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29 Cards in this Set
- Front
- Back
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dermatomes
C5, C6, 7, 8, T1, T2 |
C5: middle of the shoulder to the lateral mid forearm
C6: forearm to the thumb C7: fingers, localized in middle finger C8: little finger and little bit of the wrist region T1: medial forearm and little bit of the elbow T2: medial upper arm, armpit, across the chest |
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what is at risk when the humerous is fractured?
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the redial nerve runs down the radial groove of the humerus (accompained by the deep profunda brachial artery)
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what is involved in the elbow anastomosis?
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1. brachial artery and profunda brachii give descending anterior and posterior collateral branches
2. Radial and ulnar artery give ascending anterior and posterior recurrent arteries 3. collateral branches of profunda brachii and brachial arteries anastamose with recurrent arteries |
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name the boundaries of the cubital fossa
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proximal: imaginary line btw the condyles
lateral: the brachioradialis muscle medial: pronator teres roof is skin, fascia and bicipital aponeurosis floor: supinator(laterally) and brachialis muscle(medially) |
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what are the contents of the cubital fossa in order?
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from lateral to medial:
biceps Tendon brachial Artery median Nerve TAN (LTM) |
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describe the orientation of the cephalic and basilic veins. what is the significance of this.
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the are situated above the biceps aponeurosis, which protects the arteries from stick
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what is popeye syndrome?
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if left untreated, biceps tendinitis (long head gets excessive wear and tear) the biceps insertion ruptures and biceps muscle retracts proximally
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sometimes the tendon of the long head of the biceps can get dislodged from the intertubercular groove. what test is used?
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yergason test
if its unstable, the tendon will pop out |
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what is the most commonly fractured hand bone?
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the scaphoid
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what is found in the antebrachial fascia?
what is found superficial to this fascia? |
cephalic and basilic veins
superficial: superficial and cutaneous nerves |
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what is compartment syndrome?
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edema from a soft tissue injury has nowhere to go because the entire forearm is enclosed by tough antebrachial fascia.
thus, veins then arteries and nerves are compressed irreversible damage can occur after >4 hours |
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what are the 6 P's of compartment syndrome?
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1. Pain out of proportion to injury (pain with passive stretch)
2. Paresthesia (abnormal sensations from pressure on a nerve or altered perfusion) 3. Pressure (tightness of skin and tissues) 4. Pallor in hands and poikilothermia (cold skin) from lack of perfusion 5. Paresis (partial paralysis, secondary to nerve involvement, primary ischemia) 6. pulse is abesent |
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what is contained inside the carapal tunnel? what makes the boundaries?
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anything deep to the flexor retincaculum and superficial to the bones of the carpal arch
FDP FDS FPL Median Nerve FCR is in flexor retinaculum but NOT in carpal tunnel |
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what is carpal tunnel syndrome and how is it relieved?
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inflamation in tendons and synovial sheahts in carpal tunnel can lead to edema and pressure in confined space--->compression of median nerve in carpal tunnel
this compression is relieved by cutting the flexor retinaculum |
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what is contained in the fibrous flexor sheaths? what is there purpose?
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enclose front and sides of long flexor tendons and synovial sheaths
the prevent tendons from pulling away from phalanges during flexions osseofibrous tunnel: 2 layered digitial sheath that surrounds the tendons, reduces friction of the movement of tendons through tight compartments over bone |
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CLINICAL
what is trigger finger? |
during extension of a finger, a sudden palpable and audible snap occurs, which indicates an enlargement of a tendon or thickening of a pulley.
temporarily stops distal movement of tendon through the fibrous flexor sheath |
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CLINICAL
what is tenosynovitis? |
inflammation of synovial sheath (the communicating bursae). communication of synovial sheaths can lead to spread of infection from thumb to little finger, which can result in an horseshoe abcess
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describe the flexor synovial sheaths (bursae) in the hand.
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radial: surrounds FPL tnedon
ulnar: FDS and FDP (ususally communicates with digital sheath of little finger) communicating: 50% of radial and ulnar bursae communicate (tenosynovitis) |
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what is the functional purpose of the extensor expansion hood?
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the insertion of lumbricals and interossei muscles into the extensor expansion provides a LINE OF PULL for these muscles that is anterior to MCP joint and posterior to PIP and DIP joints thus:
they flex the MCP and at the same time, extend the PIP and DIP joints |
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CLINICAL
what is "mallet finger" |
hyperflexion injury of the DEP joint
2 lateral bands of expansion avulse fragment of fase of distal phlanx results in flexed DEP joint due to unopposed action of flexor digitiorum profundus muslce |
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what muscles are involved in pronation?
supination of extended arm? supination of flexed arm? |
pronation: PT and PQ
supination: supinator supination of flexed: biceps brachii |
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CLINICAL
why is the EPL tendon susceptible to injury? what would a torn tendon result into? |
EPL: tendon takes sharp turn at dorsal radial tubercle (running separately from other two long tendons of thumb)
Rheumatoid arthritis or fracture may result in rupture of tear of tendon this results in failure to extend the interphalangeal joint of the thumb |
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what are the attachments of the extensor retinaculum? what is its fucntional purpose?
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lateral attachment: distal radius
medial: P, Hook of H, Triq, styloid of ulna deep fascia is thickened for muscle origens and near the wrist, this holds extensor tendons in position has septa which form 6 osteofibrous canals: transmit extensor tendons and synovial sheaths |
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CLINICAL
where is a common site for synovial cysts in the wrist? |
insertion of ECRB into base of 3rd metacarpal
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CLINICAL
what is DeQuervian's syndrome? what test is used for Dequervian's syndrome? |
YOU HAD DEQUERVIAN'S SYNDROME!!!!!!
TRIGGER THUMB friction btw: APL and EP (and styloid process of radius) results in edematous swelling and fibrosis of synovial sheaths produces stenosing tensynovitis in the case of stenosing tenosynovitis, the movement of APL and EPB become restricted Finkelstein's test: tuck thumb into fist and adduct hand. if there is pain or popping |
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what are the borders of the anatomical snuffbox? what is contained inside?
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lateral: EPB and APL
medial: EPL floor: scaphoid and trapezium contents: radial artery and cephalic vein |
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what makes the DBR vulnerable to injury?
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passes betwen 2 heads of supinator and crosses head and neck of radius
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what is the mobile wad of three?
what nerve is exposed when they are moved? |
brachioradialis, ECRL, and ECRB
othopedic surgeons remove these easily to approach the radius. surgical plane of exposure: in between ECRB and ED can see the DBR (posterior interosseous) |
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CLINICAL
describe the degree of flexion and extension of the wrist and interphalangeal joints to make a strong grip. |
interphalangeal joints flexed
wrist joint extended |
