Some Clinical Aspects of the Soft

Tissues of the Superior Extremity

Dr. Rayhan Shahrear, MS Resident

Phase A, Year 2, Block 5

Dept. of Anatomy, BSMMU

Guided by:

Dr. Nahid Farhana Amin

Associate Professor

Dept. of Anatomy, BSMMU

Objective

Audience will be able to describe and explain the

anatomical aspects of the common clinical conditions of

the superior extremity

2

3

AXILLARY ARTERY ANEURISM

Excessive localized enlargement of an artery

4

Axillary Artery Aneurism (contd.) 5

Axillary Artery Aneurism (contd.) 6

Axillary Artery Aneurism (contd.) 7

Axillary Artery Aneurism (contd.) 8

ENLARGEMENT OF AXILLARY LYMPH

NODES

9

Enlargement of Axillary Lymph Nodes (contd.) 10

INJURY TO THE AXILLARY NERVE

11

Injury to the Axillary Nerve (contd.) 12

WINGING OF THE SCAPULA

13

Winging of the Scapula (contd.) 14

IMPINGEMENT SYNDROME

Rotator cuff lesions

15

Impingement Syndrome (contd.) 16

Impingement Syndrome (contd.) 17

BICIPITAL TENDON RUPTURE

18

Bicipital Tendon Rupture (contd.) 19

Bicipital Tendon Rupture (contd.) 20

Bicipital Tendon Rupture (contd.) 21

Bicipital Tendon Rupture (contd.) 22

Bicipital Tendon Rupture (contd.) 23

VOLKMANN’S ISCHAEMIC

CONTRACTURE

24

Volkmann’s Ischaemic Contracture (contd.) 25

Volkmann’s Ischaemic Contracture (contd.) 26

DE QUERVAIN SYNDROME

27

De Quervain Syndrome (contd.) 28

De Quervain Syndrome (contd.) 29

De Quervain Syndrome (contd.) 30

DUPUYTREN'S CONTRACTURE

Palmar fibromatosis

31

Dupuytren's Contracture (contd.) 32

Dupuytren's Contracture (contd.) 33

Dupuytren's Contracture (contd.) 34

Dupuytren's Contracture (contd.) 35

GAMEKEEPER'S THUMB

Insufficiency of the ulnar collateral ligament of thumb

36

Gamekeeper's Thumb (contd.) 37

Gamekeeper's Thumb (contd.) 38

Gamekeeper's Thumb (contd.) 39

GOLFER'S ELBOW

Tendinosis of the medial epicondyle of the elbow

40

Golfer's Elbow (contd.) 41

Golfer's Elbow (contd.) 42

TENNIS ELBOW

43

Tennis Elbow (contd.) 44

Tennis Elbow (contd.) 45

GUYON'S CANAL SYNDROME

Ulnar nerve palsy

46

Guyon's Canal Syndrome (contd.) 47

Guyon's Canal Syndrome (contd.) 48

Guyon's Canal Syndrome (contd.)

Location Symptoms Associations

Zone 1

Proximal

(prior to ulnar

nerve

bifurcation)

Mixed motor

& sensory

Ganglia &

hook of

hamate

fractures

Zone 2

Surrounding

deep motor

branch ulnar

nerve

Motor only

Ganglia &

hook of

hamate

fractures

Zone 3

Surrounding

superficial

sensory

branch of

ulnar nerve

Sensory onlyUlnar artery

pathology

49

MALLET FINGER

50

Mallet Finger (contd.) 51

Mallet Finger (contd.) 52

Mallet Finger (contd.) 53

PREISER'S DISEASE

Avascular necrosis of scaphoid

54

Preiser's Disease (contd.) 55

Preiser's Disease (contd.) 56

Preiser's Disease (contd.) 57

Preiser's Disease (contd.) 58

Preiser's Disease (contd.) 59

Preiser's Disease (contd.) 60

TRIGGER FINGER

61

Trigger Finger (contd.) 62

TENOSYNOVITIS

63

Tenosynovitis (contd.) 64

MEDIAN NERVE PALSY

65

Median Nerve Palsy (contd.) 66

Median Nerve Palsy (contd.) 67

Median Nerve Palsy (contd.) 68

Median Nerve Palsy (contd.) 69

CARPAL TUNNEL SYNDROME

Pressure on the median nerve

70

Carpal Tunnel Syndrome (contd.) 71

Carpal Tunnel Syndrome 72

Carpal Tunnel Syndrome (contd.) 73

Carpal Tunnel Syndrome (contd.) 74

Carpal Tunnel Syndrome (contd.) 75

ANTERIOR INTEROSSEOUS NERVE

ENTRAPMENT SYNDROME

Damage to the anterior interosseous nerve

76

Anterior Interosseous Nerve Entrapment Syndrome (contd.) 77

ULNAR NERVE INJURY

Claw hand

78

MCPPIP

DIP

Ulnar Nerve Injury (contd.) 79

Ulnar Nerve Injury (contd.) 80

IOL

EDL

FDP

FDS

Ulnar Nerve Injury (contd.) 81

Flexor Digitorum Superficialis

Ulnar Nerve Injury (contd.) 82

Flexor Digitorum Profundus

Ulnar Nerve Injury (contd.) 83

Extensor Pollicis Longus

Ulnar Nerve Injury (contd.) 84

Interossei

Ulnar Nerve Injury (contd.) 85

Lumbrical

Ulnar Nerve Injury (contd.) 86

Ulnar Nerve Injury (contd.) 87

Ulnar Paradox 88

Ulnar Paradox (contd.) 89

90Hand of Benediction

ERB’S PALSY

Injury of the upper trunk of the brachial plexus

91

Erb’s Palsy (contd.) 92

Erb’s Palsy (contd.) 93

Erb’s Palsy (contd.) 94

Erb’s Palsy (contd.) 95

Erb’s Palsy (contd.) 96

KLUMPKE'S PARALYSIS

Partial palsy of the lower roots of the brachial plexus

97

Klumpke's Paralysis (contd.) 98

Klumpke's Paralysis (contd.) 99

Klumpke's Paralysis (contd.) 100

RADIAL NERVE PALSY

101

Radial Nerve Palsy (contd.) 102

Radial Nerve Palsy (contd.) 103

Radial Nerve Palsy (contd.) 104

Radial Nerve Palsy (contd.) 105

Radial Nerve Palsy (contd.) 106

Radial Nerve Palsy (contd.) 107

Radial Nerve Palsy (contd.) 108

Reference Books

• McMinn and Abraham’s Clinical Atlas of Human

Anatomy

• Moore’s Clinically Oriented Anatomy

• Snell’s Clinical Anatomy by Regions

• Datta’s Essentials of Human Anatomy

109

Web References

• teachmeanatomy.info

• wikipedia.org

• clinicalgate.com

• balourdas.com

• jscr.oxfordjournals.org

• worldscientific.com

• orthosports.info

110

Softwares

111