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Upper Extremity Flashcards

1
Q

TRUE JOINTS

A

AC
SC
GH jt

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2
Q

FALSE JOINTS

A

Subacromial jt
Bicipital groove
Scapulothoracic jt

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3
Q

Orientation of clavicle

A

Lateral 1/3 - concave anteriorly

Medial 2/3 - convex anteriorly

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4
Q

FRAGMENTS OF CLAVICLE
Medial fragment?
Lateral fragment?

A

Pulled superiorly by SCM

Pulled inferiorly by gravity
Pulled medially by PECS MAJOR

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5
Q

Content of brachial plexus

A

Subclavian artery

Brachial plexus

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6
Q

Orientation of acromion

Mnemonics?

A

Acromion PLS
Posterior
Lateral
Superior

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7
Q

TYPES OF ACROMION PROCESS
MC?
Rare?
Assoc c impingement?

A

I - Flat
II - Curved
III - Hooked
IV - Upturned

Curved
Upturned
Hooked

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8
Q

Orientation of coracoid process

A

Anterior, superior

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9
Q

Ligament that prevents the superior translation of humerus

A

Coracoacromial ligament

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10
Q 
GREATEST TUBEROSITY OF HUMERUS
Location?
Palpation?
Mm attachment?
Best viewed in?
A

Lateral
IR
SIT
ER

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11
Q

LESSER TUBEROSITY OF HUMERUS
Location?
Palpation?
Mm attachment?

A

Medial
ER
Subscap

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12
Q

What sign when there is posterior deltoid weakness

-Hyperextend both UE, results in asymmetrical in both UE

A

SWALLOW TAIL SIGN

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13
Q

SC JOINT
Type?
Articulation?
DOF/axes?

A

Saddle/sellar/double plane joint
Medial end of clavicle + manubrium
3 DOF / 3 axes

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14
Q

Ligament that limits excessive depression of distal clavicle

A

Interclavicular (IC) ligament

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15
Q

Ligament that limits excessive elevation of distal clavicle

A

Costoclavicular (CC) ligament

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16
Q

SC LIGAMENT
Limits protraction?
Limits retraction?

A

Posterior SC

Anterior SC

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17
Q

SC DISC

Code??

A

EDi Sa PRC

During elevation, depression, disc becomes part of sternum

During protraction, retraction, disc becomes part of clavicle

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18
Q

Concave-Convex Rule
Elevation depression?
Protraction retraction?

A

Opposite

Same

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19
Q

What are the contributions of the SC joint during elevation:

<90 degrees of arm elevation?
More than 90 degrees of arm elevation?

A

Elevation

Depression

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20
Q

If there is no posterior rotation of the clavicle, arm elevation is up to how many degrees?

A

110

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21
Q

AC JOINT
Type?
Articulation?
DOF/axes?

A

Synovial plane joint
Acromion + lateral end of clavicle
3 DOF

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22
Q

Primary ligament for inferior translation?

A

SUPERIOR AC LIGAMENT

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23
Q

Primary ligament for superior translation?

A

CORACOCLAVICULAR LIGAMENT - CONOID

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24
Q

2 types of CORACOCLAVICULAR LIGAMENT

A

Conoid

Trapezoid

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25
``` CC - CONOID Shape? Anterior/Posterior? Medial/Lateral? Orientation of fibers? ```
Triangular Posterior Medial Vertical fibers
26
``` CC - TRAPEZOID Shape? Anterior/Posterior? Medial/Lateral? Orientation of fibers? ```
Quadrangular Anterior Lateral Horizontal fibers
27
What ligament that prevents medial displacement of scapula?
CC - TRAPEZOID LIGAMENT
28
What ligament that protects the subclavian artery & brachial plexus?
IC LIGAMENT
29
KINEMATICS OF AC For horizontal curvature? For vertical curvature?
ER & IR (protracts, retract) | Anterior & posterior tilting (shrug)
30
What are the contributions of the AC joint during arm elevation?
Upward elevation & posterior tilting
31
Type of joint in GH joint?
Ball & socket Spheroidal jt Universal jt
32
ORIENTATION OF ARTICULATION IN GH JOINT Mnemonics? Humeral head? Glenoid fossa?
MPS SAL MPS SAL
33
NORMAL ANGLES FOR THE HUMERAL HEAD Angle of inclination? Angle of torsion?
130-150 degrees | Approx 30 degrees of retrotorsion
34
What ligament that prevents downward translation of humerus?
CORACOHUMERAL LIGAMENT
35
What ligament that is greatly involved in AdCap?
CORACOHUMERAL LIGAMENT
36
What ligament that is greatly involved in DM & PD?
CORACOHUMERAL LIGAMENT
37
What ligament that is accompany of supraspinatus that prevents inferior trans of humerus?
CORACOHUMERAL LIGAMENT
38
ACTIONS & DEGREESTHAT GH LIGAMENT LIMIT Superior? Middle? Inferior?
0-45 degrees - ER, inf 45-90 degrees - ER, primary More than 90 degrees - ER, IR, inf
39
FORAMEN IN GH JOINT Bet. sup & middle lig? Bet. middle & inf lig?
FORAMEN OF WEITBRECHT | FORAMEN OF ROUVIER
40
INFERIOR GH LIGAMENT PARTS & THEIR LIMITS ACTION
Anterior band - ER Posterior band - IR Axillary pouch - inf translation
41
Bicipital groove aka?
Intertubercular groove
42
BOUNDARIES OF BICIPITAL GROOVE Mnemonics?? Roof?
Pec-Lat Me-Ter Lady between the 2 majors Pectoralis major - lateral Teres major - medial Lats Dorsi - floor THL - roof
43
Actions of Teres major & Lats dorsi
EXADIR
44
Subacromial joint aka?
Suprahumeral jt | Supraspinatus outlet
45
ACROHUMERAL INTERVAL Arms at side? Elevated?
10mm | 5mm
46
Recite the SCAPULOHUMERAL RHYTHM table
...
47
Action line of Deltoids
Large positive translatory | Small rotatory force
48
Action line of ITS
Negative translatory force
49
Action line of Supraspinatus
Small positive translator force of the supraspinatus is immediately counteracted by the negative translator force of gravity
50
Recite/write the BRACHIAL PLEXUS | Mnemonics?
``` RoTunDaCuBao Roots Trunk Division Cord Branches (MARMU) ```
51
How many branches in BP?
16 branches
52
Largest branch in BP?
RADIAL NERVE
53
NERVE ROOTS IN BRANCHES OF BRACHIAL PLEXUS Mnemonics? ``` Musculocutaneous? Axillary? Radial nerve? Median nerve? Ulnar nerve? ```
``` 3 Muskeeters - C5 C6 C7 2 Assasination - C5 C6 5 Rats - C5-T1 5 Mice - C5-T1 2 Unicorns - C8 T1 ```
54
WALLS OF AXILLA Mnemonics?? Anterior? Posterior? Lateral? Medial?
ANTERIOR (SUBPECPEC) Subclavius Pecs major Pecs minor POSTERIOR (SULATEMA) Subscapularis Lats Dorsi Teres Major LATERAL (BIBICO) Biceps tendon in bicipital groove - LH of Biceps Coracobrachialis MEDIAL SA Ribs 2-6
55
Where does Brachial Plexus comes from?
Anterior rami C5-T1
56
BOUNDARIES OF TRIANGULAR SPACE IN SHOULDER
Superior - teres minor Inferior - teres major Lateral - LH of triceps
57
BOUNDARIES OF QUADRANGULAR SPACE IN SHOULDER
Superior - teres minor Inferior - teres major Lateral - humerus Medial - LH of triceps
58
STRUCTURES THAT PASSES THROUGH THE SPACES OF: Quadrangular? Triangular?
Posterior circumflex humeral artery Axillary nerve Circumflex scapular artery
59
LTN aka?
Nerve of Bell
60
Axillary nerve aka?
Circumflex nerve
61
Radial nerve aka?
Musculospiral nerve
62
Thoracodorsal nerve aka?
Middle subscapular nerve
63
Musculocutaneous nerve aka?
Lateral cutaneous nerve
64
``` HUMERORADIAL JT Type of jt? Articulation? Ligaments? Kinematics? CC rule? ```
``` Modified hinge joint (ginglymus jt) Capitulum & radial fovea LCL - Lateral radial (primary), lateral ulnar 1 degree Same ```
65
``` HUMEROULNAR JT Type of jt? Articulation? Ligaments? Kinematics? CC rule? ```
``` Modified hinge joint (ginglymus jt) Trochlea & trochlear notch MCL - Anterir (primary), transverse, posterior 1 degree Same ```
66
CUBITAL FOSSA | Mnemonics??
``` Be Right There Always My PT (Lat to Medial) Brachioradialis Radial nerve Tendon of biceps brachial Artery Median nerve Pronator Teres ```
67
Why is there a CARRYING ANGLE?
Bc of the medial portion of trochlea which extends more distally forcing the ulna to deviate laterally
68
Importance of ulna? | Importance of radius?
Elbow | Wrist
69
``` NORMAL VALUES CARRYING ANGLE Male? Female? Cubitus varus? Cubitus valgus? Gunstock deformity? ```
``` 5-10 10-15 <5 More than 15 -15 ```
70
CARRYING ANGLE Present during? Absent during?
Elbow EXT FA supination Elbow flexion beyond 30 degrees FA pronation
71
``` SPURT MUSCLE Aka? Origin? Insertion? Effect? Muscle fiber orientation? Ex? ```
``` Mobility muscle Far from the jt Near the jt Rotatory effect Perpendicular ``` Biceps Brachialis
72
``` SHUNT MUSCLE Aka? Origin? Insertion? Effect? Muscle fiber orientation? Ex? ```
``` Stability muscle Near the jt Far from the jt Translatory/compress effect Parallel ``` Brachioradialis
73
``` PRIMARY ELBOW FLEXORS Chief elbow flexor? Strongest elbow flexor? Unaffected FA position? Affected by sh & FA position? Affected by FA position? ```
...
74
What mm that is: Unaffected by FA position Affected by shoulder position
TRICEPS BRACHII
75
TRICEPS BRACHII Prone to insufficiency? Strongest head? Active during resisted/unresisted motion?
Long head Lateral head Medial/Short head
76
What glide happens in prox radius during: Pronation? Supination?
Posterior glide | Anterior glide
77
PRU joint Type of jt? Articulation? CC rule?
Pivot/trochoid jt Radial head & radial notch Opposite
78
DRU joint Type of jt? Articulation? CC rule?
Pivot/trochoid jt Ulnar head & ulnar notch Same
79
What ligament that is taut in supination?
Oblique cord
80
What ligament that primary limit spin of radius?
Quadrate ligament
81
Strongest pronator
Pronator Teres
82
Chief pronator
Pronator Quadratus
83
CARPALS | Mnemonics?
Some Lovers Try Position | That They Cannot Handle
84
``` OTHER NAMES Scaphoid? Trapezium? Trapezoid? Capitate? Hamate? ```
``` Navicular Greater Multangular Lesser Multangular Os Magnum Unciform ```
85
Most mobile carpal
Scaphoid
86
``` ANATOMICAL SNUFFBOX Lateral? Medial? Floor? Content? ```
(LaTWOral) APL, EPB EPoL Scaphoid Radial artery
87
AVASCULAR NECROSIS Scaphoid? Lunate? Distal lunate?
(ScapPreiss) Preisser's Kienbock's Burn's Disease
88
Smallest carpal bone? 2nd smallest carpal bone? Largest carpal?
Pisiform Trapezoid Capitate
89
ORDER OF OSSIFICATION IN CARPALS | Mnemonics?
``` Come Home Tonight, Let's Try New Position Capitate Hamate Triquetrum Lunate Trapezium, Trapezoid Navicular Pisiform ```
90
Type of joint in RADIOCARPAL JOINT?
Condyloid/Ellipsoidal jt
91
Type of joint in 1st CMC jt?
Saddle/sellar jt
92
KINEMATICS (CC) IN 1ST CMC JT: Flexion/Extension Abd/Add
(Farehas) SAME | (Apposite) OPPOSITE
93
KINEMATIC - WRIST EXTENSION Full flexed - extend --? Neutral position - max contact of? - extend beyond neutral --? 45 degrees extension -- ?? -- extend beyond 45 degrees -- ??
Distal carpals Scaphoid + capitate --- distal carpals + scaphoid Scaphoid + lunate --- both proximal & distal carpals
94
KINEMATICS DURING RADIAL DEVIATION
Ulnar glide Flexion of prox carpals Extension of distal carpals (EXT OF MCP)
95
Type of joint in MCP jt?
Condyloid/Ellipsoidal jt
96
FLEXOR ZONES
``` I --- Insertion of FDP II --- Insertion of FDS III --- Neck of metacarpals (Lumbricals) IV --- Wrist; carpal tunnel V --- proximal to the wrist (FA) ```
97
Muscles active in Finger Extension
EDC (primary mm for finger extension) | Lumbricals & interossei -- assist EDC
98
EDC alone action:
MCP Hyperextension
99
CARPAL TUNNEL Contents? Roof? Floor?
4 FDS 4 FDP 1 FPL 1 median nerve Transverse carpal lig/Flexor retinaculum Scaphoid
100
EXTENSOR TUNNEL
``` I --- APL, EPB II --- ECRL, ECRB III --- EPL IV --- EI, EDC V --- EDM VI --- ECU ```
101
CLAVICULAR FRACTURES (%) Lateral? Middle? Medial?
15% 80% 5%
102
(+) step deformity
AC JOINT SPRAIN
103
Gold standard special test for AC JOINT SPRAIN
Horizontal adduction test
104
Horizontal adduction test aka?
Crossbody test AC Crossover test Apley scarf test
105
PAINFUL ARC GH? AC?
60-120 | 170-180
106
Recite the ROCKWOOD CLASSIFICATION
...
107
Sprengel's deformity aka?
Eulenberg's Deformity
108
Snapping scapula aka?
Scapulothoracic crepitus
109
Types of sound in Snapping scapula
Gentle friction sound Louder grating sound Loud snapping sound
110
SNAPPING SCAPULA Loud grating sounds conditions (Mnemonics?)
BAFA Bursitis Atrophy Fibrotic muscle Anomalous muscular insertion
111
SNAPPING SCAPULA Loud snapping sounds conditions (Mnemonics??)
TOM Tumor Osteophyte formation Malunion of rib fracture
112
SCAPULA WINGING | Mnemonics??
SMB SLut Serratus Anterior Medial Winging Book paralysis Sliding door paralysis Lateral winging Trapezius
113
Cause of medial winging
Radial mastectomy | Racksack palsy
114
Cause of lateral winging
Radical neck dissection
115
SICK SCAPULA | Mnemonics?
SICK Scapular malposition (forward tilt & protraction) Inferomedial border prominence Coracoid pain dysKinesia (abN mvt of scapula)
116
SHOULDER DISLOCATION | Mnemonics?
SAPA PALP Superior - AC Anterior - SC & GH (anteroinferior) Posterior - Elbow (posterolateral) Anterior - Lunate Posterior - Hip Anterior - knee Lateral - patella Posterior - ankle
117
MOI of anterior shoulder disloc
ABER
118
MOI of posterior shoulder disloc
FADIR + FOOSH
119
Assoc injuries in anterior shoulder disloc
Axillary nerve traction Bankart lesion Hill Sach's Lesion
120
BANKART LESION
BANKAI Anteroinferior
121
HILL SACH LESION
Posterolateral
122
BENNET'S LESION
Posteroinferior
123
Assoc injuries in posterior shoulder disloc
Lesser tuberosity fx Bennet's lesion Reverse Bankart Reverse Hill Sach
124
TYPES OF SLAP LESION (Snyder Classification)
...
125
MC type of SLAP LESION
TYPE 2 | Labral fraying + Detached biceps tendon
126
Maffet Subclassification of SLAP Lesion
(additional) V = II + bankart lesion VI = II + unstable flap VII = II + middle GH lig injury
127
MC surgical procedure in SLAP lesion
Bankart Surgery
128
Subscap tendon transfer from lesser to greater tuberosity
Magnuson Stack
129
Subscap tendon transfer from lesser to glenoid rim
Putti-Platt
130
Failure of acromion to ossify
Os acromiale
131
Supraspinatus Tendinitis aka?
Swimmer's shoulder
132
ROTATOR CUFF SPECIAL TEST | Mnemonics??
``` HENDY Hawkin's impingement Empty can (supra) Neer's impingment Drop arm (rotator) Yocum's ```
133
Recite the table of NEER'S STAGES OF SUPRASPINATUS TENDINITIS
...
134
What part of the tendon is MC torn in BICIPITAL TENDINITIS?
Proximal
135
(+) popeye sign
BICIPITAL TENDINITIS
136
SPECIAL TEST IN BICIPITAL TENDINITIS | Mnemonics?
SLY Speed's test Ludington's test Yergason's test
137
CALCIFIC TENDINITIS | Deposits of??
Hydroxyapatite
138
CALCIFIC TENDINITIS | Calcifications are usually located:
``` Supraspinatus = 80% Infraspinatus = 15% Subscapularis = 5% ```
139
Adhesive Capsulitis aka?
Frozen shoulder | Diabetic Periarthritis
140
Causes of Adhesive Capsulitis | mnemonics?
DIRATI ``` Diabetes Immobilization Recent strain Arthritis Trauma Idiopathic - MC ```
141
FROZEN SHOULDER STAGES
I: Pre-freezing, pre-adhesive II: Freezing stage III: Frozen stage IV: Thawing stage
142
TOS | Extra rib which arises from C7 vertebra
Cervical rib syndrome
143
SPECIAL TEST IN TOS | Mnemonics?
``` CHARAW Costoclavicular test Halstead Adson's Roo's Allen's Wright's test ```
144
CRPS aka? | mnemonics??
CRAPS (3 P, 4 S) ``` Causalgia Reflex sympathetic dystrophy Algoneuropathy Post traumatic vasospasm Post traumatic osteoporosis Post infectious sclerodactylia Stein Brocker's syndrome Shoulder hand syndrome Sudeck's atrophy Sympathalgia ```
145
Type 1 CRPS? | Type 2 CRPS?
RSD | Causalgia
146
SIGNS OF CRPS | Mnemonics?
``` STAMP Sensory Trophic skin changes Autonomic Motor Pain ```
147
DEAD ARM SYNDROME | Mnemonics?
PLAR Pyschological d/o (depression) Labral tear Anterior shoulder disloc Rotator cuff tear
148
Mobile wad of 3
ECRB ECRL Brachioradialis
149
MCL injury; excessive valgus at elbow
LITTLE LEAGUE'S ELBOW
150
OLECRANON BURSITIS Acute? Chronic?
Student's elbow | Miner's / Draftman's elbow
151
Posterior elbow impingement; hyperextension injury & valgus force at the elbow
Boxer's elbow
152
FEMALE ATHLETE TRIAD | Mnemonics?
AAO Amenorrhea Anorexia Osteoporosis
153
MYOSITIS OSSIFICANS (sites) UE? LE?
Brachialis > Biceps | Quadriceps
154
``` MYOSITIS OSSIFICANS (triad) Mnemonics? ```
PaPa FLEX Pain Palpable mass Flexion contracture
155
Volkmann's Ischemic Contracture aka?
Anterior FA Compartment Syndrome
156
Volkmann's Ischemic Contracture PRESENTATION?
Wrist FLEX MCP EXT IP FLEX
157
Volkmann's Ischemic Contracture (mmHg) Necrosis? Surgery?
30mmHg | 40mmHg
158
AVN of capitulum
Panner's disease
159
Fx in base of 1st MCP
Bennet's fx
160
Boxer's Fx
Neck of 5th MCP
161
Monteggia & Gallezi Fx | Mnemonics??
MUGR Monteggia - ulna Galleazi - radius
162
Trigger Finger aka?
Snapping finger Stenosing Tenovaginitis Digital Tenovaganitis Stenosans
163
Thickening of flexor tendon sheath is call what in trigger finger
Notta's nodule
164
Trigger finger is MC in??
3rd-4th finger
165
De Quervain's Disease aka?
Washerwoman's thumb Hoffman's disease Stenosing tenosynovitis
166
Dupuytren's contracture MC in?
4th and 5th digit
167
Rupture of FDP
Jersey finger
168
Rupture of EDC
Mallet/Baseball finger
169
Gamekeeper's thumb aka?
Skier's thumb
170
Sprain at ulnar collateral ligament of thumb
Gamekeeper's thumb
171
ZIGZAG DEFORMITY (RA) - thumb IP? MCP? CMC?
Flexion Extension Flexion
172
Mannerfelt syndrome aka?
Boutonniere of the thumb
173
Rupture of FPL; IP is extended
Mannerfelt syndrome
174
Dorsal displacement of lateral band
Swan neck
175
Volar displacement of lateralAPL + EPB | ECRL + ECRB band
Boutonniere
176
Ruptured central band (EDC)
Boutonniere
177
Grade 3 UCL sprain
Stener's lesion
178
Muscles involved in INTERSECTION SYNDROME
APL + EPB | ECRL + ECRB
179
Absence of an upper limb
Amelia
180
Absence of phalanges
Aphalangia
181
Absence of wrist & hand
Acheira
182
Absence of metacarpal
Adactylia
183
Partial absence of a limb
Meromelia
184
Absence of half of a limb
Hemimelia
185
"Seal limb" | Flipper like limb
Phocomelia
186
Numerous fingers
Polydactyly
187
Enlarged finger
Macrodactyly
188
Webbed finger (2nd & 4th)
Syndactyly
189
Curved little finger
Clinodactyly
190
Bent little finger
Camptodactyly
191
Absent 2nd-4th metacarpals/fingers
Lobster claw hand
192
Ulnar prominence. Radius & wrist are volarly displaced
Madelung's deformity

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