Upper Extremity, CDB Flashcards
Sweat vs sebaceous gland: The breast is a modified ___
Sweat
Sebaceous glands surrounding the breast
Montgomery tubercle
Axillary LN levels
Level I: Inferolateral to pectoralis minor Level II: Posterior to pectoralis minor Level III: Superomedial to pectoralis minor
Least vascular portion of breast
Inferior
Most common site of breast CA
Upper outer quadrant
Intraosseous vs intramembranous ossification: Clavicle
Intramembranous
Scapular landmarks (rib): Superior angle
2nd rib
Scapular landmarks (rib): Spine
3rd rib
Scapular landmarks (rib): Inferior angle
7th rib
Suprascapular notch transmits
Suprascapular nerve
Humerus: Shape of head
1/3 of sphere
Humerus: Anatomical vs surgical neck, more frequently fractured
Surgical
Vessel/s/Nerve/s related to the surgical neck of humerus
1) Posterior humeral circumflex artery 2) Axillary nerve
Radius and ulna, fracture-dislocation: Radial fracture, inferior dislocation
GRIMUS Galleazi
Radius and ulna, fracture-dislocation: Ulnar fracture, superior dislocation
GRIMUS Monteggia
Nursemaid elbow: Bone dislocated
Radial head
Nursemaid elbow: Ligament torn
Annular ligament
Most common fracture of metacarpals
Boxer fracture
Anterior vs posterior dislocation: Humeral head at subcoracoid position
Anterior
Anterior vs posterior dislocation: Humeral head at subglenoid position
Posterior
Acromioclavicular joint dislocation is due to a tear in what ligament
Coracoclavicular
Cubitus varus vs valgus: Gunstock deformity
Varus
Malunion of supracondylar fractures give rise to
Gunstock deformity
Most common dislocation in children
Elbow dislocation
Most common dislocation in adults
Shoulder dislocation
2nd most common dislocation in adults
Elbow dislocation
Partial dislocation
Subluxation
Most common cause of elbow dislocation
Fall on outstretched hand
Most common type of shoulder dislocation
Anterior dislocation
Injury to the brachial artery in elbow dislocation brings about
Volkmann ischemic contracture
Osteoarthritis, DIP vs PIP: Heberden node
DIP
Osteoarthritis, DIP vs PIP: Bouchard node
PIP
Brachial plexus: Trunk affected by downward displacement of arm
Upper
Brachial plexus: Trunk affected by forced abduction of arm
Lower
Causes of thoracic outlet syndrome (2)
1) Scalene spasm 2) Cervical rib
Thoracic outlet syndrome: Structures compressed
1) Lower trunk of brachial plexus 2) Subclavian artery
Canal in the wrist that transmits the ulnar artery and nerve into the hand
Guyon canal
Channel which allows the ulnar nerve to travel over the elbow
Cubital tunnel
Condition brought on by increased pressure on the ulnar nerve at the elbow.
Cubital tunnel syndrome
The funny bone is related to what nerve
Ulnar nerve
A thin aponeurotic band extending from medial head of triceps to the medial intermuscular septum which could be a site of ulnar nerve entrapment after arm surgery
Arcade of Struthers
Fracture of this bone causes compression of ulnar nerve at the Guyon canal
Hook of hamate
Nerve paralysis: (+) Froment sign
Ulnar nerve
(+) Froment sign
Flexion of PIP of thumb with paper between fingers
Nerve paralysis: Pronator teres syndrome
Median nerve
Nerve paralysis: Saturday night palsy
Radial nerve
A fibrous band extending from the supracondylar process to the median epicondyle in which the median nerve may be compressed
Ligament of Struthers
Nerve paralysis: Honeymooner’s palsy
Radial nerve
Nerve paralysis: Anterior interosseous syndrome
Ulnar nerve
Nerve paralysis: Crutch palsy
Radial nerve
Nerve paralysis: Weak supination
Radial nerve
Nerve paralysis: Simian hand
Median nerve
Nerve paralysis: Posterior interosseous syndrom
Radial nerve
T/F Compression of the radial nerve at the cubital fossa (arcade of Frohse) results in wrist drop and sensory loss
F
Radial vs ulnar artery: Deep palmar arch
Radial
Radial vs ulnar artery: Common interosseous artery
Ulnar
Radial vs ulnar artery: Superficial palmar arch
Ulnar
Test: The hand is elevated and the patient/person is asked to make a fist for about 30 seconds. Pressure is applied over the ulnar and the radial arteries so as to occlude both of them. Still elevated, the hand is then opened. It should appear blanched. Ulnar pressure is released.
Allen Test
Allen test: Positive result
Color does not return within 7 seconds
Allen test: Done prior to
Heart bypass surgery
Allen test: Determines
Patency of ulnar artery prior to radial artery cannulation
Tendon ruptured with inability to initiate abduction of arm
Supraspinatus
Reflex-roots: Ankle
S1,2
Reflex-roots: Knee
L3,4
Extensor tendon compartments: Compartment 1
1) Abpolo 2) Expobre
Extensor tendon compartments: Compartment 2
1) Extensor carpi radialis brevis 2) Extensor carpi radialis longus
Extensor tendon compartments: Compartment 3
Extensor pollicis longus
Extensor tendon compartments: Compartment 4
1) Extensor digitorum 2) Extensor indicis
Extensor tendon compartments: Compartment 5
Extensor digiti minimi
Extensor tendon compartments: Compartment 6
Extensor carpi ulnaris
Extensor compartment affected in De Quervain’s tenosynovitis
Compartment 1
Maneuver to test for De Quervain’s tenosynovitis
Finkelstein test
(+) Finkelstein test
Most frequently fractured carpal bone
Scaphoid
Tests for carpal tunnel syndrome (3)
1) Phalen 2) Tinel 3) Carpal compression test
Phalen test
Tinel test
Positive Phalen, Tinel, and carpal compression test
Tingling (pins and needles) sensation at the median nerve distribution
Carpal compression test
No man’s land
Zone 2: Poor prognosis
Laceration of extensor tendon over DIP joint
Mallet finger
Laceration of extensor tendon over PIP joint
Boutonniere deformity
Injury to ulnar collateral ligament of thumb
Gamekeeper’s thumb
Reverse Phalen
(+) Froment sign: Muscle paralyzed
Adductor pollicis
