upper limb

upper limb

1. Anatomy

2. fractures

   • Psychological Complications
     • Adjustment Disorder
     • Acute stress disorder/ Post-traumatic stress disorder
     • Depression and anxiety
   • nerves affected
     • midshaft fracture
       • radial nerve damage.
     • surgical neck fracture
       • axillary nerve injury
     • distal end of humerus fracture
       • medial nerve injury
       • ex: supracondylar fracture
     • medial epicondyle fracture
       • ulnar nerve injury
   • causes
     • Car accidents
     • Pathological
     • Repetitive forces
     • Direct blow
     • Falls
   • signs and symptoms
     • Pain
     • Numbness
     • Bleeding
     • Swelling or tenderness
     • Broken skin with protruding bone
     • Limitation of movement
   • types
   • managment
     • Stop any bleeding immobilization
     • Plaster casts or plastic, functional braces, Metal plates and screws, Intra-medullary nails and External fixators
     • Surgery
     • Physical therapy
       • Exercises for Wrist Drop
         • Wrist Extension Stretch
         • Wrist flexion Stretch
         • Wrist Supination
         • Radial Nerve Glide
   • healing
     • stages
       • Acute inflammatory response
       • Mesenchymal stem cell (MSc) recruitment
       • Callus formation
       • Neo-angiogenesis
       • Resorption and replacement of soft cartilaginous callus by hard callus
       • Remodeling of bone
   • a break in the continuity of a bone or cartilage

3. bone

   • tissue
     • It is a specialized hard type of C.T., with calcified extra-cellular matrix
     • It has a rich blood supply, Dynamic( constantly changes shape)
   • cells
     • Osteoprogenitor cells
       • Undifferentiated mesenchymal cells
     • Osteoblasts
       • The stem cells from which bone tissue develops
     • Osteocytes
       • Mature resting bone cells lying inside bone tissues
     • Osteoclasts
       • Bone eating cells
   • development and growth
     • Ossification
       • process of bone formation by osteoblasts
         • Intramembranous ossification
         • Endochondral ossification
     • growth
       • In length
         • Chondrocytes on the epiphyseal side of the epiphyseal plate divide
       • In width
         • Increase in the diameter of bones by the addition of bony tissue at the surface of bones

4. cast

   • types
     • Plaster Cast
     • Synthetic cast
     • cast brace
     • Splint (half cast)
   • complications
     • Compartment syndrome
     • pressure sores
     • Thermal Injuries
     • Dermatitis
     • Joint stiffness

5. radiology

   • projectional radiography (X-rays)
   • fluoroscopy
   • detect?
     • fractures
     • dislocation
     • subluxion
       • partial loss of contact between the bones of a joint

6. neurology

   • brachial plexus
   • sensory neurons
     • Neurons that convert a specific type of stimulus, by their receptors.
       • They convert stimulus into action potentials or graded potentials in a process called sensory transduction.
     • Photoreceptors
       • e found the retina that is capable of visual phototransduction
     • Chemoreceptors
       • Sensory receptors which transduce chemical substances
         • taste
         • O2 regulation
     • Nociceptors
       • responds to damaging or potentially damaging stimuli
         • pain
     • Thermoreceptors
       • feeling hot or cold
     • Mechanoreceptors
       • Sensory cell that responds to mechanical pressure or distortion.
         • Merkel’s disks
         • Meissner’s corpuscles
         • Ruffini endings
         • Pacinian corpuscle
   • examination
     • Tone
       • Pronate & supinate the forearm
       • Roll the patient’s wrist
       • Flex and extend the elbow
     • Reflexes
       • Using the hammer
         • Biceps (C5, C6)
         • Triceps (C5, C6)
         • Supinator (C5, C6)
     • Power
       • Shoulder
         • abduction
         • adduction
       • elbow
         • flexion
         • extension
       • wrist
         • flexion
         • extension
     • Sensory
       • Light touch
       • Pin prick
       • Vibration

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