. Tx
rest, ice, compression bandage, NSAIDS
If septic = antistaphylococal abs and drainage
if inflammatory - treat gout, RA
UW. Lateral epicondylitis. Tx?
brace (M buvo forearm strap), modified activity, nsaids