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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
What is a Colles fracture, and what causes it?
- Distal radial fracture with distal segment pushed dorsally ("dinner fork" deformity) - Fall on extended hand
26
What is a Smith fracture, and what causes it?
- Distal radial fracture with distal segment pushed ventrally ("garden spade" deformity) - Fall on flexed hand
27
What are risks with a Smith/Colles fracture?
- Median + ulnar nerve injury - Compartment syndrome
28
8 carpal bones (proximal then distal rows, lateral to medial for each)
- She looks too pretty, try to catch her: > Scaphoid > Lunate > Triquetrum > Pisiform > Trapezium > Trapezoid > Capitate > Hammate
29
Symptoms of a scaphoid fracture
Swelling and tenderness around anatomical snuff box
30
What causes a scaphoid fracture?
FOOSH
31
Why is avascular necrosis of the proximal segment possible in a scaphoid fracture?
- Blood supply arrives from distal to proximal end - Fracture cuts off this blood supply to the proximal segment
32
What causes Erb's palsy?
- Birth injury - Fall on shoulder
33
Which nerve roots are affected in Erb's palsy?
C5-6
34
Which nerves are affected in Erb's palsy?
- Axillary - Musculocutaneous - Suprascapular
35
Where does sensory loss occur in Erb's palsy?
Lateral part of arm + forearm
36
What position is the arm in in Erb's palsy?
"Waiter's tip" position: - Arm medially rotated - Elbow extended - Forearm pronated - Wrist flexed
37
Which nerve roots are affected in Klumpke's palsy?
C8-T1
38
Which nerves are affected in Klumpke's palsy?
- Median - Ulnar
39
Where does sensory loss occur in Klumpke's palsy?
Hand over territory covered by median + ulnar nerves
40
What causes Klumpke's palsy?
- Fall whilst stretching shoulder (grabbing tree when falling) - Birth injury
41
What causes Saturday night palsy and which nerve does this damage?
- Compression axilla - Radial nerve
42
What are the signs of Saturday night palsy?
- Wrist drop - Loss of sensation over radial area of distribution
43
What causes carpel tunnel syndrome?
Entrapment of median nerve
44
What is Tinel's sign, and what does it indicate?
- Tapping over ventral aspect of wrist produces paraesthesia - Carpal tunnel syndrome
45
Risk factors of carpel tunnel syndrome
- Pregnancy - Hypothyroid - DM - RA
46
Treatment of carpel tunnel syndrome
- Splinting - Rest - Surgical decompression
47
What causes Guyon's canal syndrome?
Ulnar nerve compressed near hook of hamate (eg. from using bike handlebars)
48
What are the signs of Guyon's canal syndrome?
Numbness + tingling in ring + small finger
49
Treatment of Guyon's canal syndrome
- Splint - Surgical decompression
50
Order of main arterial tree of the upper limb
- Subclavian artery - Axillary artery - Brachial artery - Radial + ulnar arteries - Deep + superficial palmar arches - Digital arteries
51
Order of main venous tree of the upper limb
- 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
Hard signs of vascular injury
- Active arterial bleeding - Pulseless/ischaemia - Expanding pulsatile haematoma - Bruit or thrill
53
Soft signs of vascular injury
- Minor bleeding - Injury in proximity to major vessel - Small/moderate size haematoma - Associated nerve injury
54
What is the modified Allen test for?
Checking overall blood supply to hand
55
What causes Volkmann's ischaemic contracture?
Compartment syndrome of the flexor forearm compartment
56
Treatment of Volkmann's ischaemic contracture
- Removal of cast - Surgical decompression with fasciotomy

RA1 (2) (15 decks)

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