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Regional Anatomy > Upper Limb Trauma and Applied Vascular Anatomy > Flashcards

Upper Limb Trauma and Applied Vascular Anatomy Flashcards

1
Q

What are some causes of shoulder pain

A
  • Bursitis
  • Frozen shoulder
  • Rotator cuff injuries
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2
Q

What is a bursa

A
  • Fluid-filled sac that works as a cushion and gliding surface to reduce friction between body tissues
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3
Q

What is Bursitis

A
  • Inflammation of bursa
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4
Q

What are potential causes of bursitis

A
  • Overuse
  • Infection
  • Injury
  • Tendinitis
  • Arthiritis
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5
Q

What is the course of treatment for bursitis

A
  • RICE and anti-inflammatory medicines
  • Rest
  • Ice
  • Compression
  • Elevation
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6
Q

What is the name of the bursitis which may cause shoulder pain

A
  • Subacromial bursitis
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7
Q

What is painful arc syndrome

A
  • Pain during abduction of the arm between 60 and 120 degrees.
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8
Q

How can subacromial bursa cause painful arc syndrome

A
  • Subacromial bursa prevents rubbing of acromion and supraspinatus ligament during abduction of the arm.
  • In subacromial bursitis the tendon will press onto the swollen bursa during abduction causing pain.
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9
Q

What are some other causes of painful arc syndrome

A
  • Supraspinatus tendinitis
  • Bone spurs
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10
Q

What is a frozen shoulder

A
  • The capsule of the shoulder joint is red and inflamed.
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11
Q

What is popeye’s sign and why does it occur

A
  • Bulge at biceps caused by bunching up of biceps muscle due to the tear of the tendon of biceps when overused.
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12
Q

What would be found in the ultrasound of someone with popeye’s sign

A
  • Absence of biceps tendon in bicipital groove
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13
Q

What is olecranon bursitis also known as and what causes it

A
  • Students bursitis
  • Caused by constant pressure to olecranon process (student)
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14
Q

What is Golfer’s elbow

A
  • Medial epicondylitis
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15
Q

What is tennis elbow

A
  • Lateral epicondylitis
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16
Q

What is shoulder separation and what happens at each grade of it

A
  • Tear of the acromial clavicular joint which can lead to total separation.
  • Grade I - Tear in the acromioclavicular joint capsule.
  • Grade II - Subluxation (bones forced slightly from normal position)
  • Grade III - Complete separation
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17
Q

What direction is dislocation of shoulder at

A
  • Antero-inferiorly
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18
Q

What nerve is affected by dislocation of glenohumeral joint and what presentation does this have

A
  • Axillary nerve
  • Squared of shoulder
  • Supporting arm with opposite hand
  • Loss of sensation in regiment bath area
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19
Q

What is the most common injury in the elbow joint and what is it known as in lay terms

A
  • Radial head subluxation
  • Pulled elbow
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20
Q

What are the 2 types of joints at the elbow complex and which bones form which joint

A
  • Hinge joint - Trochlear of humerus and ulna
  • Ball and socket joint - Capitulum of humerus and head of radius
  • Pivot joint - Head of radius and ulnar
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21
Q

How does radial head subluxation occur and why is it more common in children

A
  • Annular ligament which joints radius to ulna is loose and the head of the radius is subluxed.
  • More common in children because their annular ligament is looser as it does not narrow towards the distal end.
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22
Q

What is radial head subluxation also known as

A
  • Nursemaid’s elbow
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23
Q

What is the treatment for radial head subluxation

A
  • Supination and flexion of the arm
  • Hyper pronation
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24
Q

What are the 3 types of humeral fractures and what are the nerves effected by each

A
  • Surgical neck - axillary nerve
  • Midshaft - Radial nerve
  • Supracondylar - Structures in cubital fossa
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25
Q

What are some important things to look for if a supracondylar fracture is suspected

A
  • Absence of radial pulse
  • Symptoms of ischaemia
  • Swelling in forearm
  • Open injury
  • Neurological injury
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26
Q

What is an avulsion fracture of medial epicondyle

A
  • Fall on straight hand causing small piece of medial epicondyle to be broken off
27
Q

What is a moneteggia fracture in the forearm

A
  • Fracture of ulna and dislocation of head of radius. (Upper forearm)
28
Q

What is a galeazzi fracture

A
  • Fracture of radius and dislocation of head of ulna (Lower forearm)
29
Q

What are the common distal radial fractures and what is the difference between them.

A
  • Colles fracture - Distal segment is pushed dorsally (towards back of hand)
  • Smith fracture - distal segment is pushed ventrally (towards palm)
30
Q

What causes the 2 distal radial fractures and what do the fractures present as

A
  • Colles - FOOSH - Dinner fork deformity
  • Smiths - Fall on Flexed Hand Garden spade deformity
31
Q

What are the bones that make up the proximal row of the carpal bones

A
  • She Looks Too Pretty
  • Scaphoid
  • Lunate
  • Triquetral
  • Pisiform
32
Q

What are the 4 bones that make up the distal row of the carpal bones

A
  • Try To Catch her
  • Trapezium
  • Trapezoid
  • Capitate
  • Hammate
33
Q

What causes a scaphoid fracture and what are the effects of this fracture

A
  • FOOSH
  • Swelling and tenderness just below thumb
  • Pain in anatomical snuffbox
  • A vascular necrosis of scaphoid
34
Q

What does winging to the long thoracic nerve cause

A
  • Winging of the scapula
35
Q

What is upper brachial plexus palsy also known as and what causes such an injury

A
  • Erb’s Palsy
  • Difficulty during labour
  • Fall on shoulder
36
Q

What will be the position of the upper limb in Erb’s Palsy

A
  • Waiter’s tip position
  • Internal (medial) rotation of arm
  • Extended elbow
  • Pronated forearm
  • Flexed wrist
37
Q

What nerve roots and nerves are affected in Erb’s Palsy

A
  • C5-C6
  • Axillary, Musculocutaneous and suprascapular nerve
38
Q

What is neuropraxia

A
  • Damage to a nerve caused by stretching. Is reversible in 3 to 4 months
39
Q

What is lower brachial plexus palsy also known as and what injuries cause this

A
  • Stretching of the shoulder during a fall
  • Stretching of the shoulder during birth
40
Q

What is lower brachial plexus palsy also known as and what injuries cause this

A
  • Klumpke’s Palsy
  • Stretching of the shoulder during a fall
  • Stretching of the shoulder during birth
41
Q

What nerve roots and nerves are affected by Klumpke’s palsy and what does this look like

A
  • C8 - T1
  • Median and Ulna nerves
  • Claw hand and loss of sensation in hands
42
Q

What is crutch paralysis also known as

A
  • Saturday night palsy
43
Q
  • What nerve is affected by radial nerve and what does that look like
A
  • Radial nerve
  • Wrist drop
  • Loss of sensation in area supplied by radial nerve
44
Q

What are 2 carpal overuse syndromes

A
  • Carpal tunnel syndrome
  • Guyon’s canal syndrome
45
Q

What is carpal tunnel syndrome

A
  • Compression of the medial nerve in the carpal tunnel due to inflammation of tendons or sheath enclosed in the small space
46
Q

What are some risk factors of carpal tunnel syndrome

A
  • Pregnancy
  • Hypothyroid
  • DM
  • RA
47
Q

What are some risk factors of carpal tunnel syndrome

A
  • Pregnancy
  • Hypothyroid
  • DM
  • RA
48
Q

What are some treatments of carpal tunnel syndrome

A
  • Splinting
  • Rest
  • Surgical Decompression (last result)
49
Q

What is Guyon’s canal syndrome

A
  • Compression of ulna nerve compression near the hook of the hammet bone.
50
Q

What type of injuries affect the musculocutaneous nerve and why are they not common

A
  • Stab wounds to upper arm
  • Not common as nerve is protected by bulk of biceps muscle
51
Q

What are the effects of injury to the musculocutaneous nerve

A
  • Numb lateral forearm
  • Weak elbow flexion
  • Weak forearm supination
  • Absent biceps reflex
52
Q

describe the blood supply in the upper limb

A
  • Subclavian artery (branch of brachiocephalic in the right side but on the left side directly from the arch of the aorta)
  • Becomes axillary artery at the outer border of 1st rib
  • Become brachial at the inferior border of teres major
  • Bifurcates into radial and ulna at the neck of the radius.
  • Radial artery forms the deep palmar arch
  • Ulna artery forms superficial palmar arch
53
Q

Describe the venous drainage of the upper limb distal to proximal (superficial)

A
  • Cephalic vein from the lateral end of the superficial palmer arch goes along the lateral side of the forearm then arm through the deltopectoral groove and pierces the clavipectoral fascia draining into the axillary nerve.
  • Basilic vein from the medial end of the superficial palmer arch goes along the medial side of the forearm and become deep in the middle of the arm draining into the brachial vein.
  • Median cubital vein connects cephalic and basilic veining
54
Q

Describe the veinous drainage of the upper limb (deep)

A
  • Vena commutants of radial artery
  • Vena commutants of ulna artery
  • Vena commutants of brachial artery
  • Axillary vein
55
Q

What veins are used to gain access for clinical procedures and what are those clinical procedures

A
  • Axillary
  • Cephalic
  • Subclavian
  • Placement of pacemaker
  • Defibrillator
  • Access to central venous lines
56
Q

What are the 2 types of signs for vascular injuries

A
  • Hard signs
  • Soft signs
57
Q

What are the 2 types of signs for vascular injuries and what doe these mean

A
  • Hard signs - Immediate surgical response is required
  • Soft signs - Further work can be done
58
Q

Give some hard signs of vascular injury

A
  • Active arterial bleeding
  • Pulseless/ ischemia
  • Expanding pulsatile hematoma
  • Bruit or thrill
59
Q

Give some soft signs of vascular injury

A
  • Minor bleeding
  • Injury in proximity to major vessels
  • Small to moderate size hematoma
  • Associated nerve injury
60
Q

What is the modified Allen test used for

A
  • Test overall blood supply to the hand
61
Q

How is a modified Allen test carried out

A
  • Locate radial and ulnar arteries and ask the patient to clench their fist for 30 seconds.
  • Use 2 fingers on each artery and apply pressure to restrict blood flow.
  • Ask the patient to unclench, if the palm does not blanch start again and apply more pressure.
  • Release pressure on ulnar artery
62
Q

What does a positive modified Allen’s test look like and what does this mean

A
  • Hand will not flush within 5-15 seconds.
  • Circulation of ulnar artery is not sufficient.
  • Radial artery should not be punctured
63
Q

What does a negative modified Allen’s test look like

A
  • Hand flushes within 5-15 seconds
  • Circulation of ulnar artery is sufficient.
  • Radial artery can be punctured.

Regional Anatomy (13 decks)

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