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Medicine (MD/DO)
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USMLE Step 2
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Musculoskeletal (Orthopedics)
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Upper Extremity Disorders

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Musculoskeletal (Orthopedics) | Medicine (MD/DO) School Study Aid

Upper Extremity Disorders
16 Picmonics to Learn | 27 mins
Anterior Shoulder Dislocation
Axillary Nerve Damage
Axillary Artery
Rotator Cuff Injury
Supraspinatus Tendon
Anterior Glenohumeral Ligament
Anatomic Lesions
Bankart's Lesion
Hill-Sachs Lesion
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1 min
Supracondylar Fracture Of Humerus
Mechanism
Fall On Outstretched Hand (FOOSH)
More Common In Children
Signs & Symptoms
Elbow Pain & Swelling
Diagnosis
X-ray Shows Elbow Effusion
Anterior Sail Sign
Posterior Fat Pad Sign
Treatment
Non-displaced: Splint And Sling
Displaced: Closed Reduction With Percutaneous Pin Placement
Considerations
Compartment Syndrome
Volkmann Ischemic Contracture
Brachial Artery Injury
Median Nerve Palsy
Cubitus Varus Deformity
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3 mins
Nursemaid's Elbow (Radial Head Subluxation)
Pathophysiology
Radial Head Subluxation
Inferiorly Under Annular Ligament
Axial Traction on Forearm
Pulled or Lifted by the Hand or Forearm
Children Aged (1-4 Years Old)
Signs & Symptoms
Extended & Pronated Forearm
Refusal to Bend Elbow
Treatment
Manual Reduction
Hyperpronation of Forearm
Gentle Supination of Elbow at 90 Degrees Flexion
No Immobilization
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3 mins
Carpal Tunnel Syndrome
Median Nerve Entrapment
Compression at Carpal Tunnel
Numbness, Tingling and Pain in Hand
Diagnosis
Phalen's Maneuver
Tinel's Sign
Treatment
Splints
Surgery
Steroids
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2 mins
Nerve Palsies - Klumpke's Palsy
Nerve
C8 to T1 Roots
Lower Trunk
Causes
Upward Arm Force during Delivery
Adult Trauma
Grabbing Tree Branch to Break a Fall
Muscle Affected
Intrinsic Hand Muscles
Presentation
Claw Hand
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1 min
Nerve Palsies - Winged Scapula
Nerve
Long Thoracic Nerve
Causes
Axillary Node Dissection in Mastectomy
Stab Wound
Muscle Affected
Serratus Anterior
Functional Deficit
Scapula Cannot Anchor to Thorax
Presentation
Inability to Raise Arm Above Head
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1 min
Nerve Palsies - Pope's Blessing
Nerve
Proximal Median Nerve
Causes
Supracondylar Fracture of Humerus
Functional Deficit
Loss of Flexion of Thumb, Pointer and Middle Finger
Presentation
Trouble Making a Fist
Hand Resembles Popes Blessing on Flexion
Complications
Atrophy of Thenar Eminence
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1 min
Nerve Palsies - Median Claw
Nerve
Distal Median Nerve
Causes
Carpal Tunnel Syndrome
Deficit
Unable to Extend Thumb, Pointer and Middle Finger
Presentation
Clawing of Digits 1-3
Tinels Sign
Phalens Sign
Complication
Atrophy of Thenar Eminence
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2 mins
Nerve Palsies - OK Gesture
Nerve
Proximal Ulnar Nerve
Causes
Fracture Medial Epicondyle of Humerus (proximal injury)
Deficit
Unable to Flex 4th and 5th Digits
Presentation
Trouble Making a Fist
Resembles OK gesture
Complication
Hypothenar Atrophy
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2 mins
Nerve Palsies - Erb's Palsy (Waiter's tip)
Nerves
C5-C6 Roots
Superior (Upper) Trunk
Causes
Lateral Traction on Neck during Delivery
Trauma in Adults
Functional Deficit
Deltoid
Infraspinatus
Biceps Brachii
Presentation
Waiter's Tip Deformity
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2 mins
Nerve Palsies - Ulnar Claw
Nerve
Distal Ulnar Nerve
Causes
Fracture Hook of Hamate (distal injury)
Cyclists
Compression Guyon's Canal
Functional Deficit
Unable to Extend 4th and 5th Digits
Presentation
Hand Resembles Ulnar Claw on Extension
Complications
Atrophy of Hypothenar Eminence
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1 min
Nerve Palsies - Thoracic Outlet Syndrome
Nerve
Compression of Brachial Plexus
Compression of Subclavian Vessels
Causes
Cervical Rib Abnormality
Trauma
Weight Lifters
Pancoast Tumor
Presentation
Edema
Claw Hand
Pain
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1 min
Lateral Epicondylitis (Tennis Elbow)
Characteristics
Overuse Injury of Extensor Tendons
Wrist Extension
Forearm Supination
Pain over Lateral Epicondyle
Management
Conservative Management
Surgery
Injections
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1 min
Medial Epicondylitis (Golfer's Elbow)
Characteristics
Overuse Injury of Flexor Tendons
Wrist Flexion
Forearm Pronation
Pain over Medial Epicondyle
Management
Conservative Management
Injections
Surgery
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1 min
De Quervain Tenosynovitis
Inflammation of the Sheath
Extensor Pollicis Brevis
Abductor Pollicis Longus
Styloid Process of the Radius
Progressive Stenosis
CLINICAL FEATURES
Radial Styloid Process Pain
Movement and Object Grasping Increase Pain
Risk Groups
New Mothers
Golfers and Tennis Players
"Thumb" Texters
DIAGNOSIS
Finkelstein Maneuver
TREATMENT
Conservative
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2 mins
Metacarpal Neck Fracture
Characteristics
Fifth Metacarpal Neck Fracture
Boxer's Fracture
Mechanism
Direct Trauma to a Clenched Fist Against Hard Surface
Signs and Symptoms
Pain
Swelling
Diagnosis
X-Ray
Treatment
Splints
Surgery
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2 mins

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