PBL 2 Flashcards
(24 cards)
what does elbow reduced mean
approached by either a prone or supine, prone approach is used first, it is when the long arm split is applied, flex the elbow at 90 degrees and place the forearm in a neutral position with respect to pronation and supination
what is a triage nurse
this is a nurse that is the first point of contact for people in an emeregency department
describe the elbow joint, what joints are there present in it and what ligaments does it form
- Made out of the humeroradial joint, the humeroulnar joint these both allow flexion and extneison
- The proximal radioulnar joint allows pronation and supination
- Carrying angle larger in women then in men
- There is a radial collateral ligament and an ulnar collateral ligament
- As well as an anular ligament this goes around the head of the radius, this is what can become dislocated if there is a wide angle between the shoulder and rest of the body when children are being lifted up by there hands
- Anular ligament creates the proximal radioulnar joint and this permits pronation and supination of the forearm
what causes flexion of the forearm
- Biceps brachii
- Brachilais
what causes extension of the forearm
- Triceps brachii
what causes pronation of the forearm
- Pronator teres
- Protantor quadratus
what causes supination of the forearm
- Biceps brachii
- Supinator
what innervates the posterior compartment
radial nerve
what innervates the anterior compartment
musculocutaneous nerve
what makes up the cubital fossa
- brachioradialis
- bicipital aponeurosis
- pronator teres
what is the content of the cubital fossa
- Biceps brachii tendon
- Terminal part of the brachial artery
- Deep veins – brachial deep veins
- Median nerve
what are the superficial flexors
– Pronator teres, - pronates
– Flexor carpi radialis
– Palmaris longus
– Flexor carpi ulnaris
what do the superficial flexors act on
the wrist
what are muscles that close the hand
- Flexor digitorum superficialis - flexes MCP and PIP
- Flexor digitorum profundus – flexes MCP PIP DIP
- Flexor pollicis longus – MCP and IP of thumb
what are the muscles that open the hand
• Extensor digitorum communis, – 4 tendons • Extensor indicis – index finger • Extensor digiti minimi – little finger
what are the intrinsic muscles of the hand
- thenar – act of the thumb
- hypothenar – act on the little finger
- Lumbricals, flex MCP extend interphalangeal joints of 2nd-5th digits
- Dorsal interossei, abduct 2nd-4th digits. Assist lumbricals
- Palmar interossei, adduct 2nd,4th and 5th digits, assist lumbricals
what is the sensory supply for the median nerve
palm of the hand - thumb to. half of ring fingeringer
- back of the hand tips of the thumb, to half of ring finger
what is the sensory supply for ulnar nerve
half of ring finger to little finger for both palm and back of hand
what is the sensory supply for radial nerve
back of hand until ring finger half
what are the sensory tests for the hand
radial - first inter web
median - lateral half of index finger
ulnar - medial half of little finger
what happens when you have radial nerve damage
- Gives wrist drop
- No extensors as they are in the posterior part of the arm where the radial nerve innervates
- Depends on where injury takes place – mid shaft radial innervation to long head of triceps has already come off already so only lateral and medial heads of triceps is lost therefore you have weak elbow extensions
what happens when you have high median nerve damage
- Hands of benedicition
- Supracondylar fractures of the humerus
o Hand of benediction - When patient asked to make a fist (classic)
o Loss of flexion of MCP digits 2-3
o Loss of flexion of PIP in digits 1-3
o Loss of DIP flexion digits 2-3
o Weak PIP flexion of digits 4-5
o Can flex DIP of digits 4-5
Because ulnar nerve innervates medial FDP and FCU
what happens when you have low median nerve damage
- Carpal tunnel syndrome:
- Any condition reducing size of carpal tunnel causes compression of median nerve
- Progressive loss of co-ordination and strength in thumb
what happens if you have ulnar nerve damage
- Claw hand
- Muscles paralyzed are:
- flexor carpi ulnaris,
- medial half of FDP,
- medial two lumbricals,
- all interossei (palmar and dorsal)
- adductor pollicis
