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CABS - MSK > Pathophysiology of Upper Extremity > Flashcards

Pathophysiology of Upper Extremity Flashcards

1
Q

what do we need to consider in regards too humeral fractures

A

vasculator

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2
Q

what are the compartments of the upper arm

A

Anterior and posterior compartments

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3
Q

what is within the anterior compartment of the upper arm

A

flexor
contains musculocutaneous nerve
biceps (flexion, supination) brachii
brachialis

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4
Q

What is within the posterior compartment of the upper arm

A

extensor
contains radial nerve
triceps

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5
Q

What motor function does the musculocutaneous nerve supply

A

coricobrachialis, brachialis, biceps brachii

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6
Q

what sensory function does the musculocutaenous nerve supply

A

sensation for that lateral arm

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7
Q

what motor function does the axillary nerve supply

A

deltoid (3 parts) and teres minor

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8
Q

what sensory function does the axillary nerve supply

A

posterior/lateral deltoid - easily damaged in trauma

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9
Q

what motor function does the radial nerve supply

A

ALOT
- triceps, anconeous, brachioradialis, supinator

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10
Q

what sensory function does the radial nerve supply

A

posterior/lateral upper aspect and dorsal and lateral hand/thumb

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11
Q

what motor function does the median nerve supply

A

pronator teres, quadratus, flexor of the wrist/fingers, intrinsic hand muscles and opponenes polllicus brevis

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12
Q

what sensory function does the medial nerve suppply

A

ventral and lateral plam and dorsal side of 2 and 3rd finger

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13
Q

what motor function does the ulnar nerve supply

A

abductor polliculs brevis, flexor carpi ulnaris and some flexors, abductors of the fingers

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14
Q

what sensory supply does the ulnar nerve supply

A

ventral and dorsal 1/3 of the hand

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15
Q

what are the common MOA for brachial flexopathies

A

trauma- pull or stretch
thoracic outlet
tumor invasion
post operative complications (sternotomy)
radiation

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16
Q

what are the symptoms of brachial plexopathy

A

weakness
pain
sensory loss

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17
Q

what motor neurons can be affected with brachial plexus lesions

A

Upper (C5,C6)
or
Lower (C8 - T1)

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18
Q

what is the MOA for brachial plexus lesions of the Upper motor neurons

A

head being pulled to one side with shoulder depression

Traction or tearing of the nerve fibers

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19
Q

what does brachial plexus lesions of the upper motor neurons result in

A

paralysis of: supraspinatus, infraspinatus, biceps brachialis, coracobrachialis, deltoid

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20
Q

what is the MOA for brachial plexus lesions of the lower motor neurons

A

falling and catching themselves

nerve may tear during the trauma

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21
Q

what does brachial plexus lesion of the lower motor neurons result in

A

median and ulnar nerve involved which will affect functionality of the hand

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22
Q

What is an Electromyography

A

EMG
used to asses neurons ability to transmit signals
needle put into the muscle in question or superficial sensor
during muscular activation, the degree of contraction measured in milivolts

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23
Q

what is an erbs palsy

A
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24
Q

what nerves may be involved with proximal humerus fractures

A

axillary and suprascapular nerve

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25
Q

why are you concerned about vasculature involvement with a proximal humerus fracture

A

fractures of the neck can disrupt the axillary artery leading to AVN of the humoral head

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26
Q

what is the concern regarding humeral shaft fractures

A

radial nerve injury can occur as it runs through spiral groove along the posterior aspect under the tricep

27
Q

what is the most common population with distal humerus fractures

A

children with FOOSH

28
Q

what is the stability of the shoulder joint maintained through

A

glenoid labrum
glenohumeral ligaments
RTC

29
Q

What is a bankart lesion

A

inferior tear that is associated with dislocations

30
Q

What makes up the RTC

A

Supraspinatus
Infraspinatus
Teres minor
subscapularis

31
Q

what is the MOA for the supraspinatus

A

ABDuction

32
Q

what is the MOA for the infraspinatus

A

ER

33
Q

what is the MOA for the Teres minor

A

ER

34
Q

what is the MOA for the Subscapularis

A

IR

35
Q

what is shoulder impingement syndrome

A

supraspinaus passes through the space created by the humeral head and acromion - initiates elevation and will keep humerus seated in GH joint when deltoid contracts - causes pain/inflammation of the RTC

36
Q

what is the most common MOA for shoulder impingement

A

repetitive overhead GH motion

37
Q

what does the Neers test assess for

A

Shoulder impingement

38
Q

what is subacromial impingement syndrome

A

inflammation of the RTC and bursa secondary to compression

39
Q

what is the presentation of Subacromial impingement syndrome

A

presents with OH activity discomfort and can be painful at night

40
Q

what are the causes of RTC injuries

A

acute after trauma (less common)
Chronic impingement
Chronic degenerative tearing

41
Q

what structures are involved in acute RTC injuries

A

supraspinatus
infraspinatus
teres minor

42
Q

what structure are involved with chronic impingement RTC injuries

A

bursal surface and bicep tendon

43
Q

what structures are involved with chronic degenerative RTC injury

A

supraspinatus
infraspinatus
teres minor

44
Q

what is adhesive capuslitis also known as

A

frozen shoulder

45
Q

what is adhesive capuslitis

A

loss of ROM in both active and passive ROM
inflammatory process during which there is increased fibroblastic activity and the joint capsule will become thickened, fibrotic and there will be scaring of the tissue together

46
Q

when does thawing of adhesive capusulitis typically happen

A

5-26 months - slow return to function

47
Q

What is the freezing stage of adhesive capusulitis

A

very painful, onset of progressive tightening typically weeks to months

48
Q

what is the frozen stage of adhesive capusulitis

A

shoulder is very stiff with ROM, making ADLS difficult and typically last 4- months

49
Q

where does the tendon insert

A

radial tuberosity of the radius

50
Q

what does the long head of the bicep assist with for motion

A

ABduction and IR

51
Q

what does the short head of the bicep assist with for motion

A

adduction

52
Q

what part of the bicep attenuated with the labrum

A

long head of the bicep

53
Q

what is the common cause of anterior shoulder pain

A

biceps tendonitis

54
Q

what can biceps tendonitis progress to

A

SLAP tear

55
Q

what type of bicep rupture is more significant

A

distal biceps rupture

56
Q

what type of muscles are located on the anterior aspect of the forarm

A

flexors

57
Q

where are the extensor muscles located on the forarm

A

posterior aspect

58
Q

what is medial epicondylitis

A

golfers elbow
due to repetitive pronation (flexors)
decreased/painful grip strength

59
Q

what is tennis elbow

A

lateral epicondylitis
extensor tendonitis

60
Q

what is a abductor pollicis longus and extensor pollicus brevis overuse injury called

A

deQuervains

61
Q

what does the finklstein test assess for

A

deQuervains

62
Q

what joints does dups pull on

A

pull MCP and/or PIP into flexion

63
Q

what are DRF at risk for

A

median nerve compression
compartment syndrome

CABS - MSK (12 decks)

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