LAB #7
3-5: Clinical
Correlates of the
Upper Limb
Acromioclavicular Joint
Coracoclavicular ligament: Conoid
& Trapezoid Part
Glenohumeral Joint
Coracohumeral Ligament
Coraco-acromial Ligament
Superior, Middle, and Inferior
Glenohumeral Bands
Tendon of the Long Head of
the Biceps Brachii Muscle
Transverse Humeral Ligament
Glenoid Labrum
Clinical Aspects
Cutaneous
Dermatome Testing
Cutaneous
Referred Pain
(reflective pain)
Subdiaphragmatic irritation- due to peritonitis,
gall bladder inflammation, hepatic abscess, pleurisy or
accumulations of CO2 following laser surgery is referred
to the tip of the shoulder (phrenic nerve C3,4,5:
subclavicular nerve C3,4)
Angina Pectoris- Radiation of pain from the thorax
down the left upper limb (pain fibers associated with
sympathetics from T1-T4: T1-T3 dermatomes of upper
limb)
fascia
Dupuytren’s Contracture
Compartmental
Axilla- stretching of cords of the brachial plexus;
compression of the axillary artery to stop profuse bleeding.
Cubital Fossa- T.A.N. from lateral to medial: tendon of
the biceps, brachial artery, median nerve: care during
venapuncture.
Radial and Ulnar Bursae- tenosynovitis:
inflammation and distention (with pus) of synovial
tendon sheaths. Infection can spread within these burae
in the hand and also be limited within them to prevent
spread to the rest of the hand.
Carpal Tunnel Syndrome
What nerve is responsible for
Carpal Tunnel Syndrome?
The Median Nerve.
Osseous and Related Structures
Clavicle
What type of fracture is
common with the clavicle?
“Green stick” fracture
Osseous and Related Structures
Shoulder
Seperation- involves injury to acromioclavicular
joint. A
complete seperation would be a rupture of acromioclavicular and
coracoclavicular ligaments.
Bursitis- inflammation of subdeltoid or subacromial bursa.
Rotator Cuff- cuff is necessary for glenohumeral stability.
Injury to any component of the cuff can lead to instability.
Supraspinatus tendon can be torn while trying to lift too much or
catching a heavy falling object.
Ruptured tendon of the long head of the bicepsintracapsular tendon becomes inflamed and erodes over time.
Osseous and Related Structures
FOOSH
(Falls On the OutStretched Hand)
Youth:
Which carpal bones are
most often affected?
Adolescent:
Elderly:
-Scaphoid-most often fractured
-Lunate- most often dislocated
Vascular- Arteries
Compression Sites
Axillary artery- proximal humerus, medial surface
Brachial artery- medial to anterior humerus from above
downward
Ulnar artery- distal anterior
wrist lateral to pisiform
Radial artery- distal anterior
radius, “snuff box”, 1st dorsal
digital space
Vascular- Arteries
Avascular Necrosis of
Scaphoid Bone
Vascular- Lymphatics
Lymphangitis
Lymphedema
Lymphadenitis
Nerves
Tendon Reflexes
Test integrity of segmental regions of spinal cord
Biceps- C5,6 9 (mainly C5)
Triceps- C7,8 (mainly C7)
Brachioradialis- mainly C6
Erb-Duchenne’s Palsy
(Erbs’ Palsy)
Nerves
Nerves
Klumpke’s Palsy
Nerves
“Winged Scapula”
Nerves
Axillary Nerve
Nerves
Radial Nerve
Nerves
Musculocutaneous Nerve Injury
Nerves
Median Nerve Injury
Nerves
Ulnar Nerve
Nerves
Clawing of Hand
Tinel’s Sign/Test
What is this test used for?
To see if a nerve
is irritated.
Phalen’s Test
What is this test used for?
Diagnostic test for
Carpal Tunnel
Syndrome.
Finkelstein’s Test
This tests for what
condition?
DeQuervain’s
Tenosynovitis
Vascular- Arteries
Collateral Anastomoses
Anastomosis: The connection of normally separate
parts. An anastomosis may be naturally occurring or it
may be created during embryonic development,
surgery, or trauma, or by pathological means. An
anastomosis may, for example, connect two blood
vessels, or it may connect the healthy sections of the
colon or rectum after a cancerous or otherwise
diseased portion has been surgically removed.
Scapular
Elbow
Hand