MSK UL Fractures

Question 1

What are the 3 main fractures that can happen to the humerus?

Answer 1

Surgical neck fracture, distal humeral fracture and mid shaft fracture

Question 2

Which fracture can lead to damage of the axillary nerve?

Answer 2

Surgical neck fracture

Question 3

If the axillary nerve is damaged what is the patient unable to do? Why>?

Answer 3

Abduct their arm

Deltoid and teres minor muscles are damaged

Question 4

Why are humeral fracture commonly seen in elderly people?

Answer 4

Because they are more likely to suffer from osteoporosis

Question 5

What is osteoporosis?

Answer 5

Decreased bone strength

Question 6

What is the difference between osteoporosis and osteoarthritis?

Answer 6

Osteoporosis is the decrease in bone density and quality, making them more brittle.
Osteoarthritis, however, affects the joing and involves the thinning of cartilage

Question 7

What are the 2 examples of distal humeral fractures?

Answer 7

Supracondylar and medial epicondyle fractures

Question 8

Which blood vessel can be damaged in a supracondylar fracture? What effect can this have?

Answer 8

Brachial artery.

Can cause ischaemia and the resulting ischaemia can cause volkmann’s ischaemic contracture

Question 9

What is volkmann’s ischaemic contracture?

Answer 9

Uncontrolled flexion of the hand because flexor muscles become fibrotic and short

Question 10

Which nerves can be damaged in a supracondylar fracture of the humerus?

Answer 10

Median, ulnar or radial

Question 11

When a medial epicondylar fracture of the humerus what nerve can be damaged and what does this cause?

Answer 11

The ulnar nerve. Can cause ulnar claw

Question 12

What structures could be damaged in a mid shaft fracture of teh humerus?

Answer 12

Radial nerve and profunda brachii artery

Question 13

What can damage to the radial nerve cause? Why?

Answer 13

Unopposed flexion (wrist drop).
Because the radial nerve innervates the extensors of the wrist .
Also, sensory loss to ….

Question 14

What is thoracic outlet syndrome cause by?

Answer 14

Trauma, fractures clavicle or repetitive lifting of the arms above the head

Question 15

What are the symptoms of thoracic outlet syndrome?

Answer 15

Tingling, muscle weakness and discolouration

Question 16

What is winged scapula most commonly caused by?

Answer 16

Damage to the long thoracic nerve

Question 17

How may damage to the long thoracic nerve occur?

Answer 17

Trauma to the shoulder, repetitive movement involving the shoulder, structure becoming inflammed around the shoulder which press on the nerve, lymph node biopsy and axillary clearance

Question 18

Where can the brachial pulse be found? Which is is used?

Answer 18

Medial to the biceps tendon. Used when taking blood pressure with a stethoscpope to hear korotkoff sounds

Question 19

On what is venepuncture performed?

Answer 19

On the medial cubital vein

Question 20

How can a supracondylar fracture occur?

Answer 20

By falling on a flexed elbow.

Question 21

What is a supracondylar fracture?

Answer 21

A transverse fracture which spans between two epicondyles. The displaced fragments may damage the contents of the cubital fossa.

Question 22

What can carpal tunnel syndrome cause?

Answer 22

Compression of the median nerve

Question 23

What are the most likely causes of carpal tunnel syndrome?

Answer 23

Thickened ligaments and tendon sheaths

Question 24

What are the symptoms of carpal tunnel syndrome?

Answer 24

Weakness and atrophy of thenar muscles if left untreated

Tingling, numbness an pain in distribution of median nerve and pain radiating down the forearm.

Question 25

What are the tests for carpal tunnel syndrome?

Answer 25

Tinel’s sign: tapping median nerve in the carpal tunnel to elicit pain OR
Phalens manoeuvre: Holding wrist in flexion for 60 seconds to give numbness or pain in median nerve

Question 26

When axillary clearance is carries out what is remove?

Answer 26

The lymph nodes and lymphatic vessels draining the upper limb and breast

Question 27

When may axillary clearance take place? Why?

Answer 27

When someone has a confirmed cancer biopsy.
It is carried out because lymph nodes may contain malignant cells from the breast hat may enter the lymph vessel and be carried in the lymph to the regional lymph nodes in the axilla.

Question 28

When may axillary clearance take place? Why?

Answer 28

When someone has a confirmed cancer biopsy.
It is carried out because lymph nodes may contain malignant cells from the breast hat may enter the lymph vessel and be carried in the lymph to the regional lymph nodes in the axilla.

Question 29

In thoracic outlet syndrome what structures are compressed by the corocoid process? What can this lead to?

Answer 29

Subclavian vein, subclavian artery and chords of the brachial plexus.
Can lead to pain running down the arms, numbness and parethesia

Question 30

In thoracic outlet syndrome what structures are compressed by the corocoid process? What can this lead to?

Answer 30

Subclavian vein, subclavian artery and chords of the brachial plexus.
Can lead to pain running down the arms, numbness and parethesia

Question 31

What nerve are the extensors of the forearm innervated by?

Answer 31

Radial

Question 32

What nerve are the flexors of the anterior forearm innervated by?

Answer 32

Median

Question 33

What nerve are the flexors of the anterior forearm innervated by?

Answer 33

Median

Question 34

How can carpal tunnel syndrome be treated?

Answer 34

Using a splint to hold the wrist in dorsoflexion overnight to relieve symptoms.
Corticosteroid injections into carpal tunnel