Surgical anatomy of the upper limb Flashcards
A common cause of Clavicle fractures ?
Fall on outstretched hand
Intervention to Clavicle fractures ?
Describe passage of Radial n. Around humerus
Passes from posteriomedial to antrolateral in the spiral groove
Nerve at highest risk of injury ,, in humeral fractures ?
Radial nerve
Part of humerus with highest risk of injuring the radial nerve ?
• Distal 1/3 spiral fracture
Motor complications associated with radial nerve injury ?
• Wrist and finger drop
Conservative treatment of Humerus fractures ?
• U shaped Slab
• Hanging cast
When is Surgical treatment needed for humeral fractures ?
• Open
• Vascular injury
• Nerve injury
• Multiple fractures
• Non-union
Commonest Distal Radiul Fractures ?
Common complications of Distal Radiul Fractures ?
Deformity and fracture haematoma can result in compression of the Median nerve
Cause of Scaphoid fracture ?
• Fall on outstretched hand
…. Is a wrist bone with Retrograde blood supply
The Scaphoid
Figure shows three types of scaphoid fractures ,, mention eacg one of them
Scaphoid fracture with best prognosis ?
Scaphoid fracture with worst prognosis ?
Point to the lesion and give general diagnosis
Acromio-Clavicular dislocation
The Acromio-Clavicular joint is stabilized by :
-AC ligamnet
And
-CC ligamnet (Conoid & Trapezoid))
Why is the humerus shifted medially in shoulder dislocation ?
Due to action of subscapularis muscle
Complications of Shoulder dislocation ?
• Axillary n injury
• Labrum injury (Bankart lesion)
• Bone injury (Hill-Sachs lesion)
Sensory affection associated with axillary nerve injury ?
Motor affection associated with axillary nerve injury ?
What’s Bankart lesion ?
Labrum injury often associated with Shoulder dislocation
Hill-Sachs lesion ?
injury of the glenoid bone due to shoulder dislocation
Rotator cuff muscles ?
-Subscapularis
- Supraspinatoues
- infraspinatoues
-Teres minor
Common Rotator Cuff disorders ?
-Shoulder impingement
-Rotator cuff tear
What’s Shoulder impingement ?
Compression of the rotator cuff tendons in the tight subacromial space
Predisposing factor to Shoulder impingement ?
Causes of Rotator cuff tear ?
Can result from acute injury or chronic impingement
Functional deficit : of Rotator cuff tear depends on…..
the muscle involved
Complications of Supraspinatus tendon tear ?
inability to initiate abduction
Complications of Infraspinatus tendon tear ?
Weak lateral rotation
Complications of Teres Minor tendon tear ?
Weak lateral rotation
Complications of Subscapularis tendon tear ?
Weak medial rotation
What’s a ganglion cyst ?
a mucous-filled synovial cyst caused by either:
– trauma
– mucoid degeneration
– synovial herniation
Where does ganglion cysts arise ?
Arises from a joint or tendon sheath
The word volar means ?
Related to palm of hand
What’s a Mallet finger ?
• Rupture or avulsion of distal tendon insertion
Describe Boutonniere deformity
Finger is flexed at the proximal interphalangeal joint (PIP) and hyperextended at the distal interphalangeal joint (DIP)
The Carpal tunnel contains …..(no-) tendons
9 tendons
Name the condition and mention it’s cause
Thenar weakness or atrophy ; a complication of Carpal tunnel syndrome
Felt affection associated with medial nerve injury at wrist ?
Numbness and tingling in radial 3 ½ digits
Cubital tunnel syndrome ?
Ulnar nerve entrapment neuropathy
Usual cause of Ulnar nerve entrapment , in cubital tunnel syndrome ?
Usually chronic entrapment between the 2 heads of Flexor Carpi Ulnaris (FCU)
Felt affection of Cubital tunnel syndrome ?
Numbness in ulnar 1 ½ fingers
Atrophic affection associated with Cubital tunnel syndrome ?
Interosseous and first web space atrophy
Motor affection associated with Cubital tunnel syndrome
• Ring and small finger clawing
Guyon’s canal ?
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)
Explain the Ulnar Paradox
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.
What is Felon ?
Pulp space infection
Fibrous septae extends from…. To….
from periosteom to skin
Common complication of Pulp space infection ?
Pressure on blood vessels can result in necrosis of diaphysis
When felon disrupts the blood flow , diaphysis of phalanges can develop necrosis while Epiphesis is spared ; why ?
blood supply is proximal to the pulp space
What’s Pyogenic flexor tenosynovitis ?
Infection of the synovial sheath that surrounds the flexor tendon
Diagnose the condition and define it
Pyogenic flexor tenosynovitis ;
Infection of the synovial sheath that surrounds the flexor tendon
Common causitive prganism of Pyogenic flexor tenosynovitis ?
Staph Aureus
Define the condition and mention how it presents
– flexed posture
– tenderness
– pain with passive extension
– fusiform swelling
