Upper limb injuries Flashcards
what is thoracic outlet syndrome? What 2 things can cause it? AXILLA
- compression of nerves and vessels in the apex of the axilla
- trauma
- repetition in arm lifting
what does thoracic outlet syndrome present with? AXILLA
- pain in affected limb (depending on severity and no. of nerves damaged)
- tingling
- muscle weakness and discolouration
what can be biopsied to test for breast cancer and why? AXILLA
- axillary lymph nodes
- most of lymph from breast tissue drains here
what is the name for the removal of axillary lymph nodes? What can this lead to the damage of and what does this cause as a consequence? AXILLA
- axillary clearance
- damamge to long thoracic nerve which will cause a winged scapula as serratus anterior is innervated by this nerve (holds scapula against ribcage)
what vein connects the basillic and cephalic vein and what is it commonly used for? CUBITAL FOSSA
- median cubital vein
- venepuncture
how is a suprachondylar fracture caused? CUBITAL FOSSA
-falling on a flexed elbow
fractures affecting blood flow into the forearm from the brachial artery causes what (specific name)? explain. CUBITAL FOSSA
- volkmanns ischaemic contractures
- ischaemia resulting in flexors of forearm becoming fibrotic and short=uncontrolled flexion of wrist
what is carpel tunnel syndrome and what can it cause if left untreated? CARPAL TUNNEL
- compression of median nerve due to thickened ligaments and tendon sheath
- cause atrophy and weakness of thenar muscles
what 2 physcial examinations can be done to test for carpal tunnel syndrome? CARPAL TUNNEL
- lightly touch wrist to detect pain
- flex wrist for 60 secs to detect pain
Tenderness in the anatomical snuffbox is caused by what? How does this most commonly occur? ANATOMICAL SNUFFBOX
- fracture of the scaphoid
- falling on an outstretched hand
Why can scaphoid fractures be an emergency? ANATOMICAL SNUFFBOX
- arterial supply is distal to proximal
- fracture towards proximal end of scaphoid can cause avascuar necrosis of the bone tissue=arthritis
What causes a winged scapula? SCAPULA
- damage to long thoracic nerve
- loss of innervation to serratus anterior
- can no longer hold scapula against ribcage
Give 3 ways of damaging the long thoracic nerve
- trauma to shoulder
- repetitive movements involving shoulder
- inflammation of structures around the nerve
How can you test for a winged scapula
push against a wall
what is the most common point of fracture on the clavicle? CLAVICLE
junction of medial 2/3 to lateral 1/3
What movement occurs to lateral 1/3 of clavicle when fractured and why?
- inferior and medial
- inferior due to weight of upper limb
- medial due to pec major
What movement occurs to medial 2/3 of clavicle when fractured and why?
-superiorly due to sternocleidomastoid
Upwards movement of medial 2/3 of clavicle can result in what position and why?
- waiters tip position (erbs palsy)
- damage to suprascapula nerve which supplies supra and infraspinatus which are lateral rotators
- results in unopposed medial rotation of upper limb
Why can a mid shaft fracture of the humerus cause wrist drop? HUMERUS
- damage to radial nerve which is tightly adhered to the radial groove
- innervates wrist extensors in forearm and so unopposed flexion occurs
what type of humerus fracture can cause ischaemic volkamnns contracture?
- distal humerus
- e.g. supracondylar, medial epicondyle, supraepicondylar fracture
what nerve in particular can be damaged by a medial epicondyle fracture and what happens as a result?
- ulnar nerve
- ulna claw and loss of sensation to medial 1 and a half fingers (dorsal and ventral)