Problems with the upper limb Flashcards
how does the blood supply to the scaphoid affect the healing of fractures there
the blood supply runs distally to proximally so more proximal fractures are more likely of non union as they receive the least blood
where would pain be experienced in scaphoid fractures
in the anatomical snuff box
what is tenosynovitis
inflammation of the fluid filled sheaths surrounding a tendon
what are symptoms of tenosynovitis
pain, swelling, difficulty moving joint
what test can be used to diagnose tenosynovitis in the wrist
Finkelstein’s where the thumb is placed in the closed wrist and tilted down to see if pain is experienced
what is osteoarthritis
the wearing down of the articular cartilage at joints, narrowing the joint space
what are osteophytes
extra bone growths seen in osteoarthritis
what is Dupuytrens disease
soft tissue in the palm develops into scar tissue
what causes Dupuytrens disease
alcoholic liver disease, epilepsy and diabetes
what does the hand look like in Dupuytrens disease
the proximal interphalangeal joints are flexed
what is carpal tunnel syndrome
compression of the median nerve causing a loss of sensation to the 3 and 1/2 radial fingers and a loss of motor function to the LOAF intrinsic muscles
what are the symptoms of carpal tunnel syndrome
paraesthesia, numbness and worsening at night
why don’t you lose sensation to the palm in carpal tunnel syndrome
the branch of medial nerve innervating the palm braches off before the tunnel and lie superficial
what is tendon avulsion
when the flexor digitorum profundus snaps and takes some bone with it
what happens to the fingers in tendon avulsion
they cant bend as the flexor digitorium profundus is not working
what is a boxers fracture
where the metacarpals break
what is ulnar claw
damage to the ulnar nerve at the wrist affecting the little and ring finger causing hyperextension at the MCP and flexion at the IP joints as these are no longer opposed by the lumbricals
why can fat pad displacement be an indication of fractures
the fractures cause effusion of blood from bone which can displace the fat pads
what is tennis elbow
overuse of the tendons from the extensor muscles attaching to the lateral epicondyle causing pain and inflammation
what is golfers elbow
overuse of tendons from the flexor muscles attaching to the medial epicondyle causing pain and inflammation
what is cubital tunnel syndrome
when the ulnar nerve is compressed as it runs between the medial and lateral epicondyles of the humerus
why doesn’t cubital tunnel syndrome result in a severe ulnar claw
as the branch of ulnar nerve supplying the flexor digitorum profundus has not branched at the elbow whereas it has at the wrist
what causes cubital tunnel syndrome
repeated leaning on the elbows or bending of the elbows
what is pulled elbow
partial dislocation where the radial head is displaced from the annular ligament distally
why does pulled elbow occur in children
the annular ligament strengthens with age
what is olecranon bursitis
when the olecranon bursa becomes inflamed due to repeated injury, one off injury, arthritis or infection
what is a colle’s fracture
fracture of the distal radius giving a dinner fork deformity of an inward/dorsal displacement
what is a smith’s fracture
fracture of the distal radius giving a dinner fork deformity of an outward/palmer displacement
what is calcium tendinitis
when calcium hydroxyapatite deposits cause the collagen tendons in the shoulder joint to ossify
what must you be careful about in a mi clavicular fracture
that the fracture doesn’t puncture the lung causing a haemothorax
where is the lateral and medial ends displaced in a mid clavicular fracture
- distal = inferiorly due to the weight of the arm and pectoralis major
- medial = superiorly due to the sternocleidomastoid muscle
what causes a proximal and mid humerus fracture
falling on an outstretched hand
what causes an elbow dislocation
falling on a flexed elbow
what are the 3 types of shoulder dislocation
anterior, posterior and inferior
what is the most common type of shoulder dislocation
anterior as the pull of the muscles and the shallow glenoid fossa make it more prone to dislocation
what causes posterior shoulder dislocations
epileptic fits or electric shock
what nerve is damaged in anterior dislocations
axially causing paralysis to the deltoid and teres minor
what artery may be damaged in an anterior shoulder dislocation
axially artery
how will the arm be held in an anterior shoulder dislocation
externally rotated and slightly abducted
how will the arm be held in a posterior shoulder dislocation
internally rotated and adducted
what nerve is damaged in a proximal humerus fracture
axially
what nerve is damaged in a mid humerus fracture
radial
what is seen in a mid humerus fracture
wrist drop as the extensors to the wrist have lost their nerve supply so there’s unopposed flexion
what causes a distal humerus fracture
falling on a flexed elbow
