MS - Anat & Phys (Knee injury, Clinical landmarks, Rotator cuff muscles, & Wrist bones) Flashcards
Pg. 411-412 in First Aid 2014 Sections include: -Knee injury -Clinically important landmarks -Rotator cuff muscles -Wrist bones
In general, how does knee injury present?
Presents with acute knee pain and signs of joint injury/instability
What are 5 signs of joint injury/instability that are associated with knee injury? What type of injury does each indicate?
Presents with acute knee pain and signs of joint injury/instability: (1) Anterior drawer sign –> ACL injury (2) Posterior drawer sign –> PCL injury (3) Abnormal passive abduction (valgus stress) –> MCL injury (4) Abnormal passive adduction (varus stress) –> LCL injury (5) McMurray test: pain on external rotation –> medial meniscus; pain on internal rotation –> lateral meniscus
What is valgus versus varus stress? What does an abnormality in each indicate?
Abnormal passive abduction (valgus stress) –> MCL injury; Abnormal passive adduction (varus stress) –> LCL injury
What are 2 possible indications of the McMurray test?
McMurray test: (1) pain on external rotation –> medial meniscus; (2) pain on internal rotation –> lateral meniscus
What do the Anterior versus Posterior drawer signs indicate?
Anterior drawer sign –> ACL injury; Posterior drawer sign –> PCL injury
To what do “anterior” and “posterior” in ACL and PCL refer?
“Anterior” and “posterior” in ACL and PCL refer to sites of tibial attachment
Draw the knee joint, including and labeling the following: (1) ACL (2) Femur (3) Fibula (4) Lateral condyle (5) Lateral meniscus (6) LCL (7) MCL (8) Medial condyle (9) Medial meniscus (10) PCL (11) Tibia.
See p. 411 in First Aid 2014 for visual at top right
In what context is unhappy triad a common injury, and what causes it?
Unhappy triad - common injury in contact sports due to lateral force applied to a planted leg
Of what does the Unhappy triad classically consist? What is a more common injury?
Classically, consists of damage to the ACL, MCL, and medial meniscus (attached to MCL); however, lateral meniscus injury is more common
What nerve block is used to relieve pain of delivery? What is the best landmark for the pudenal nerve?
Pudenal nerve block (to relieve pain of delivery) - ischial spine
What is the landmark for the appendix? Name and describe this location.
Appendix - 2/3 of the distance between the umbilicus and the anterior superior iliac spine (ASIS), just proximal to the ASIS (McBurney point)
What is the best landmark for the site of lumbar puncture?
Lumbar puncture - iliac crest
Name the 4 shoulder muscles that form the rotator cuff. Which of these is the most common rotator cuff injury?
Should muscles that form the rotator cuff: (1) Supraspinatus (most common rotator cuff injury) (2) Infraspinatus (3) Teres minor (4) Subscapularis; Think: “SITs (small t is for teres minor)”
What nerve innervates the Supraspinatus muscle? What is this muscle’s function? How does it relate to the deltoid’s action?
Supraspinatus (suprascapular nerve) - abducts arm initially (before the action of the deltoid)
What nerve innervates the Infraspinatus muscle? What is this muscle’s function? What usually causes its injury?
Infraspinatus (suprascapular nerve) - laterally rotates arm; pitching injury
What nerve innervates the Teres minor muscle? What is this muscle’s function?
Teres minor (axillary nerve) - adducts and laterally rotates arm
What nerve innervates the Subscapularis muscle? What is this muscle’s function?
Subscapularis (subscapular nerve) - medially rotates and adducts arm
What root(s) primarily innervate(s) the rotator cuff muscles?
Innervated primarily by C5-C6.
Draw a lateral view of the rotator cuff muscles, including and labeling: (1) Acromion (2) Biceps tendon (3) Coracoid (4) Infraspinatus (5) Subscapularis (6) Supraspinatus (7) Teres minor.
See p. 411 in First Aid 2014 for visual at bottom right
Name the 8 wrist bones.
(1) Scaphoid (2) Lunate (3) Triquetrum (4) Pisiform (5) Hamate (6) Capitate (7) Trapezoid (8) Trapezium. Think: “So Long To Pinky, Here Comes The Thumb.”
Draw and label the major 8 bones, showing their relation to one another.
See p. 412 in First Aid 2014 for visual
What muscle is palpated in the anatomical snuff box?
Scaphoid (palpated in anatomical snuff box)
What is the most commonly fractured carpal bone?
Scaphoid (palpated in anatomical snuff fox) is the most commonly fractured carpal bone
To what condition is the scaphoid prone, and why?
Scaphoid (palpated in anatomical snuff box) is the most commonly fractured carpal bone and is prone to avascular necrosis owing to retrograde blood supply
What is the lunate? What can its dislocation cause?
Wrist bone; Dislocation of lunate may cause acute carpal tunnel syndrome
What wrist bone can be damaged by a fall on an outstretched hand? What type of injury can damage to the hook of this bone cause?
A fall on an outstretched hand that damages the hook of the hamate can cause ulnar nerve injury
What is Carpal tunnel syndrome?
Carpal tunnel syndrome: Entrapment of median nerve in carpal tunnel
What are the symptoms of Carpal tunnel syndrome, and what causes these?
Carpal tunnel syndrome: Entrapment of median nerve in carpal tunnel; nerve compression –> paresthesia, pain, and numbness in distribution of median nerve
What is Guyon canal syndrome? In what patient population is it classically seen, and why?
Guyon canal syndrome: Compression of the ulnar nerve at the wrist or hand, classically seen in cyclists due to pressure from handlebars
