pathophys of upper extremity Flashcards
What is contained in the anterior compartment of the upper arm
Flexor
Musculocutaneous nerve
bicep brachii (flexion, supination)
Brachialis
What are the compartments of the upper arm separated by
fascia
What is contained in the posterior compartment of the upper arm
Extensor
Contains radial nerve
tricep
What symptoms are associated with brachial plexopathy
Weakness
pain
sensory
*all in the upper arm
What are some causes of brachial plexopathy
Trauma
TOS
Tumor invasion
Post operative complication (sternotomy)
Radiation
Where are upper brachial plexus lesions seen
C5, C6
What causes an upper brachial plexus lesion
head being pulled to one side with shoulder depression
-trauma
-difficult delivery
*traction or tearing of the nerve fibers
What is the result of an upper brachial plexus injury
Paralysis of
-supraspinatus
-infraspinatus
-biceps
-brachialis
-coracobrachialis
-deltoid
Where are lower brachial plexus lesions seen
C8, T1
What is the cause of a lower brachial plexus injury
Falling and catching yourself causing a tearing of the nerve
Which nerves are involved with a lower brachial plexus injury
Median and ulnar nerve -> affects functionality of the hand
What are the different types of brachial plexopathy
Avulsion
stretch
rupture
What is important about the surgical neck of the humerus
Where the joint capsule attaches
vascular supply for the humeral head
Where does the subscapularis insert
Lesser tuberosity
What is the major complication that can arise from a fracture of the surgical neck of the humerus
AVN of humeral head
Which arteries could be injured with a supracondylar fracture of the distal humerus
radial, ulnar, or brachial artery
What stabilizes the shoulder
Labrum
Rotator cuff
Glenohumeral ligaments
If there is an injury to the radial artery with a shoulder dislocation, what effects might a patient experience
Weakness and difficulty with extension of the wrist and fingers
What is the purpose of the labrum
Fibrocartilaginous joint that deepens the glenoid fossa and aids in stability
What type of labral tear is seen with dislocations and bankers lesions
Inferior
What type of labral tear is associated with SLAP tears
Superior
What is seen with stage 1 impingement syndrome
Edema and hemorrhage
What is seen with stage 2 impingement syndrome
Fibrosis and tendonitis
What is seen with stage 3 impingement syndrome
Rotator cuff tear and/or bicep rupture
Which part of the rotator cuff is generally injured in trauma or chronic degenerative tearing
Supraspinatus, infraspinatus, teres minor
How are rotator cuff tears classified
By size
-small 0-1
-medium 1-3
-large 3-5
What causes frozen shoulder
Increased fibroblastic activity causing the joint capsule to become thickened and fibrotic
How soon after surgery is PT required for adhesive capsulitis
Within a day or it will start to freeze again
Where does the bicep insert
Radial tuberosity
What movement does the long head of the bicep control
assists with abduction and internal rotation
What movement does the short head of the bicep control
Adduction (to the coracoid)
When both heads of the bicep fire together, what movement do they control
elbow flexion and supination
Where is the pain the greatest with bicep tendonitis
Bicepital groove
What does a SLAP tear stand for
Superior labrum, anterior to posterior
What part of the bicep is effected with a bicep tendon rupture
Long head at the bicipital groove
What type of bicep tendon rupture is most significant
distal
What movement does the flexor carpi radials allow for
Flexion and abduction of the wrist
What movement doesn’t the flexor carpi ulnaris allow for
Flexion and adduction of the wrist
What muscle only flexes the wrist
Palmaris longus
Which muscle flexes the wrist and middle phalanges from finger 2-5
Flexor digitorum superficialis
Which muscle extends and adducts the wrist
Extensor carpi ulnaris
Which muscle extends the wrist and abducts the hand
Extensor carpi radialis
What is the difference between intrinsic and extrinsic muscles of the hand
Intrinsic are within the hand
extrinsic come from forearm
What is a side effect of medial epicondylitis
decreased grip strength
What causes dupuytrens contracture
Proliferative disorder of myofibroblasts that leads to fibrosis of palmar fascia
What is the progression of dupuytrens contracture
Starts as nodule and progresses to for cords that pull the MCP and PIP into flexion
Overgrowth of fibrocartilage that causes narrowing of the first annular pulley passage of the hand is descriptive of which pathology
trigger finger
What is a contracture
Chronic, progressive loss of joint ROM secondary to tightening of non-bony tissue
What is contracture typically due to
Immobilization
