Anatomy clinical correlates: Arm, elbow and forearm

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Anatomy clinical correlates: Arm, elbow and forearm

Prerequisite basic sciences

Prerequisite basic sciences

Anatomy clinical correlates: Anterior and posterior abdominal wall

Anatomy clinical correlates: Inguinal region

Anatomy clinical correlates: Peritoneum and diaphragm

Anatomy clinical correlates: Viscera of the gastrointestinal tract

Anatomy clinical correlates: Other abdominal organs

Appendicitis: Pathology review

Complications during pregnancy: Pathology review

Diverticular disease: Pathology review

Gallbladder disorders: Pathology review

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Inflammatory bowel disease: Pathology review

Mood disorders: Pathology review

Pancreatitis: Pathology review

Anatomy clinical correlates: Female pelvis and perineum

Cervical cancer: Pathology review

Complications during pregnancy: Pathology review

Uterine disorders: Pathology review

Anatomy clinical correlates: Heart

Anatomy clinical correlates: Mediastinum

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Thoracic wall

Aortic dissections and aneurysms: Pathology review

Coronary artery disease: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

ECG cardiac infarction and ischemia

Pigmentation skin disorders: Pathology review

Skin cancer: Pathology review

Papulosquamous and inflammatory skin disorders: Pathology review

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Thoracic wall

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Lung cancer and mesothelioma: Pathology review

Nasal, oral and pharyngeal diseases: Pathology review

Obstructive lung diseases: Pathology review

Pneumonia: Pathology review

Tuberculosis: Pathology review

Chest X-ray interpretation: Clinical sciences

Amnesia, dissociative disorders and delirium: Pathology review

Cerebral vascular disease: Pathology review

Dementia: Pathology review

Electrolyte disturbances: Pathology review

Mood disorders: Pathology review

Hypothyroidism: Pathology review

Mood disorders: Pathology review

Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves

Cardiomyopathies: Pathology review

Cerebral vascular disease: Pathology review

Heart blocks: Pathology review

Supraventricular arrhythmias: Pathology review

Valvular heart disease: Pathology review

Ventricular arrhythmias: Pathology review

Vertigo: Pathology review

ECG axis

ECG cardiac hypertrophy and enlargement

ECG intervals

ECG normal sinus rhythm

ECG QRS transition

ECG rate and rhythm

Kidney stones: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

Sexually transmitted infections: Warts and ulcers: Pathology review

Urinary tract infections: Pathology review

Central nervous system infections: Pathology review

Nasal, oral and pharyngeal diseases: Pathology review

Pneumonia: Pathology review

Shock: Pathology review

Urinary tract infections: Pathology review

Anatomy clinical correlates: Anterior blood supply to the brain

Anatomy clinical correlates: Temporal regions, oral cavity and nose

Central nervous system infections: Pathology review

Cerebral vascular disease: Pathology review

Headaches: Pathology review

Traumatic brain injury: Pathology review

Vasculitis: Pathology review

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Bones, fascia and muscles of the neck

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Foot

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Wrist and hand

Seronegative and septic arthritis: Pathology review

Apnea, hypoventilation and pulmonary hypertension: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

Heart failure: Pathology review

Nephrotic syndromes: Pathology review

Renal failure: Pathology review

Anatomy clinical correlates: Anterior and posterior abdominal wall

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Vertebral canal

Aortic dissections and aneurysms: Pathology review

Back pain: Pathology review

Anatomy clinical correlates: Inguinal region

Anatomy clinical correlates: Male pelvis and perineum

Penile conditions: Pathology review

Prostate disorders and cancer: Pathology review

Testicular and scrotal conditions: Pathology review

Testicular tumors: Pathology review

Anatomy clinical correlates: Pleura and lungs

Coronary artery disease: Pathology review

Obstructive lung diseases: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Anatomy clinical correlates: Ear

Anatomy clinical correlates: Temporal regions, oral cavity and nose

Nasal, oral and pharyngeal diseases: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

Assessments

Anatomy clinical correlates: Arm, elbow and forearm

USMLE® Step 1 questions

0 / 9 complete

USMLE® Step 2 questions

0 / 9 complete

Questions

USMLE® Step 1 style questions USMLE

of complete

USMLE® Step 2 style questions USMLE

of complete

A 40-year-old man comes to the office to be evaluated for right-hand weakness. He works as a mechanic, which involves frequent screwdriver use. He does not report any trauma to his hand. Past medical history is unremarkable. Vitals are within normal limits. Physical examination demonstrates weakness with extension of the thumb and fingers of the right hand. There is no weakness with adduction and abduction of the fingers. The patient reports mild pain with resisted middle finger extension. The sensation is intact and reflexes are +2 and symmetrical bilaterally. This patient most likely has an injury to a nerve that courses through which of the following structures?  

Transcript

The majority of things we do every day require the use of our arms and forearms. Sometimes we forget how heavily we rely on our arms, and are quickly reminded how important they are when injury occurs. So, let's take a look at common injuries occurring to the arm and forearm.

Alright, let's begin by looking at fractures of the humerus, the main bone of the arm. The most common kind are fractures of the surgical neck of the humerus, which occur more frequently in elderly people with osteoporosis who have structurally weaker bones. The cause is usually indirect trauma, like falling on the hand with an extended arm.

Surgical neck fractures can result in damage to nearby structures, such as the axillary nerve causing cutaneous deficits in the proximal lateral arm, as well as damage to the anterior and posterior circumflex humeral arteries.

Next, there are humeral shaft fractures, which are usually caused by direct trauma. Now, remember that the radial nerve passes through the radial, or spiral, groove on the back of the humerus, so a common complication of midshaft humeral fractures is radial nerve injury.

Radial nerve injury results in damage to the extensors of the wrist and potential wrist drop, as well as cutaneous sensation dysfunction of the dorsal hand, forearm, and upper arm. Additionally, the deep brachial artery travels with the radial nerve in the spiral groove and can also be damaged. Finally, distal humeral fractures are a result of trauma to the elbow region, or hyperextension injuries.

In a supracondylar fracture, which is a fracture above the epicondyles, an anteriorly displaced portion of the fractured humerus on the medial supracondylar region could injure the median nerve, resulting in wrist flexion weakness and cutaneous deficits of the anterior 3 and a half digits, as well as the brachial vessels.

Sources

  1. "Interventions for treating proximal humeral fractures in adults" Cochrane Database of Systematic Reviews (2015)
  2. "Olecranon bursitis" Journal of Shoulder and Elbow Surgery (2016)
  3. "Treatment of olecranon bursitis: a systematic review" Archives of Orthopaedic and Trauma Surgery (2014)
  4. "The fate of missed atlanto-axial rotatory subluxation in children" Archives of Orthopaedic and Trauma Surgery (1998)
  5. "Low incidence of flexion-type supracondylar humerus fractures but high rate of complications" Acta Orthopaedica (2016)
  6. "Medial Epicondylitis" Journal of the American Academy of Orthopaedic Surgeons (2015)
  7. "Humerus fractures overview" StatPearls Publishing (2021)
  8. "Humeral shaft fractures" StatPearls Publishing (2021)
  9. "Fracture supracondylar humerus: a review" J Clin Diagn Res (2016)
  10. "Golfers elbow" StatPearls Publishing (2021)
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