HK 302 Exam #2 Pathology

What mechanisms cause clavicle fractures?

Direct blow and fall on outstretched arm

What is damaged from clavicle fractures?

80% of fractures occur in the middle third of the bone

How are clavicle fractures managed?

Figure 8 brave or surgery

What is the mechanism of a humerus fracture?

Fall or direct blow

What is the most common fracture spot on the humerus?

The surgical neck

What is the management for a humerus fracture?

Immobilization in sling and swathe and immediate referral to ER/Physician

What is the most common type of glenohumeral joint dislocation?

90% of dislocation are anterior and/or inferior (anterioinferior)

What other damages can a shoulder dislocation cause?

Associated fractures or nerve damage

What is a acromioclavicular joint strain also called?

Separated shoulder

Mechanisms of a acromioclavicular joint strain?

Direct blow to shoulder or fall on the point of the shoulder

What structures are damaged from a acromioclavicular joint strain?

The coracoclavicular ligaments, AC ligaments, and deltoid and trapezius muscles

What are the different grades of an AC joint sprain?

Grade1: sprain of AC ligaments

Grade 2: tear of AC ligament and sprain of coracoclavicular ligaments

Grade 3: complete tear of AC and coracoclavicular ligament

What is the most common structure damaged for a rotator cuff tear?

Supraspinatus is often involved in chronic tears and supraspinatus/infraspinatus are involved in acute tears

What is the mechanism that causes a biceps tendon rupture?

Prolonged tendonitis, degenerative, or traumatic

What happens to the biceps tendon when it ruptures?

It contracts and balls up, when repaired it has to be pulled back down to be reattached

What is olectanon bursitis?

When the bursa surrounding the olecranon is inflamed, often caused by intense friction on the elbow bc the bursa is so superficial, not super painful

What is the mechanism that causes an elbow dislocation?

Hyperextension, FOOSH, or extreme valgus force

What are common fracture associated with elbow dislocations?

Radial head and coranoid process

What is the management for an elbow dislocation?

Immobilization, reduction under anesthesia and maybe surgery if fractures are present

What is a colles fracture?

Fracture of the distal radius an ulna

What is the management of a colles fracture?

Immobilization of elbow and wrist by splint, referral to physician, more urgent in younger children if close to the growth plate

What is a scaphoid fracture?

Most common wrist bone fracture

Signs and symptoms of a scaphoid fracture?

Hard to diagnose on x-ray so history of FOOSH and pain with anatomical snuff box palpitation

Management for a scaphoid fracture?

RICE, application of splint, physician referral

What is carpal tunnel syndrome?

Most common compression syndrome of the wrist/hand, typically in dominant arm, median nerve gets compressed

Signs of carpal tunnel syndrome?

Pain, numbness, tingling, or burning in thumb, middle and index fingertips

Management for carpal tunnel?

Ice, NDAIDs, injection or surgical release

Boxers fracture

Fracture of distal end of fourth and fifth metacarpal, generally from punching something

Where are phalanx dislocations generally located?

PIP is most common but MCP is also possible

Mechanism of phalanx dislocations?

Hyperextension combined with axial compression

what causes lateral epicondylitis?

Eccentric loading of extensor muscles mainly extensor carpi radialis brevis

Treatment for lateral epicondylitis?

Counter force brace below the extensor muscle to offset stress on extensor tendon

Jersey finger

Rupture/avulsion of flexor digitorum profundus, grab a jersey while they await to get away, can’t bend affected finger

Mallet finger

Rupture/avulsion of the extensor tendon at distal phalanx, immobilize at full extension for 6-8 weeks

Boutonnière deformity

Rupture of the center slip of the extensor tendon at middle of phalanx, causes flexi on of PIP and extension of DIP (what it looks like when gripping a pen really hard)

Swan neck deformity

Loosening of volar plate at PIP, extensor tendon pulls PIP into Hyperextension and flexor digitorum profundus pulls DIP into flexion

Trigger finger

Most commonly occurs in ring and middle finger, inflammation causes thickening of flexor tendon and nodule grows within tendon sheath, finger locks into flexion

winging of scapula

abnormal protrusion of scapula, due to weakness in serratus anterior or entrapment of long thoracic nerve