Pathophysiology of Upper Extremity

Question 1

what do we need to consider in regards too humeral fractures

Answer 1

vasculator

Question 2

what are the compartments of the upper arm

Answer 2

Anterior and posterior compartments

Question 3

what is within the anterior compartment of the upper arm

Answer 3

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

Question 4

What is within the posterior compartment of the upper arm

Answer 4

extensor
contains radial nerve
triceps

Question 5

What motor function does the musculocutaneous nerve supply

Answer 5

coricobrachialis, brachialis, biceps brachii

Question 6

what sensory function does the musculocutaenous nerve supply

Answer 6

sensation for that lateral arm

Question 7

what motor function does the axillary nerve supply

Answer 7

deltoid (3 parts) and teres minor

Question 8

what sensory function does the axillary nerve supply

Answer 8

posterior/lateral deltoid - easily damaged in trauma

Question 9

what motor function does the radial nerve supply

Answer 9

ALOT
- triceps, anconeous, brachioradialis, supinator

Question 10

what sensory function does the radial nerve supply

Answer 10

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

Question 11

what motor function does the median nerve supply

Answer 11

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

Question 12

what sensory function does the medial nerve suppply

Answer 12

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

Question 13

what motor function does the ulnar nerve supply

Answer 13

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

Question 14

what sensory supply does the ulnar nerve supply

Answer 14

ventral and dorsal 1/3 of the hand

Question 15

what are the common MOA for brachial flexopathies

Answer 15

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

Question 16

what are the symptoms of brachial plexopathy

Answer 16

weakness
pain
sensory loss

Question 17

what motor neurons can be affected with brachial plexus lesions

Answer 17

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

Question 18

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

Answer 18

head being pulled to one side with shoulder depression

Traction or tearing of the nerve fibers

Question 19

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

Answer 19

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

Question 20

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

Answer 20

falling and catching themselves

nerve may tear during the trauma

Question 21

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

Answer 21

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

Question 22

What is an Electromyography

Answer 22

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

Question 23

what is an erbs palsy

Question 24

what nerves may be involved with proximal humerus fractures

Answer 24

axillary and suprascapular nerve

Question 25

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

Answer 25

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

Question 26

what is the concern regarding humeral shaft fractures

Answer 26

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

Question 27

what is the most common population with distal humerus fractures

Answer 27

children with FOOSH

Question 28

what is the stability of the shoulder joint maintained through

Answer 28

glenoid labrum glenohumeral ligaments RTC

Question 29

What is a bankart lesion

Answer 29

inferior tear that is associated with dislocations

Question 30

What makes up the RTC

Answer 30

Supraspinatus Infraspinatus Teres minor subscapularis

Question 31

what is the MOA for the supraspinatus

Answer 31

ABDuction

Question 32

what is the MOA for the infraspinatus

Answer 32

ER

Question 33

what is the MOA for the Teres minor

Answer 33

ER

Question 34

what is the MOA for the Subscapularis

Answer 34

IR

Question 35

what is shoulder impingement syndrome

Answer 35

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

Question 36

what is the most common MOA for shoulder impingement

Answer 36

repetitive overhead GH motion

Question 37

what does the Neers test assess for

Answer 37

Shoulder impingement

Question 38

what is subacromial impingement syndrome

Answer 38

inflammation of the RTC and bursa secondary to compression

Question 39

what is the presentation of Subacromial impingement syndrome

Answer 39

presents with OH activity discomfort and can be painful at night

Question 40

what are the causes of RTC injuries

Answer 40

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

Question 41

what structures are involved in acute RTC injuries

Answer 41

supraspinatus infraspinatus teres minor

Question 42

what structure are involved with chronic impingement RTC injuries

Answer 42

bursal surface and bicep tendon

Question 43

what structures are involved with chronic degenerative RTC injury

Answer 43

supraspinatus infraspinatus teres minor

Question 44

what is adhesive capuslitis also known as

Answer 44

frozen shoulder

Question 45

what is adhesive capuslitis

Answer 45

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

Question 46

when does thawing of adhesive capusulitis typically happen

Answer 46

5-26 months - slow return to function

Question 47

What is the freezing stage of adhesive capusulitis

Answer 47

very painful, onset of progressive tightening typically weeks to months

Question 48

what is the frozen stage of adhesive capusulitis

Answer 48

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

Question 49

where does the tendon insert

Answer 49

radial tuberosity of the radius

Question 50

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

Answer 50

ABduction and IR

Question 51

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

Answer 51

adduction

Question 52

what part of the bicep attenuated with the labrum

Answer 52

long head of the bicep

Question 53

what is the common cause of anterior shoulder pain

Answer 53

biceps tendonitis

Question 54

what can biceps tendonitis progress to

Answer 54

SLAP tear

Question 55

what type of bicep rupture is more significant

Answer 55

distal biceps rupture

Question 56

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

Answer 56

flexors

Question 57

where are the extensor muscles located on the forarm

Answer 57

posterior aspect

Question 58

what is medial epicondylitis

Answer 58

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

Question 59

what is tennis elbow

Answer 59

lateral epicondylitis extensor tendonitis

Question 60

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

Answer 60

deQuervains

Question 61

what does the finklstein test assess for

Answer 61

deQuervains

Question 62

what joints does dups pull on

Answer 62

pull MCP and/or PIP into flexion

Question 63

what are DRF at risk for

Answer 63

median nerve compression compartment syndrome