Upper limb disorders + bone stuff

Question 1

What is the most common malignant bone tumour in younger patients?

Answer 1

Osteosarcoma

<50 yrs

Question 2

What is the most common malignant bone tumour in older patients?

Answer 2

Myeloma bone disease

>50yrs

Question 3

How common is metastatic bone disease?

Answer 3

25x more common than primary bone tumours

Question 4

what is a benign tumour of the skeleton?

Answer 4

Osteoid osteoma.

Question 5

what is the malignant tumour of soft tissue?

Answer 5

Liposarcoma

Question 6

What is the benign tumour of soft tissue?

Answer 6

Lipoma.

Question 7

What happens when theres damage to the supraspinous muscle?

Answer 7

The humerus migrates superiorly - can’t abduct properly.

Question 8

What is the diagnosis of a rotator cuff tear?

Answer 8

MRI

US

Question 9

What is the treatment of a rotator cuff tear?

Answer 9

Ice
rest
NSAIDs
small exercise

surgery - open or closed.

Question 10

Treatment of clavicular fracture?

Answer 10

Leave in most people - progressive mobilisation from 2 weeks onwards
adults with displaced bone - should have surgery.

Question 11

Treatment of proximal humeral fracture?

Answer 11

younger - surgery

older - conservative

Question 12

What is the most common fracture in older patients?

Answer 12

Distal radial fracture.

Question 13

How is laceration of the flexor tendons treated?

Answer 13

Repair should be done in the position of injury

Question 14

Which ligament is most commonly sprained in the shoulder?

Answer 14

acriomioclavicular,

coracoacromion
coracoclavicular

Question 15

What is neuropraxia?

Answer 15

conduction loss of the nerve without structural changes.

Question 16

What is a cause of Saturday night palsy?

Answer 16

Wrist drop - radial nerve

cause of compression under the arm.

Question 17

What are causes of neuropraxia?

Answer 17

Saturday night compression
starvation of oxygen
compression

Question 18

what is the prognosis for neuropraxia?

Answer 18

Should fully recover in weeks to months.

Question 19

what is the Sunderland scale?

Answer 19

1 - neuropraxia - axon is intuit but theres an area not working

2- axonotmesis

Question 20

what is neuropraxia, axonotmesis, neuronotmesis?

Answer 20

neuropraxia - conduction loss
axonotmesis - axon divided
neurotmesis - nerve divided

Question 21

what is axonotmesis?

Answer 21

where the axons and their myelin sheath are injured

Question 22

what is wallerian degeneration?

Answer 22

the nerve fibres distal to the injury disappear. the nerve fibres proximal shrink back to the last node of Ranvier. they still grow back.

Question 23

what is the recovery for axonotmesis?

Answer 23

Sensory recovery is often better than motor recovery

Question 24

what is neuronotmesis?

Answer 24

Complete division of the nerve - theres usually no recovery unless its repaired

Question 25

what is a complication of neuronotmesis?

Answer 25

Neuroma

Question 26

what is the rate of axonal growth?

Answer 26

1-3mm/day

Question 27

what is trigger finger?

Answer 27

when swelling in the tendons catch on the pulleys, you can feel a lump in the palm.

Question 28

what is treatment of trigger finger?

Answer 28

Steroids splintage at night surgery

Question 29

What is duputrens disease?

Answer 29

it is an autosomal dominant disease - due to excessive production of collagen.

Question 30

what is the treatment of duputrens disease?

Answer 30

splints don't work | surgery

Question 31

what is de quervains tenovaginitis?

Answer 31

pain in the tendons of the thumb side

Question 32

where is the most common area of osteoarthritis?

Answer 32

Base of the thumb.

Question 33

what is subacromial impingement?

Answer 33

pain when abducting the arm. caused when the acromioclavicular joint produces osteophytes

Question 34

what are the signs of a posterior shoulder dislocation?

Answer 34

they can't externally rotate their shoulder

Question 35

what causes posterior shoulder dislocations?

Answer 35

Electric shock | epilepsy.

Question 36

what nerve is commonly injured in shoulder dislocation?

Answer 36

Axillary nerve