Podcast
Questions and Answers
What is the area where fractures on the clavicle are more likely to occur?
What is the area where fractures on the clavicle are more likely to occur?
Which muscles contribute to the medial displacement of the lateral segment in a clavicular fracture?
Which muscles contribute to the medial displacement of the lateral segment in a clavicular fracture?
What type of fracture occurs in the clavicle when it is not completely ossified?
What type of fracture occurs in the clavicle when it is not completely ossified?
Which condition is characterized by the characteristic sign of 'Waiter's tip position' resulting from an upper trunk brachial plexus injury?
Which condition is characterized by the characteristic sign of 'Waiter's tip position' resulting from an upper trunk brachial plexus injury?
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What is the characteristic sign of a lower brachial plexus injury?
What is the characteristic sign of a lower brachial plexus injury?
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Which muscles are involved in shoulder external rotation, and what is the resulting position?
Which muscles are involved in shoulder external rotation, and what is the resulting position?
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What action causes the medial segment of the clavicle to move superiorly after a fracture?
What action causes the medial segment of the clavicle to move superiorly after a fracture?
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What condition can be caused by excessive pulling of a newborn's arm?
What condition can be caused by excessive pulling of a newborn's arm?
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Which nerve injury causes medial winging of the scapula?
Which nerve injury causes medial winging of the scapula?
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What muscle is primarily affected by an injury to the long thoracic nerve?
What muscle is primarily affected by an injury to the long thoracic nerve?
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What condition is characterized by difficulty in initially abducting the shoulder, especially before 45 degrees?
What condition is characterized by difficulty in initially abducting the shoulder, especially before 45 degrees?
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What structure can be damaged in a fracture of the surgical neck of the humerus?
What structure can be damaged in a fracture of the surgical neck of the humerus?
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Which tendon is predominantly affected in rotator cuff tears?
Which tendon is predominantly affected in rotator cuff tears?
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What is the classic sign of radial nerve injury?
What is the classic sign of radial nerve injury?
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What condition can irritate the long tendon of the biceps under the transverse humeral ligament?
What condition can irritate the long tendon of the biceps under the transverse humeral ligament?
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Which of the following symptoms is associated with a fractured humeral shaft?
Which of the following symptoms is associated with a fractured humeral shaft?
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Study Notes
Clavicle Fractures
- The clavicle is the oldest bone supporting the upper limb and connecting it to the axial skeleton.
- Fractures most commonly occur in the middle third, at the junction of the lateral and medial curvatures.
- The sternocleidomastoid muscle pulls the medial clavicular segment superiorly after fracture.
- The weight of the upper limb pulls the lateral segment inferiorly.
- The pectoralis major, deltoid, and rotator cuff muscles contribute to lateral segment displacement.
- Muscular spasms result from pain and strong muscle contractions following fracture.
- Nearby neurovascular structures at risk include the brachial plexus, subclavian artery, and subclavian vein.
- Greenstick fractures occur in incompletely ossified clavicles.
- Clavicles may be intentionally fractured and fixed to aid childbirth.
Brachial Plexus Injuries
- Erb's-Duchenne palsy results from upper brachial plexus injury, causing muscle weakness.
- Shoulder dystocia (head getting stuck during delivery) can cause excessive brachial plexus stretching.
- "Waiter's tip" position (pronated forearm, flexed wrist and fingers) is characteristic of upper trunk brachial plexus injury.
- C5 innervation of the deltoid leads to shoulder adduction in injury.
- C5 innervation of supraspinatus and infraspinatus results in internal shoulder rotation if damaged.
- C5-C6 innervation of biceps and brachioradialis leads to elbow extension if injured.
- C5-C6 innervation of supinators leads to forearm pronation if damaged.
- C6-C7 innervation of wrist extensors results in wrist flexion if injured.
- C6-C7 innervation of finger extensors leads to finger flexion if injured.
- Klumpke's palsy results from lower brachial plexus injury.
- Klumpke's palsy can be caused by grasping a branch after a fall (adult) or excessive newborn arm pulling.
- Claw hand deformity is characteristic of Klumpke's palsy.
- The ulnar nerve is affected in Klumpke's palsy.
- Erb's-Duchenne palsy affects C5 and C6 (severe cases C7).
- Klumpke's palsy affects C8 and T1.
Humeral Fractures and Nerve Injuries
- The surgical neck of the humerus is related to the circumflex humeral artery and axillary nerve.
- Surgical neck fractures may cause deltoid atrophy.
- The axillary nerve supplies the deltoid and teres minor muscles.
- The axillary nerve innervates the surgical neck of the humerus.
- Medial winging of the scapula, a prominent vertebral border, results from long thoracic nerve injury.
- Serratus anterior muscle paralysis causes medial winging of the scapula. The long thoracic nerve and serratus anterior muscle are affected.
- Bicipital tendinitis involves irritation of the long biceps tendon under the transverse humeral ligament.
- Bicipital tendinitis causes pain in the shoulder area and impairs elbow and shoulder flexion.
- Rotator cuff tears commonly affect the supraspinatus tendon.
- Rotator cuff tears cause difficulty abducting the shoulder, especially below 45 degrees.
- Humeral shaft fractures are common in the diaphysis.
- The profunda brachii artery and radial nerve are related to the humerus' spiral groove.
- Structures posterior to the humerus' spiral groove are supplied by the radial nerve.
- Humeral shaft fractures or posterior dysfunction cause wrist drop.
- Wrist drop is a classic sign of radial nerve damage.
- Advanced osteoarthritis can cause biceps tendon rupture.
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Description
This quiz covers essential information about clavicle fractures and brachial plexus injuries. It discusses anatomy, types of injuries, associated symptoms, and treatment implications. Understand the mechanics and clinical relevance of these conditions in upper limb support and movement.
