Upper Extremity Disorders Flashcards
What is the primary supinator in the arm?
Biceps
MOA of a Distal Biceps Injury
Eccentric contraction
Steroid users
How to test for a distal biceps rupture?
Hook test
Indications to Fix a Distal Biceps Rupture
Laborer: frequent use of screwdriver, doorknobs, handles
Popeye’s deformity
Cosmetic
Another Name for Tennis Elbow
Lateral Epicondylosis
What muscles are affected with lateral epicondylosis?
Forearm extensors
What muscles are affected with medial epicondylosis?
Forearm flexors
Pronator
Treatment of medial (golf) or lateral (tennis) epicondylosis (elbow)?
Patient education
Ice
NSAIDs
Begin stretching program followed by strengthening exercises
What can bursitis be secondary to?
Trauma
Infection
Arthritic conditions: gout, RA, OA
Most Common Locations of Bursitis
Olecranon
Pre-patellar
Other Locations of Bursitis
Sub-deltoid
Ischial
Trochanteric
Baker cyst
What can a constant draining of sinuses lead to?
SCC
Treatment of Bursitis
Heat Rest NSAIDs Local corticosteroid injections I&D (septic) + antibiotics
Radial Nerve Palsy
Saturday night palsy
Get drunk and lie on your arm wrong
What does the radial nerve innervate?
Flexors & ulnar mediatros
4 Sites of Compression of the Ulnar Nerve
Cubital tunnel (elbow)
IM septum
2 heads of flexor carpal ulnas
Gianes cannel (at the wrists
Tests for Cubital Tunnel Ulnar Nerve Palsy
Tinnel’s
Bent elbow test
Treatment for a Dislocating Ulnar Nerve
Dish towel
Knee pad worn backwards to keep arm extended
Indications to fix Ulnar Nerve Palsies
Persistent numbness
Instability
Muscle atrophy
What is the most common peripheral neuropathy?
Carpal tunnel/median nerve
Define Tinel’s Sign
Tingling or shock-like pain on solar wrist percussion
Define Phalen’s Sign
Pain or paresthesia in the distribution of the median nerve when both wrists are flexed to 90 degrees for 60 seconds
Define Carpal Compression Test
Numbness & tingling are induced by direct application of pressure over the carpal tunnel
Treatment of Carpal Tunnel Syndrome
1st: NSAIDs, splints, PPIs
2nd: Cortisone shots
3rd: carpal tunnel release
Indications for Carpal Tunnel Release
Atrophy of thenar muscle(s)
Chronic numbness
Define Dupuytren’s Syndrome
Thickening of the palmar fascia
Superficial to the tendons
Other Locations Dupuytren’s can Affect
Feet (Lederhosen’s)
Penis (Pyrenees disease)
Treatment of Dupuytren’s Syndrome
Needle apeuronotomy
Open palmar fasciectomy
Partial palmar fasciectomy
Collagenase injections
How does a ganglion cyst occur?
Weakness in the joint wall allowing synovial fluid to escape
1 way valve pushing fluid out of the joint
Differential Diagnosis of a Ganglionic Cyst
Ganglion
Lipoma
Schwanoma
AV malformation
Distinguishing a Ganglion Cyst from a Lipoma, Schwanoma, or AV Malformation
Clear, able to see through with a light
Distinguishing a Lipoma from a Ganglion Cyst
Feels rubbery
Not as compressible
Distinguishing a Schwanoma from a Ganglion Cyst
Solid
Can’t move proximal/distal
Distinguishing a AV Malformation from a Ganglion Cyst
Can see vessels going in & out
Define Arthritis
Inflammation of the joints
Define Arthritis Obliterans
Deformed joints
Define Osteoarthritis
Degradation of the cartilage in the joints
Treatment for Arthritis
NSAIDs
Splints
Fusion
Joint resurfacing
Describe a Swan Neck Deformity
Hyperextension at PIP joint
Flexion at DIP joint
Describe a Boutonniere Deformity
Hyperextension at DIP joint
Flexion at PIP joint
