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RA1 (2) > Upper Limb Trauma and Applied Vascular Anatomy > Flashcards

Upper Limb Trauma and Applied Vascular Anatomy Flashcards

1
Q

What is a bursa?

A

Closed, fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body

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2
Q

Common and other causes of bursitis

A
  • Common:
    > Overuse
    > Injury
  • Other:
    > Infection
    > Tendinitis
    > Arthritis
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3
Q

Management of bursitis

A
  • RICE
  • Anti-inflammatory medicines
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4
Q

What causes subacromial bursitis?

A
  • Supraspinatus tendinitis
  • Bone spurs
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5
Q

What syndrome can subacromial bursitis cause?

A

Painful arc syndrome (30° above/below horizontal)

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6
Q

What is frozen shoulder, and what causes it?

A
  • Pain in shoulder movement, limited movement
  • Inflammation of the joint capsule
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7
Q

Types of rotator cuff injuries

A
  • Tendinitis
  • Tears
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8
Q

What sign indicates a biceps tendon tear?

A

Popeye’s sign

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9
Q

What causes olecranon bursitis?

A

Repeated trauma to bursa (eg. leaning on elbows studying)

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10
Q

What is medial epicondylitis?

A

Pain caused by damage to tendons of flexor muscles of forearm (have common origin at medial epicondylitis)

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11
Q

Grades of shoulder separation at the AC joint

A
  • Grade I = non-displaced strain of AC ligament
  • Grade II = tear of AC ligament
  • Grade III = tear of AC and CC ligaments, clavicle displaced superiorly
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12
Q

In what direction is the shoulder most commonly dislocated?

A

Anteroinferior

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13
Q

What nerve can be damaged in a shoulder dislocation, and what does this cause?

A
  • Axillary nerve
  • Sensory loss in regimental badge area
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14
Q

Appearance of a shoulder dislocation

A
  • Acromion prominent
  • Shoulder flattened
  • Humeral head prominent
  • Arm slightly abducted
  • Elbow flexed
  • Forearm internally rotated, supported by other hand
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15
Q

What ligament is involved in a radial head subluxation, and what happens during this?

A
  • Annular ligament
  • Radius is partially pulled out of ligament and radial head is subluxated, annular ligament interposed between radial head and capitulum
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16
Q

What are the symptoms of radial head subluxation?

A
  • Painful swelling
  • Limited supination
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17
Q

Treatment of radial head subluxation

A

Closed reduction with either supination or hyper-rotation

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18
Q

Where is a fractured clavicle most common?

A

Junction of medial 2/3 + lateral 1/3

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19
Q

What causes a fractured clavicle?

A
  • FOOSH
  • Direct injury
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20
Q

How is a fractured clavicle managed?

A
  • Sling
  • Pain medication
  • Physiotherapy
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21
Q

Locations where the humerus can fracture

A
  • Surgical neck
  • Midshaft
  • Supracondylar
  • Medial epicondyle
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22
Q

What to look for in a supracondylar fracture of the humerus

A
  • Absence of radial pulse
  • Ischaemia of hand (pale, cool)
  • Severe swelling in forearm and/or elbow
  • Open injury
  • Neurological injury
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23
Q

What nerves can be damaged in each humerus fracture location?

A
  • SN = axillary
  • M = radial
  • S = radial, ulnar
  • ME = ulnar
24
Q

Monteggia vs Galeazzi fracture

A
  • M = ulna fracture, dislocation of radial head
  • G = radius fracture, dislocation of distal radioulnar joint
25
Q

What is a Colles fracture, and what causes it?

A
  • Distal radial fracture with distal segment pushed dorsally (“dinner fork” deformity)
  • Fall on extended hand
26
Q

What is a Smith fracture, and what causes it?

A
  • Distal radial fracture with distal segment pushed ventrally (“garden spade” deformity)
  • Fall on flexed hand
27
Q

What are risks with a Smith/Colles fracture?

A
  • Median + ulnar nerve injury
  • Compartment syndrome
28
Q

8 carpal bones (proximal then distal rows, lateral to medial for each)

A
  • She looks too pretty, try to catch her:
    > Scaphoid
    > Lunate
    > Triquetrum
    > Pisiform
    > Trapezium
    > Trapezoid
    > Capitate
    > Hammate
29
Q

Symptoms of a scaphoid fracture

A

Swelling and tenderness around anatomical snuff box

30
Q

What causes a scaphoid fracture?

A

FOOSH

31
Q

Why is avascular necrosis of the proximal segment possible in a scaphoid fracture?

A
  • Blood supply arrives from distal to proximal end
  • Fracture cuts off this blood supply to the proximal segment
32
Q

What causes Erb’s palsy?

A
  • Birth injury
  • Fall on shoulder
33
Q

Which nerve roots are affected in Erb’s palsy?

A

C5-6

34
Q

Which nerves are affected in Erb’s palsy?

A
  • Axillary
  • Musculocutaneous
  • Suprascapular
35
Q

Where does sensory loss occur in Erb’s palsy?

A

Lateral part of arm + forearm

36
Q

What position is the arm in in Erb’s palsy?

A

“Waiter’s tip” position:
- Arm medially rotated
- Elbow extended
- Forearm pronated
- Wrist flexed

37
Q

Which nerve roots are affected in Klumpke’s palsy?

A

C8-T1

38
Q

Which nerves are affected in Klumpke’s palsy?

A
  • Median
  • Ulnar
39
Q

Where does sensory loss occur in Klumpke’s palsy?

A

Hand over territory covered by median + ulnar nerves

40
Q

What causes Klumpke’s palsy?

A
  • Fall whilst stretching shoulder (grabbing tree when falling)
  • Birth injury
41
Q

What causes Saturday night palsy and which nerve does this damage?

A
  • Compression axilla
  • Radial nerve
42
Q

What are the signs of Saturday night palsy?

A
  • Wrist drop
  • Loss of sensation over radial area of distribution
43
Q

What causes carpel tunnel syndrome?

A

Entrapment of median nerve

44
Q

What is Tinel’s sign, and what does it indicate?

A
  • Tapping over ventral aspect of wrist produces paraesthesia
  • Carpal tunnel syndrome
45
Q

Risk factors of carpel tunnel syndrome

A
  • Pregnancy
  • Hypothyroid
  • DM
  • RA
46
Q

Treatment of carpel tunnel syndrome

A
  • Splinting
  • Rest
  • Surgical decompression
47
Q

What causes Guyon’s canal syndrome?

A

Ulnar nerve compressed near hook of hamate (eg. from using bike handlebars)

48
Q

What are the signs of Guyon’s canal syndrome?

A

Numbness + tingling in ring + small finger

49
Q

Treatment of Guyon’s canal syndrome

A
  • Splint
  • Surgical decompression
50
Q

Order of main arterial tree of the upper limb

A
  • Subclavian artery
  • Axillary artery
  • Brachial artery
  • Radial + ulnar arteries
  • Deep + superficial palmar arches
  • Digital arteries
51
Q

Order of main venous tree of the upper limb

A
  • Digital veins
  • Dorsal venous network of the hand
  • Basilic + cephalic veins, median vein of forearm
  • Median cubital vein
  • Cephalic, basilic + brachial veins
  • Axillary vein
  • Subclavian vein
52
Q

Hard signs of vascular injury

A
  • Active arterial bleeding
  • Pulseless/ischaemia
  • Expanding pulsatile haematoma
  • Bruit or thrill
53
Q

Soft signs of vascular injury

A
  • Minor bleeding
  • Injury in proximity to major vessel
  • Small/moderate size haematoma
  • Associated nerve injury
54
Q

What is the modified Allen test for?

A

Checking overall blood supply to hand

55
Q

What causes Volkmann’s ischaemic contracture?

A

Compartment syndrome of the flexor forearm compartment

56
Q

Treatment of Volkmann’s ischaemic contracture

A
  • Removal of cast
  • Surgical decompression with fasciotomy

RA1 (2) (15 decks)

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