The document provides an overview of forearm anatomy including bones (ulna, radius), joints (elbow, radioulnar), muscles, nerves, blood vessels, and approaches. Key points include:
- The ulna articulates with the trochlea of the humerus at the elbow joint. The radial head articulates with the capitellum.
- Flexor and extensor muscle groups originate on the humerus, ulna, and radius to flex/extend the elbow, pronate/supinate the forearm, and flex/extend the wrist and fingers.
- The median, radial, and ulnar nerves innervate muscles in the forearm and hand.
-
Radial Nerve is very important topic for first year MBBS Students and as well as for day today clinical practice. This slide gives you full course & relations with clear diagrams as well as applied anatomy with clinical Co-relation.
hey this is Vedika Agrawal and this presentation is TO EXPLAIN AND HELP YOU UNDERSTAND ANATOMY OF FOREARM.
The topic is usually mixed with hand making it difficult to understand and so i seperated it to make it easy for you.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
Anatomy of forearm
1. ANATOMY OF FOREARM
ESSEX LOPRESSETI INJURY
PLASTIC DEFORMATION OF
FOREARM
APPROACHES TO FOREARM
PRESENTER : DR. SANDEEP TRIPATHI
MODERATOR : PROF.SURENDHER KUMAR
7. Muscles acting on elbow
Anterior arm
Posterior arm
Muscles originating at elbow, acting on forearm, wrist
and hand
Flexor/pronator group (hand reference)
Extensor/supinator group (3 medial, 3 lateral, 3
“outcropping”, 3 “accessory”)
Muscular Anatomy
11. Origin: common flexor tendon at
medial epicondyle and medial
coronoid process
Insertion: lateral surface of radial
shaft
Innervation: median nerve
Action: forearm pronation
Pronator Teres
12. Origin: common flexor tendon
at medial epicondyle
Insertion: base of 2nd and 3rd
metacarpals
Innervation: median nerve
Action: flexes and abduction
/radial deviate the wrist
Flexor Carpi Radialis
13. Present in approximately 70% of
population
Origin: common flexor tendon at
medial epicondyle
Insertion: palmar aponeurosis
Action: flexes wrist and tenses
palmar aponeurosis
Palmaris Longus
14. Origin: common flexor tendon at
medial epicondyle and proximal
2/3 of posterior ulnar border
Insertion: pisiform, hamate and
5th metacarpal
Innervation: ulnar
Action: flexes and
adduction/ulnar deviate the wrist
Flexor Carpi Ulnaris
15. Origin: common flexor tendon at
medial epicondyle, medial aspect of
coronoid process and oblique line of
radius
Insertion: sides of middle phalanges of
2nd – 5th digits
Innervation: median nerve
Action: flexes PIP joints, assists flexion
of MCP and wrist joints
Flexor Digitorum Superficialis
16. Origin: anteriomedial proximal ulna
Insertion: bases of distal phalanges
(anteriorly) of 2nd-5th digits
Innervation: 1st and 2nd tendons by
anterior interosseous nerve (median
nerve), 3rd and 4th tendons by ulnar
nerve
Action: flexes DIP joints, assists in
flexion of PIP and MCP joints
Flexor Digitorum Profundus
17. Flexor Pollicus Longus
Origin: anterior radius
Insertion: palmar surface
of base of distal phalanx
of thumb
Innervation: palmar
interosseous nerve
Action: flexion of 1st
interphalangeal and
metacarpophalangeal
joints
25. Extensor Digitorum
Origin: common tendon
from lateral epicondyle
Insertion: bases of middle
and distal phalanges via
bands of 4 tendons
Innervation: radial nerve
Action: MCP/IP joint
extension
26. Extensor Carpi Ulnaris
Origin: common extensor
tendon at lateral
epicondyle
Insertion: ulnar side of
base of 5th metacarpal
Innervation: radial nerve
Action: extend and
adduct/ulnar deviate the
wrist
27. Extensor Digiti Minimi
Origin: common extensor
tendon at lateral
epicondyle
Insertion: base of the 5th
proximal phalanx
Innervation: posterior
interosseous (radial)
nerve
Action: extension of 5th
MP joint
36. Vascular Structures
Brachial artery
Descends along arm
along medial aspect of
brachialis muscle
Enters antecubital
fossa medial to biceps
brachii tendon and
lateral to median nerve
Terminates at radial
head as radial/ulnar
arteries
37. Vascular Structures
Radial artery
Originates at radial
head, emerges from
antecubital fossa
between
brachioradialis and
pronator teres muscles
Continues laterally
along forearm deep to
brachioradialis muscle
40. Terminal branches of brachial plexus
Axillary
Musculocutaneous
Median
Radial
Ulnar
Anterior interosseous nerve
Dermatomes and myotomes
Neurological Structures
41. Musculocutaneous/Axillary Nerves
Musculocutaneous
nerve
Innervates biceps brachii,
coracobrachialis and brachialis
muscles
Sensory distribution is anterior
arm and lateral forearm
Axillary nerve
Innervates deltoid and teres
minor muscles
Sensory distribution is lateral
arm
42. Median Nerve
Median nerve
Enters antecubital
fossa medial to biceps
brachii tendon and
brachial artery
Courses down medial
forearm to hand/wrist
distribution
Sensory distribution is
pad of index finger
43. Radial Nerve
Radial nerve
Enteres antecubital fossa
posterior to brachialis
muscle
Divides into superficial and
deep (posterior
interosseous) branches
Courses down lateral
forearm to hand/wrist
distribution
Sensory distribution is 1st
dorsal webspace
44. Ulnar Nerve
Ulnar nerve
Courses in cubital tunnel
posterior to medial
epicondyle
Superficial and susceptible
to compression or
entrapment
Courses down medial
forearm to hand/wrist
distribution
Sensory distribution is pad
of little finger
45. Anterior Interosseous Nerve
Anterior interosseous
nerve (branch of median
nerve)
Passes between 2 heads
of pronator teres muscle,
may be impinged upon
Anterior interosseous
nerve syndrome
characterized by
abnormal pinch deformity
(inability to extend DIP of
thumb and index finger)
46. Dermatomes
C5 – lateral arm
C6 – lateral forearm,
thumb and index finger
C7 – posterior forearm
and middle finger
C8 – medial forearm, ring
and little fingers
T1 – medial arm
48. Olecranon Bursa
Most frequently injured
bursa in the elbow
Lays between skin and
olecranon process
Allows
unrestricted/fluid
movement of skin over
olecranon process
50. is a complex injury that includes
fracture of the radial head
rupture of the interosseusmembrane of the forearm
impaired integrity of the distal radioulnar joint
51. Essex –Lopresti lesion leads to instability of the
forearm
central migration of the radius.
restriction of the radiocarpal motion
reduction of the grip strength and wrist pain.
57. VOLAR APPROACH TO RADIUS(HENRY)
INDICATIONS
RADIAL OSTEOTOMY
TUMOR / ABSCESS BIOPSY AND EXCISION
ORIF OF RADIUS FIXATION
ANTERIOR EXPOSURE OF BICIPITAL TUBEROSITY
58. POSITION
PLACE SUPINE ON TABLE AND SUPINATE
ARM AND PLACE ON ARMBOARD
EXSANGUINATE ARM
INCISION
LONGITUDINAL INCISION
BEGIN JUST LATERAL TO BICEPS
TENDON ON FLEXOR CREASE OF
ELBOW
END AT RADIAL STYLOID PROCESS
60. SUPERFICIAL DISSECTION
INCISE THE DEEP FASCIA IN LINE WITH SKIN
INCISION
DEVELOP A PLANE BETWEEN BR AND
FCR DISTALLY
MOVE PROXIMAL TO DEVELOP PLANE
BETWEEN PT AND BR
IDENTIFY THE SUPERFICIAL RADIAL
NERVE BENEATH BR
LIGATE THE BRANCHES OF THE RADIAL
ARTERY TO AID LATERAL RETRACTION OF BR
61. DEEP DISSECTION -
PROXIMAL THIRD
FOLLOW THE BICEPS TENDON TO ITS
INSERTION ON THE BICIPITAL
TUBEROSITY
RADIAL TO THE INSERTION OF BICEPS
TENDON INCISE THE BURSA TO GAIN
ACCESS TO THE PROXIMAL PART OF
RADIUS
FULLY SUPINATE THE FOREARM TO
DISPLACE THE PIN RADIALLY AND BRING
THE ORIGIN OF THE SUPINATOR MUSCLE
INTO THE ANTERIOR ASPECT OF THE
RADIUS
INCISE THE SUPINATOR MUSCLE ALONG
THE LINE IF ITS BROAD INSERTION AND
CONTINUE SUBPERIOSTEAL DISSECTION
LATERALLY
62. DEEP DISSECTION -
MIDDLE THIRD
PRONATE THE FOREARM TO BRING THE
INSERTION OF THE PRONATOR TERES, ALONG
THE RADIAL ASPECT OF THE RADIUS, INTO
VIEW
DETACH THE PRONATOR INSERTION FROM
BONE AND RETRACT MEDIALLY
DEEP DISSECTION -
DISTAL THIRD
PARTIALLY SUPINATE THE FOREARM
DISSECT THE PERIOSTEUM OFF THE LATERAL
ASPECT OF THE DISTAL THIRD OF THE
RADIUS, LATERAL TO THE PRONATOR
QUADRATUS AND FLEXOR POLLICIS LONGUS
63. DANGERS
POSTERIOR INTEROSSEOUS NERVE
THE POSTERIOR INTEROSSEOUS NERVE ENTERS THE SUPINATOR MUSCLE
SUPERFICIAL RADIAL NERVE
VULNERABLE WITH MANIPULATION OF MOBILE WAD OF THREE
DAMAGE TO IT CAN CAUSE A PAINFUL NEUROMA
RUNS DOWN FOREARM UNDER BODY OF BRACHIORADIALIS
RADIAL ARTERY
RUNS DOWN MIDDLE OF FOREARM UNDER BRACHIORADIALIS
64. DORSAL APPROACH TO
RADIUS(THOMPSON)
ACCESS
PROVIDES EXPOSURE TO PROXIMAL
1/3 OF RADIUS
INDICATIONS
ORIF OF RADIAL FRACTURES
TREATMENT OF NONUNION
ACCESS TO THE PIN AS IT PASSES
THROUGH THE ARCADE OF FROHSE
FOR
NERVE PARALYSIS
RESISTANT TENNIS ELBOW
RADIAL OSTEOTOMY
OSTEOMYELITIS AND BONE TUMORS
66. POSITION
PLACE PATIENT SUPINE
IF ARM IS ON ARM BOARD, THEN PRONATE THE FOREARM
IF ARM IS ACROSS CHEST, THE SUPINATE THE FOREARM
INCISION
STRAIGHT OR GENTLY CURVED INCISION FROM
POINT( 1.5) ANTERIOR TO THE LATERAL EPICONDYLE OF THE
HUMERUS
TO POINT JUST DISTAL TO LISTER'S TUBERCLE( mid point of the wrist)
67. SUPERFICIAL
DISSECTION
PROXIMALLY DEVELOP INTERVAL
BETWEEN ECRB AND THE EDC
PROXIMALLY EXPOSE PROXIMAL
THIRD OF THE RADIUS AND
OVERLYING SUPINATOR
DISTALLY DEVELOP PLANE BETWEEN
THE ECRB AND EPL AND EXPOSES
LATERAL ASPECT OF DISTAL THIRD OF
THE RADIUS
68. DEEP DISSECTION -
PROXIMAL THIRD
PRONATE ARM TO EXPOSE
ANTERIOR ASPECT OF RADIUS
AND MOVE PIN AWAY FROM
ORIGIN OF SUPINATOR
DETACH SUPINATOR MUSCLE AT
INSERTION ON ANTERIOR ASPECT
OF RADIUS
SUBPERIOSTEALLY STRIP
SUPINATOR TO EXPOSE
PROXIMAL THIRD OF RADIUS
69. DEEP DISSECTION - MIDDLE THIRD
MAKE INCISION ALONG SUPERIOR AND INFERIOR BORDERS OF APL AND
EPB AND RETRACT THEM OFF BONE TO EXPOSEMIDDLE THIRD OF RADIUS
DANGERS
POSTERIOR INTEROSSEOUS NERVE
INJURY USUALLY FROM RETRACTION
IN 25% OF PATIENTS THE NERVE ACTUALLY TOUCHES THE DORSAL
ASPECT OF THE RADIUS
PLATES PLACED HIGH ON THE DORSAL SURFACE MAY TRAP THE NERVE
PIN MUST BE IDENTIFIED WITHIN THE SUPINATOR MUSCLE
70. APPROACH TO ULNA
INIDICATIONS
ORIF OF ULNAR SHAFT FXS
ULNAR OSTEOTOMY
ULNAR LENGTHENING (KIENBOCK'S
DISEASE)
ULNAR SHORTENING (FOR RADIAL
MALUNION)
OSTEOMYELITIS AND TUMORS OF ULNA
INTERNERVOUS PLANE
BETWEEN ECU AND FCU
POSITION
PLACE SUPINE ON TABLE
PLACE ARM ACROSS CHEST TO EXPOSE
SUBCUTANEOUS BORDER OF ULNA
71. APPROACH
LINEAR LONGITUDINAL INCISION OVER
SUBCUTANEOUS BORDER OF ULNA
SUPERFICIAL DISSECTION
INCISE DEEP FASCIA IN DISTAL INCISION IN LINE
WITH SKIN INCISION
DIVIDE PLANE BETWEEN ECU AND FCU
DISSECT DOWN TO SUBCUTANEOUS BORDER
OF ULNA
DEEP DISSECTION
INCISE PERIOSTEUM OVER ULNA
PERFORM SUBPERIOSTEAL DISSECTION
72. DANGERS
ULNAR NERVE
PROXIMALLY PASSES
THROUGH HEADS OF FCU
TRAVELS DOWN FOREARM UNDER
FCU AND ON TOP OF FDP
ULNAR ARTERY
TRAVELS DOWN FOREARM WITH
ULNAR NERVE (RADIAL SIDE)
PROTECT BY DISSECTING FCU
SUBPERIOSTALLY
73. POSTERIOR APPROACH TO PROXIMAL 3RD
ULNA AND RADIAL HEAD(BOYDS)
INDICATION
PROXIMAL THIRD ULNA FRACTURE WITH RADIAL HEAD
DISLOCATION(MONTEGGIA)
ISOLATED RADIAL HEAD AND NECK FRACTURE
INCISION
INCISION GIVEN ABOUT 2.5 CM ABOVE ELBOW JOINT JUST LATERAL TO
TRICEPS TENDON
EXTEND OVER OLECRONON TO PROXIMAL AND MIDDLE 3RD OF ULNA
POSTERIORALY
74. DISSECTION
DEVELOP THE INTERVAL
BETWEEN THE ULNA ON
MEDIAL SIDE , ANCONEUS AND
ECU LATERALLY
STRIP THE ANCONEUS
SUBPERIOSTEALLY TO EXPOSE
THE RADIAL HEAD
DISTAL TO RADIAL HEAD,
REFLECT THE SUPINATOR
SUBPERIOSTEALLY FROM ULNA
75. FCR APPROACH TO DISTAL RADIUS
INDICATIONS
ORIF OF FRACTURE AND DISLOCATIONS OF
DISTAL RADIUS AND CARPUS
POSITION
PLACE SUPINE ON TABLE
SUPINATE ARM AND PLACE ON ARMBOARD
APPLIED TOURNIQUET
INCISION
MAKE INCISION ALONG PALPABLE FLEXOR
CARPI RADIALIS (FCR) TENDON SHEATH
76. SUPERFICIAL DISSECTION
INCISE SKIN FLAPS AND SUBCUTANEOUS
FAT
SECTION FIBERS OF VOLAR FCR TENDON
SHEATH IN LINE WITH TENDON
RETRACT FCR TENDON ULNARLY AND
INCISE THROUGH THE DORSAL ASPECT
OF THE FCR SHEATH
CAN RETRACT FCR RADIALLY IF CARPAL
TUNNEL ACCESS IS NECESSARY
77. DEEP DISSECTION AND ACCESS TO VOLAR WRIST
JOINT
UNDERNEATH THE FCR SHEATH IS THE FLEXOR POLLICIS LONGUS (FPL) - THIS
MUST BE RETRACTED ULNARLY
AFTER THE FPL RETRACTED, THE PRONATOR QUADRATUS (PQ) IS SEEN
INCISE THE RADIAL AND DISTAL BORDERS OF THE PQ, ELEVATING THE
MUSCLE OFF THE VOLAR RADIUS
78. PROXIMAL EXTENSION
DISSECTION
EXTEND INCISION UP MIDDLE OF ARM
INCISE DEEP FASCIA BETWEEN PL AND
FCR
RETRACT PL AND FCR TO EXPOSE FDS
INDICATIONS
TO FURTHER EXPOSE MEDIAN NERVE
OR RADIUS
MEDIAN NERVE IS IMMEDIATELY UNDER
THE DEEP SURFACE OF FDS
79. DISTAL EXTENSION
INDICATIONS
TO FURTHER EXPOSE THE SCAPHOID
DISSECTION
EXTEND INCISION OBLIQUELY IN A RADIAL DIRECTION ACROSS
THE FLEXOR CREASE
CONTINUE THIS IN LINE WITH THE THUMB RAY
ELEVATE THE THENAR MUSCULATURE OFF THE VOLAR WRIST
CAPSULE
OPEN CAPSULE IF NECESSARY