Surgical anatomy of the upper limb

Question 1

A common cause of Clavicle fractures ?

Answer 1

Fall on outstretched hand

Question 2

Intervention to Clavicle fractures ?

Answer 2

Question 3

Describe passage of Radial n. Around humerus

Answer 3

Passes from posteriomedial to antrolateral in the spiral groove

Question 4

Nerve at highest risk of injury ,, in humeral fractures ?

Answer 4

Radial nerve

Question 5

Part of humerus with highest risk of injuring the radial nerve ?

Answer 5

• Distal 1/3 spiral fracture

Question 6

Motor complications associated with radial nerve injury ?

Answer 6

• Wrist and finger drop

Question 7

Conservative treatment of Humerus fractures ?

Answer 7

• U shaped Slab

• Hanging cast

Question 8

When is Surgical treatment needed for humeral fractures ?

Answer 8

• Open

• Vascular injury

• Nerve injury

• Multiple fractures

• Non-union

Question 9

Commonest Distal Radiul Fractures ?

Answer 9

Question 10

Common complications of Distal Radiul Fractures ?

Answer 10

Deformity and fracture haematoma can result in compression of the Median nerve

Question 11

Cause of Scaphoid fracture ?

Answer 11

• Fall on outstretched hand

Question 12

…. Is a wrist bone with Retrograde blood supply

Answer 12

The Scaphoid

Question 13

Figure shows three types of scaphoid fractures ,, mention eacg one of them

Answer 13

Question 14

Scaphoid fracture with best prognosis ?

Question 15

Scaphoid fracture with worst prognosis ?

Answer 15

Question 16

Point to the lesion and give general diagnosis

Answer 16

Acromio-Clavicular dislocation

Question 17

The Acromio-Clavicular joint is stabilized by :

Answer 17

-AC ligamnet
And

-CC ligamnet (Conoid & Trapezoid))

Question 18

Why is the humerus shifted medially in shoulder dislocation ?

Answer 18

Due to action of subscapularis muscle

Question 19

Complications of Shoulder dislocation ?

Answer 19

• Axillary n injury

• Labrum injury (Bankart lesion)

• Bone injury (Hill-Sachs lesion)

Question 20

Sensory affection associated with axillary nerve injury ?

Answer 20

Question 21

Motor affection associated with axillary nerve injury ?

Answer 21

Question 22

What’s Bankart lesion ?

Answer 22

Labrum injury often associated with Shoulder dislocation

Question 23

Hill-Sachs lesion ?

Answer 23

injury of the glenoid bone due to shoulder dislocation

Question 24

Rotator cuff muscles ?

Answer 24

-Subscapularis

• Supraspinatoues
• infraspinatoues

-Teres minor

Question 25

Common Rotator Cuff disorders ?

Answer 25

-Shoulder impingement -Rotator cuff tear

Question 26

What’s Shoulder impingement ?

Answer 26

Compression of the rotator cuff tendons in the tight subacromial space

Question 27

Predisposing factor to Shoulder impingement ?

Answer 27

Question 28

Causes of Rotator cuff tear ?

Answer 28

Can result from acute injury or chronic impingement

Question 29

Functional deficit : of Rotator cuff tear depends on…..

Answer 29

the muscle involved

Question 30

Complications of Supraspinatus tendon tear ?

Answer 30

inability to initiate abduction

Question 31

Complications of Infraspinatus tendon tear ?

Answer 31

Weak lateral rotation

Question 32

Complications of Teres Minor tendon tear ?

Answer 32

Weak lateral rotation

Question 33

Complications of Subscapularis tendon tear ?

Answer 33

Weak medial rotation

Question 34

What’s a ganglion cyst ?

Answer 34

a mucous-filled synovial cyst caused by either: – trauma – mucoid degeneration – synovial herniation

Question 35

Where does ganglion cysts arise ?

Answer 35

Arises from a joint or tendon sheath

Question 36

The word volar means ?

Answer 36

Related to palm of hand

Question 37

Answer 37

Question 38

What’s a Mallet finger ?

Answer 38

• Rupture or avulsion of distal tendon insertion

Question 39

Describe Boutonniere deformity

Answer 39

Finger is flexed at the proximal interphalangeal joint (PIP) and hyperextended at the distal interphalangeal joint (DIP)

Question 40

The Carpal tunnel contains …..(no-) tendons

Answer 40

9 tendons

Question 41

Name the condition and mention it’s cause

Answer 41

Thenar weakness or atrophy ; a complication of Carpal tunnel syndrome

Question 42

Felt affection associated with medial nerve injury at wrist ?

Answer 42

Numbness and tingling in radial 3 ½ digits

Question 43

Cubital tunnel syndrome ?

Answer 43

Ulnar nerve entrapment neuropathy

Question 44

Usual cause of Ulnar nerve entrapment , in cubital tunnel syndrome ?

Answer 44

Usually chronic entrapment between the 2 heads of Flexor Carpi Ulnaris (FCU)

Question 45

Felt affection of Cubital tunnel syndrome ?

Answer 45

Numbness in ulnar 1 ½ fingers

Question 46

Atrophic affection associated with Cubital tunnel syndrome ?

Answer 46

Interosseous and first web space atrophy

Question 47

Motor affection associated with Cubital tunnel syndrome

Answer 47

• Ring and small finger clawing

Question 48

Guyon’s canal ?

Answer 48

Guyon canal serves as a protection for the ulnar nerve and ulnar artery as they traverse from the distal wrist into the hand. It is formed by the following structures: The volar portion/roof of the canal is created by the volar carpal ligament (also known as the palmar carpal ligament)

Question 49

Explain the Ulnar Paradox

Answer 49

Less clawing of the fingers is seen in high ulnar nerve lesions than a low lesion, because FDP (Flexor Digitorum Profundus ) is involved in high lesions, thus relaxing the interphalangeal joints.

Question 50

What is Felon ?

Answer 50

Pulp space infection

Question 51

Fibrous septae extends from…. To….

Answer 51

from periosteom to skin

Question 52

Common complication of Pulp space infection ?

Answer 52

Pressure on blood vessels can result in necrosis of diaphysis

Question 53

When felon disrupts the blood flow , diaphysis of phalanges can develop necrosis while Epiphesis is spared ; why ?

Answer 53

blood supply is proximal to the pulp space

Question 54

What’s Pyogenic flexor tenosynovitis ?

Answer 54

Infection of the synovial sheath that surrounds the flexor tendon

Question 55

Diagnose the condition and define it

Answer 55

Pyogenic flexor tenosynovitis ; Infection of the synovial sheath that surrounds the flexor tendon

Question 56

Common causitive prganism of Pyogenic flexor tenosynovitis ?

Answer 56

Staph Aureus

Question 57

Define the condition and mention how it presents

Answer 57

– flexed posture – tenderness – pain with passive extension – fusiform swelling