Orthopedics 5th year, 10th/part one lecture (Dr. Bakhtyar)
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Transcript of Orthopedics 5th year, 10th/part one lecture (Dr. Bakhtyar)
![Page 1: Orthopedics 5th year, 10th/part one lecture (Dr. Bakhtyar)](https://reader036.fdocuments.in/reader036/viewer/2022062307/556c6619d8b42ad85e8b4806/html5/thumbnails/1.jpg)
Radial nerve
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Supplies:
TricepsBrachioradialisSupinatorAll extensors in the forearmAbductor pollicis longusA small patch of skin at the
base of the thumb
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Causes of injury:
Crutch palsy
Fracture of humerus
Tourniquet palsy
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Causes of injury:Dislocation of elbowFractures around elbowSurgical accidentsBullet or knife
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Signs and symptoms
Wasting of the above musclesWrist dropLoss of supination of extended elbow.Weak abduction of thumbSensation loss at the base of thumb.
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Treatment
Open wounds: Repair or graftClosed wounds: Spontaneous recovery during 8-12 weeks. If not: Exploration and repairIf repair failed: Tendon transfer
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Median nerve
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Supplies:All flexors in the forearm except:Flexor carpi ulnarisUlnar ½ of flexor digitorum profundusThe two pronatorsThenar eminence musclesLateral two lumbricalsSkin: lateral ⅔ of palm + lateral 3½ fingers
(palmar surface)
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Causes:
Forearm fractures
Elbow dislocation
Gunshot or stab wound
Carpal dislocation
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Symptoms and Signs:
All above muscles are wasted
Weak wrist flexion
Weak pronation
Pointing index sign is +ve
Thumb abduction is weak
Sensation loss and trophic ulcers
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Treatment:
Repair or graft
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Ulnar nerve
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Supplies:
Two flexors in the forearm
Hypothenar eminence muscles
Eight interossei and two lumbricals
Abduction and Adduction of the fingers
Flexion of M.P.J
Extension of I.P.J
Adductor pollicis
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Causes
Injuries
Pressure of a deep ganglion in the wrist
Fractures around elbow
Cubitus valgus deformity
Nerve entrapment in the cubital tunnel
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Symptoms and signs
Hypothenar wasting
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Wasting of the interossei(first dorsal interosseous
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Claw hand
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Loss of thumb adduction (Froment’s test)
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Sensation loss
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Treatment
Repair or Graft
Tendon transfer
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Femoral nerve
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Supplies:
Quadriceps muscle
Iliopsoas muscle
Skin: (1) Anterior of thigh
) 2 (Medial aspect of the leg.
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Causes
Gunshot
Bleeding into the thigh
Traction during operation
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Symptoms and signs
Loss of knee extension
Hand- knee gait
Numbness of skin
↓Knee jerk.
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TreatmentSuturing OR Grafting
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