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When things go wrong

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anskorczewski12's version from 2016-06-25 23:42

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Question Answer
greenstick fracturesincomplete breaks from bending
no pectoralis majorusually no disability, but no anterior axillary fold and nipple more inferior
paralysis of serratus anterior(injury to long thoracic n.) medial border of scapula moves laterally and posteriorly from thoracic wall (winged scapula) and arm may not abduct past 90 degrees (but trapezius will help)
spinal accessory nerve palsyipsilateral weakness when shoulders are elevated against resistance
thoracodorsal n. injuryvolunerable durin gmastectomies, paralaysis of latissimus dorsi, unable to raise trunk with upper limbs and can't use crutches
dorsal scapular n injuryaffects rhomboids, causing scapula to be farther from midline than normal
axillary n. injurydeltoid flattens, usually injured during fracture of surgical neck of humerus and damaged during dislocation of glenohumeral joint and compression from wrong crutches; also lose sensation to lateral and proximal arm
fracture/dislocation of proximal humeral epiphysisinjury to shoulder of child, because glenohumeral joint is stronger than epiphyseal plate
rotator cuff injuriessupraspinatus tendon is most commonly ruptured; common during repetitive activity of upper limb above horizontal; humeral head and cuff may affect coraco-acromial arch, which leads to degenerative tendonitis
test for rotator cuff injuryadduct arm, presence of injury if arm drops when hits 90 degrees
varies in shape more than any other bone and one of the most frequently fracturesclavicle (weak junction of middle and lateral third)
clavicle fractureshoulder drops, medial side pulls up by sternocleidomastoid
humeral fractures(most commonly at surgical neck) avulsion fracture or transverse fracture
avulsion fracture of greater tuberclearm gets pulled in medial rotation; greater tubercle gets pulled off (after falling on acromion)
transverse fracture of humerusdeltoid pulls park up
nerve injured when surgical neck brokeaxillary nerve
nerve injured when radial groove injuredradial nerve
nerve injured when distal end of humerus injuredmedian nerve
nerve injured when medial epicondyle injuriedulnar nerve
Colles fracturemost common forearm fracture; transverse of distal radius (looks like fork)
most frequently fractured carpal bonescaphoid
hook of hamate injurymay affect ulnar nerve; decreases grip strength
elbow tendinitisfollows repetitive use of superficial extensor muscles of forearm; pain on lateral surface to posterior forearm
mallet/baseball fingertension on long extensor tendon; distal interphalangeal joint suddenly flexed, tearing tendon attachment leading to inability to extend DIP
olecranon fracturecommon; olecranon pulled away by triceps brachii m
median n. injuryflexion of PIP joints of 1-3 digits is lost (and thumb function lost too), and flexion of others is weakened, flexion of DIP of 2 and 3 lost too
hand of benedictionmedial n. injury; fist with 2 and 3 partially extended
pronator syndromecompressed median n. near elbow
ulnar n. injuryusually posterior medial epicondyle; numb/tingling on medial palm and medial 1.5 fingers; difficult to make fist (MP hyperextension and can't flex 4&5 digits at DIP
claw handcan't extend IP joints; ulnar n. injury...
cubital tunnel syndromecompressed ulnar n.
radial n. injury(usually from humerus fracture) causes wrist-drop (unable to extend thumb and MP joints of other digits; sensory loss is minimal
Dupuytren contracturedisease of palmar fascia, progressive shortening, thickening, and fibrosis of palmar fascia and aponeurosis; pulls 4th and 5th fingers into partial flexion at MP and PIP joints
tenosynovitisinflammation of tendon and synovial sheath of digits (i.e. from rusty nail puncture), usually only in 1 digit, but pinky sheath continuous with common flexor sheath, so spreads to palm and carpal tunnel (thumb infection would spread via FPL sheath)
Quervain tenovaginitis stenosansexcessive friction between APL and EPB tendons (from repetitive forceful grip and wringing)
Trigger fingertendons of FDS and FDP enlarge proximal to osseofibrous tunnel, person unable to extend finger, passive extension leads to snap (and another snap when flexing)
median n. lesions usually occur at...forearm or wrist (most common when n. passes through carpal tunnel)
Carpal tunnel syndromefrom lesions reducing size of tunnel, or increase synovial sheaths/tendons; may cause decreased sensation of ulnar n. (doesn't affect palmar branch because doesn't go through tunnel), and decreased strength of thumb (unable to oppose); fix with carpal tunnel release
median n injury at elbowloss of flexion of PIP and DIP of 2 and 3 and flexion of MP of 2 and 3 is affected (from lumbrical weakness); Simian hand
Simian handthumb can only flex and extend ...
Ulnar canal syndromenumb medial 1.5 fingers and weak intrinsic hand muscles (compressed ulnar n.)
Handlebar neuropathylong time wrist extension puts pressure on hook of hamate, leading to sensory loss on medial side of hand and weak intrinsics
wrist-dropradial n. injury (forearm extensors don't work), fingers remain in flex at MP
dislocated glenohumeral jointmost common is downward dislocations; (anterior is in athletes usually when excessive extension/lateral rotation; inferior common after avulsion fracture of greater tubercle)
axillary n. injurymaybe when GH dislocates, humeral head pushes into quadrangular space, causes paralysis of deltoid and teres minor
radial head subluxationcommon in preschool girls when picked up by arm, usually hold arm in flexed and pronated position; torn anular ligament
bull rider's thumbsprain radial collateral ligament and avulsion fracture of lateral park of proximal phalanx of thumb
skier's thumbrupture of collateral ligament of 1st MP joint from hyperabduction of MP of thumb
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