PictureTorRuS fracture (隆起骨折)
Axial force applied to immature bone→ cortex buckles on compression (concave) side and fractures. Tension (convex) side Remains Solid (intact). musculoskeletal HirotoShishido
radial head subluxationCommon elbow injury in children < 5 years. Caused by a sudden pull on the arm→ immature ☆annular ligament slips over head of radius. Injured arm held in extended/slightly flexed and pronated position. musculoskeletalUWorld HirotoShishido
De Quervain tenosynovitisNoninflammatory thickening of abductor pollicis longus and extensor pollicis brevis tendons→ pain or tenderness at radial styloid.
⊕ Finkelstein test (pain at radial styloid with active or passive stretch of thumb tendons).↑risk in new mothers, golfers, racquet sport players, “thumb” texters. musculoskeletalanatomy HirotoShishido
bursitisBursae are vulnerable to injury from acute trauma or chronic repetitive pressure and may also become inflamed due to infection (septic bursitis), crystalline arthropathy (eg, gout), or autoimmune conditions (eg, rheumatoid arthritis).
☆prepatellar bursitis ("housemaid knee")→ repetitive anterior knee trauma from kneeling
anserine bursitis→ frequently results from obesity or overuse in athletes
muscle spindle and golgi tendon organ(GTO)muscle spindle→ located in body of muscle, and activated by ↑ muscle stretch (sensed by type Ⅰa and Ⅱ sensory axons)→ simultaneous inhibition of antagonist muscle (prevents overstretching) and activation of agonist muscle (contraction)
GTO→ located in tendon, and activated by ↑ muscle force (sensed by type Ⅰb sensory axons)→ inhibition of agonist muscle (reduced tension within muscle and tendon, preventing damage to musculoskeletal systems) musculoskeletal HirotoShishido
what nerve does anterior/posterior tibial artery run with?anterior tibial artery→ deep peroneal nerve
posterior tibial artery→ tibial nerve musculoskeletalanatomy HirotoShishido
distortions of the handClawing”—seen best with distal lesions of median or ulnar nerves. Remaining extrinsic flexors of the digits exaggerate the loss of the lumbricalsfingers extend at MCP, flex at DIP and PIP joints.
recurrent branch of median nerve
cause of injury, affected movementSuperficial laceration of palm
“Ape hand”
Loss of thenar muscle group: opposition, abduction, and flexion of thumb
No loss of sensation musculoskeletal HirotoShishido
what nerve will be injured?femoral nerve
Femoral nerve mononeuropathy can occur due to trauma (eg, pelvic fracture), compression from a ☆hematoma or abscess, or injury during surgery/childbirth. Findings of femoral neuropathy include quadriceps weakness (eg, difficulty with stairs, falling due to knee buckling), decreased patellar reflex, and ☆sensory loss over the anterior and medial thigh and medial leg. musculoskeletalanatomyUWorld HirotoShishido
impaired movement of fingers caused by ①lunate dislocation, ②guyon canal syndrome①Recurrent branch of the median nerve to the thenar muscles: weakness of the abductor pollicis brevis (thumb abduction), flexor pollicis brevis (thumb flexion), and opponens pollicis (thumb opposition)
② ulnar nerve) between the hook of the hamate and the pisiform bone in a fibroosseous tunnel → Guyon's canal
weakness on wrist flexion/adduction, finger abduction/adduction, and flexion of the fourth/fifth digits.
The hypothenar eminence can appear flattened due to denervated muscle atrophy... musculoskeletalanatomyUWorld HirotoShishido
manifestation of dermatomyositisstriated muscles and skin are affected
・Proximal muscle weakness affecting both sides of the body (progresses within weeks to months)
・Respiratory failure
・Myocarditis
・Esophageal disease(☆perifascicular atrophy of muscle fibers in the proximal esophageal muscularis propria)
・ovarian cancer
dermatologic
・☆heliotrope rash(pic), gottron papules
・Mechanic's hands: thickening and hyperpigmentation of the skin of the tips and sides of the fingers, resulting in irregular, dirty-appearing patc... musculoskeletalrheumatologyUWorld HirotoShishido
