Upper Limb Clinical Supplement Flashcards
1
Q
Growth plate articulation type:
A
Synchondrosis (primary cartilaginous)
2
Q
Sternoclavicular articulation type:
A
synovial saddle
3
Q
Acromioclavicular articulation type:
A
Synovial plane/gliding
4
Q
Glenoid articulation type:
A
Synovial ball and socket
5
Q
Elbow articulation type:
A
Synovial hinge
6
Q
Proximal radioulnar articulation type:
A
Synovial pivot
7
Q
Distal radioulnar articulation type:
A
Synovial pivot
8
Q
Radiocarpal articulation type:
A
Synovial condyloid
9
Q
Intercarpal articulation type:
A
Synovial plane/gliding
10
Q
Metacarpo-phalangeal articulation type:
A
Synovial condyloid
11
Q
Carpometacarpal digits 2-5 articulation type:
A
Synovial plane/gliding
12
Q
Carpometacarpal (digit 1) articulation type:
A
Synovial saddle
13
Q
Metacarpo-phalangeal articulation type:
A
Synovial codyloid
14
Q
Interphalangeal articulation type:
A
Hinge joint
15
Q
Thumb dermatome
A
C6
16
Q
Middle finger dermatome
A
C7
17
Q
5th finger (pinkie) dermatome
A
C8
18
Q
Medial forearm and arm dermatome
A
T1
19
Q
C3-C5 shoulder referred pain
A
Things in contact with phrenic nerve;
Peritonitis
Gall bladder
Pleurisy
Hepatic absess
Pericarditis
20
Q
Conoid tubercle attachment
A
Conoid ligament
21
Q
Coracoid process attachments
A
Pectoralis minor
Coracobrachialis
Short head of biceps
22
Q
Acromion Attachments
A
Deltoid and trapezius
23
Q
Scapular spine attachments
A
Deltoid
24
Q
Supraglenoid Tubercle
A
Long head of biceps brachii
25
Greater tubercle attachment
Supraspinatus
Infraspinatus
Teres Minor
26
Lesser tubercle attachments
Subscapularis
Transverse ligament of shoulder
27
Olecranon attachment
Triceps brachii
Flexor carpi ulnaris
Aconeus
28
Medial epicondyle attachment
Common flexor tendon
Pronator teres
Ulnar collateral ligament of elbow
29
Radial tuberosity attachments
Biceps brachii muscle
30
Dorsal Radial / Lister’s tubercle does what
Extensor pollicis longus pulley
31
Ulnar tuberosity attachment
Brachialis muscle
32
Radial styloid attachment
Tendon of brachioradialis muscle
Radial collateral ligament
33
Surgical neck of humerus structure at risk
Surgical neck of humerus
Posterior circumflex humeral artery
34
Midshaft humeral fracture at risk structures
Radial nerve, profunda brachial artery
35
Supracondylar humerus fracture at risk structure
Median nerve, radial nerve, ulnar nerve, brachial artery
36
UE Medial epincondyle fracture at risk structure
ulnar nerve
37
Colle’s Fx and risk
Break in radius close to wrist.
Median nerve at risk
38
Lunate dislocation structure at risk
Median nerve
39
Dupuytren’s contracture
Pathological thickening and shortening of longitudnal bundles of palmar aponeurosis.
Digits 4/5 contracted. Can mimic ulnar claw
40
Most commonly fractured bone in body
Clavicle
41
Clavicular fracture structures in danger
Suprascapular VAN
Supraclavicular nerves
Brachial plexus
Subclavian vein
42
Shoulder separation
Acromioclavicular joint dislocation
Involves acromioclavicular and coracoclavicular ligament rupture
43
Shoulder bursae locations
Subdeltoid bursa
Subacromial bursa
44
Rotator cuff function
Glenohumeral joint stability
45
Most commonly injured rotator cuff muscle
Supraspinatus
Occurs due to heavy lifting or catching falling object
46
Supraspinatus rupture test
Drop arm test
Ask patient to lower arm from 90deg abduction. Failure to do so smoothly suggest supraspinatus tear
47
Glenohumeral dislocation
Stability is sacrificed for mobility
48
Types and frequency of glenohumeral dislocation
Anterior 95%
Posterior 5%
49
Anterior glenohumeral dislocation
Anterior band of glenohumeral ligament tears and detaches labrum
Results in humeral head compression, injures axillary and radial nerves, compresses axillary artery
50
Long head of biceps rupture cause
Chronic inflamation causes intrascapular portion of tendon to erode and rupture
51
Boxers fracture
5th metacarpal
52
Golfers wrist
Hairline fracture of hook of hamate. Causes pain/tenderness in palm/wrist
53
Falls on outstreched hand by age
Youth: distal radial epiphysis broken
Adolescent: Clavicular fracture
Elderly: Colle’s fracture
54
Colle’s fracture sign
Dinner fork deformity
55
Scaphoid fracture
Often due to fall on outstretched hand
Pain in snuff box
Succeptible to avascular necrosis
Claire sucks at skateboarding
56
Lunate FOOSH
Most common carpal dislocation
Can impinge on carpal tunnel and median nerve
57
TERRIBLE TRIAD
Elbow injury:
Dislocation
Fracture of radial head
Avulsion of coronoid process
58
Tommy John surgery procedure + risk
Reconstruction of torn ulnar collateral ligament
Risk to ulnar nerve as it passes posterior to median epicondyle
59
Nursemaid’s Elbow
Yank of child’s arm tears annular ligament causing subluxation or dislocation
60
Pulses grading scale
0- absent
1- weak
2- normal
3- increased
4- BOUNDING
the bitch on the trauma team screaming 2+ radial pulses
61
Ligation of brachial artery
Greatly impaired blood flow to forearm and hand
62
Ligation of brachial distal artery
Collateral channels around elbow maintain circulation
63
Allen Test
Tests for ulnar/radial artery communication
Patient makes tight fist —> ulnar and radial arteries are compressed —> circulation should return with either artery being released.
64
What should be preserved in case of axillary vein laceration or compression
Cephalic vein to continue blood flow
65
Risk after axillary vein trauma
Air embolism
no bueno
66
Avascular necrosis of scaphoid mechanism
Transverese fracture causes distal and proximal fragments to be separated
Artery enters distally so proximal side may not perfuse
67
Lymphedema in UE is often due to iatrogenic injury of
Axillary lymph channels usually in breast or axilla surgery
68
Biceps MSR
C5-C6
musculocutaneous nerve
69
Brachioradialis MSR
C5-C6 (radial nerve)
70
Triceps MSR
C7-C8 (radial nerve)
71
Sympathetic UE innervation spinal cord levels
T2-T7
72
Shoulder aBduction myotome
C5-C6
73
Shoulder aDduction myotome
C5-T1 pec major
C5-C6 subscapularis
74
Shoulder flexion myotome
C5-C6
75
Shoulder extension myotome
C5-C8
76
Shoulder internal rotation myotome
C5-T1 pec major
C5-C6 subscapularis
77
Shoulder external rotation myotome
C5-C6
78
Elbox flexion myotome
C5-C6
79
Elbow extension myotome
C6-C8
80
Elbow supination myotome
C5-C7
81
Elbow pronation myotome
C6-C8
82
Wrist flexion myotome
C7-C8
83
Wrist extension myotome
C6
84
Wrist aDduction myotome
C7-C8
85
Finger flexion myotome
C8
86
Finger extension mytome
C7
87
Finger aBduction myotome
C8-T1
88
finger aDduction myotome
C8-T1
89
Erb’s palsy results from
C5-C6 root injury or upper trunk of brachial plexus due to neck traction
90
Erb’s palsy s/s
Paralysis of shoulder aBductors and lateral rotators, elbow flexors and wrist extensors
Sensory loss of C5-C6 dermatome
Waiter’s tip position = low key drug deal position
91
Klumkes palsy cause
Injury to C8 and T1 nerve roots or lower brachial plexus trunks… often due to falling and catching on ledge
92
Klumpkes palsy s/s
Claw hand digits 2-5
93
Neurological causes of winged scapula
Long thoracic nerve
Spinal accessory nerve
Dorsal scapular nerve
94
Dorsal scapular nerve injury
Due to entrapment as it passes through scalene muscle
Results in partially protracted scapula, weakness in elevation and retraction
