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UPPER EXTREMITY

UPPER EXTREMITY. Finger, Hand, Elbow, Shoulder. HAND & WRIST ANATOMY. GENERAL INJURIES. Fractures Direct blows or falls on outstretched hand Pain, swelling, decreased function Dislocation/Subluxation Direct blow from a ball; fall on hand Gross change in anatomy Sprains/Strains

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UPPER EXTREMITY

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  1. UPPER EXTREMITY Finger, Hand, Elbow, Shoulder

  2. HAND & WRIST ANATOMY

  3. GENERAL INJURIES • Fractures • Direct blows or falls on outstretched hand • Pain, swelling, decreased function • Dislocation/Subluxation • Direct blow from a ball; fall on hand • Gross change in anatomy • Sprains/Strains • Hyperextension or hyperflexion • Synovitis & Bursitis • Overuse & irritation of synvium or bursa • Contusions • Direct blow

  4. Buttonhole Deformity “Boutonniere” Tendon rupture of middle phalanx Forced excessive flexion Can’t fully extend finger Mallet Finger “Baseball Finger” Caught in jersey Direct blow on outstretched finger Avulsion fracture Can’t actively extend finger FINGER INJUIRIES

  5. GAMEKEEPER’S THUMB Ulna Collateral Ligament sprain or tear Forced abduction TEST: bend thumb @ 45 degree angle & abduct. Pain = sprain No end point = tear (3rd degree sprain) FINGER STRAIN “JAMMING” FINGER Hyperextension or hyperflexion of finger TEST: Valgus/Varus for stability. Resistance for strength FINGER INJURIES

  6. DE QUERVAIN’S DISEASE • Irritated thumb tendons • Tendons swell or “thicken” • Tenosynovitis • Pain in wrist numbness in fingers • Finkelstein’s test: make a fist thumb tucked in, ulnar deviate wrist. + sign:pain in thumb

  7. WRIST IMPINGEMENT • Compression of median & ulnar nerves • Repeated stress • Point tenderness, pain, numbness, loss of strength • PHALEN’S TEST:Press back of hands together, elbow’s up. Squeeze hands. + sign:tingling & numbness

  8. IMPINGEMENT Ulnar nerve compression Point tenderness, pain, numbness, loss of strenght TINEL’S SIGN:Tap on ulnar goove, +sign: tingling down arm. BICEPS BRACHI Found in upper arm Elbow flexion & hand rotation Rupture=complete tear Usually @ origin Painful bulge may apper @ belly ELBOW INJURIES

  9. Epicondylitis Swelling of epicondyles Medial affects flexors “little league elbow” Lateral=extensors “tennis elbow” Chronic overuse: twisting/throwing Pain & point tenderness VOLKMANN’S CONTACTURE Swelling or muscle spasm or bone fx putting pressure on arteries of arm Decreases blood supply Muscle damage &/or paralysis Pain when fingers extend Possible loss of pulse ELBOW INJURIES

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