Lecture 16 Outline of Last Lecture I. Muscles II. Flexor Carpi RadialisIII. III. Flexor Carpi Ulnaris IV. Palmaris Longus V. Flexor Digitorum Superficialis VI. Flexor Digitorum Profundus VII. Extensor Carpi Radialis Longus VIII. Extensor Carpi Radialis Brevis IX. Extensor Carpi Ulnaris X. Extensor Digitorum Outline of Current Lecture I. Types of Injuries II. Spine Injuries III. Shoulder Girdle Injuries IV. Glenohumeral Joint Injuries V. Injuries to Elbow Joint and Upper Arm VI. Wrist and Hand Injuries Current Lecture A. Types of Injuries 1. Fractures, sprains, strains, contusions, tendonitis, dislocations B. Spine Injuries 1. Spondylolysis a. defect of the vertebrae lamina HPER 205 1st Edition These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best !used as a supplement to your own notes, not as a substitute. !b. common to have associated fracture 2. Spondylolisthesis a. translation or slippage between adjacent segments b. older: L4-L5 degeneration due to arthritis c. young: L5-S1, end plate lesions 3. Herniated discs a. mechanism - compressive loads - hyperflexion with lateral bending - nerve root disturbance + posteriolateral displacement 4. Chronic Low Back Pain a. unknown b. possible causes - muscle strains - poor posture - weak abdominals - SI joint sprain - facet joint sprains 5. Stiffneck a. wryneck or torticollis (stiff neck, muscle spasms) b. common problem w/out direct injury to neck, most common positional problem 6. Burning Pain a. burner, pinched nerve, cervical stretch sydrome b. potentially serious7. Neck Sprain (whiplash) a. violent forward or backward snapping or the head b. soft tissue injury C. Shoulder Girdle Injuries 1. AC Seperation a. injuries to the AC ligaments and/or coracoclavicular lig. b. mechanism - falling on shoulder or outstretched arm 2 .Thoracic Outlet Syndrome a. compression of nerves, arteries, and/or veins coming from spine towards arm b. mechanism - muscle spasm 3. Sternoclavicular Sprain a. injury to the ligaments connecting the sternum to clavicle b. mechanism - direct blow or extreme twisting with arm going backward D. Glenohumeral Joint Injuries 1. Factors a. Shoulder instability - poor joint cavity - poor ligament - loose capsule - musculature - scapulohumeral balance 2. Ruptured Rotator Cuffa. inflammation —> microtears —> partial or total rupture —> movement adaptations b. supraspinatus rupture most common 3. Impingement a. Abduction b. Supraspinatus and bursae c. Categories - under 35 yr: sports or jobs with overhead movement - older: degeneration d. microtrauma-instability-subluxation-aggravation 4. Rotator Cuff Impingements a. Extrinsic: structural factors - hook acromion - hypertrophy of supraspinatus b. Intrinsic - inflammation of tissue c. Mechanism - work or sports requiring overhead movements - wheelchair (abductor dominance) 5. Dislocations a. Anterior dislocations - mostly anterior when arm is abducted, extended and external rotation (posterior forces) b. Posterior and inferior dislocation, soft tissue trauma, like to occur 6. Bursitis a. Inflammation of the bursa b. Direct trauma or overusec. Sometimes result of other injury like ligament or muscle tear 7. Pitcher’s Shoulder a. Osteochondritis dissecans b. Excessive use of shoulder primarily in young people c. Lead to damage to joint E. Injuries to Elbow Joint and Upper Arm 1. Upper arm a. anterior and posterior 2. Humeral fractures a. 7% of fractures b. Direct or indirect c. Low and high energy d. Falls, car crashes, direct loading, violent muscle contraction 3. Biceps tendon injuries a. Tenosynovitis (repetition) b. Dislocation (medial) - abduction/ext rotation - falls outstretched arm - lateral impact - hyperextension - anterior GH dislocation - bicipital groove angulations c. Rupture: tissue degeneration 4. Elbow Hyperextension a. ligament tear b. fractures of olecranon process5. Elbow Dislocations a. Avulsion fractures - medial epicondyle b. Tennis elbow - lateral epincondyle c. Golfer’s or little league elbow - medial epincondyle d. Pitcher’s elbow - medial epincondyle/osteochondritis dissecans - causes: repetitive stress or trauma 6. Elbow Bursitis a. Inflammation of bursa b. Direct blow F. W r i s t a n d H a n d I n j u r i e s 1. Carpal Tunnel a. result from repetitive stress to tissue b. 64% of work injuries c. compressive neuropathy d. wrist flexion/ext and finger movements e. risk factors - exertion - repetitive stress - posture - localized contact - cold 2. Handlebar palsy, ulnar neuropathya. pressure on ulnar nerve gripping handlebars to tightly b. pain, tingling, numbness 3. Sprained Wrist a. Falls on an outstretched hand b. forced movement 4. Carpal Fractures a. compressive loads to hyperextended wrist b. hyperflexion c. rotation loading against a fixed wrist d. Scaphoid: 60-70% e. Lunate 5. Thumb (essential for prehension) a. Sprain: skiers thumb or gamekeepers thumb - fall with thumb in abducted position - tensile loads on MCL b. Hyperextension c. Bennets fracture (fighting) d. Bowlers thumb: ulnar digital nerve trauma - tingling,