Session 1 - Fractures of the Humerus

Question 1

Name fourtypes of humeral fracture

Answer 1

Surgical, Midshaft, Supracondylar, Medial Epicondylar

Question 2

What is damaged in a surgical fracture of the humerus?

Answer 2

Posterior circumflex artery and axillary artery

Axillary nerve

Question 3

What does damage to the axillary nerve cause in a surgical fracture?

Answer 3

Loss of motor function of teres minor and deltoids

Loss of sensation to regimental badge area

Question 4

What does a midshaft fracture cause damage?

Answer 4

Radial nerve damage, causing wrist drop due to extensor paralysis and unopposed flexion

Question 5

What type of fracture is a midshaft fracture of the humerus?

Answer 5

Spiral

Question 6

What damage does a supracondylar fracture do?

Answer 6

Damages brachial artery, leading to loss of blood supply to flexors resulting in volkmans ischaemic contractures. Flexors shortan and cause uncontrolled flexion.

Question 7

What does a medial epicondylar fracture of the humerus cause?

Answer 7

Damages ulnar nerve and ulnar claw becomes apparent

Question 8

What are the four rotator cuff muscles?

Answer 8

SITS
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis

Question 9

Action and innvervation of supraspinatus

Answer 9

Suprascapular nerve

Abduction up to 15*

Question 10

Action and innervation of infraspinatus

Answer 10

Supracscapular nerve

Lateral rotation of the arm

Question 11

Action and innervation of subscpularis

Answer 11

Upper and lower subscapular nerve

Prevents displacement of the head of the humerus

Question 12

What is the action of the rotator cuff mmuscles together?

Answer 12

Stabilisation of the glenohumeral joint

Question 13

What is painful arc syndrome?

Answer 13

Normally: Supraspinatus rubs against the coraco-acromial arch, friction of which is usually reduced by subacromial bursa.
HOWEVER
Pain in the middle of abduction when the supraspinatus tendon comes into contact with the acromion due to degenerative changes in both the supraspinatus tendin and the subacromial bursa

Question 14

What are the three muscles of the arm?

Answer 14

BBC
Biceps
Brachialis
Coracobrachialis

Question 15

What is the attachment of the bicep?

Answer 15

Long head at the supraglenid tubercle, short head at the coracoid process
Attaches distally to the radial tuberosity

Question 16

What is the aciton of the bicep?

Answer 16

Responsible for supination of forearm and flexion at the elbow and shoulders

Question 17

What is popeye sign?

Answer 17

Bulging bicep after rupture of the long tendon of the biceps. Very littleweakness on flexion due to actions of the supinator and brachialis.

Question 18

What is the origin of the corachobrachialis?

Answer 18

Coracoidprocess of scapula

Question 19

What is actions of the corachobrachialis?

Answer 19

Flexion at shoulder

Question 20

What is the innervation of the three arm muscles?

Answer 20

Musculocutaneous nerve

Question 21

What is the action of the brachialis?

Answer 21

The brachialis muscle is the main flexor at the elbow

Question 22

What is the attachment of the brachalis?

Answer 22

It originates from the medial and lateral surfaces of the humeral shaft, and inserts into the tuberosity of ulna just distal to the elbow joint.