Matt and Maria are both extremely active in their hobbies during their free time
ID: 3507845 • Letter: M
Question
Matt and Maria are both extremely active in their hobbies during their free time. Matt enjoys being the pitcher in a recreational baseball league, while Maria enjoys writing blogs online. However, both of them have been experiencing health issues caused by the repetitive motor functions associated with their pastimes.
During extended periods of typing, Maria has begun to notice an aching pain in the palmar sides of her wrists bilaterally. She has also been experiencing numbness and tingling in her thumb, index, and middle fingers. Maria went to her primary care physician to find out the cause of her pain. What is Maria’s most likely diagnosis? Related to the diagnosis, what would be the cause of Maria’s symptoms? Explain the mechanism.
Matt, an avid member of a local baseball rec league, is right handed and uses repetitive overhead motion when pitching the baseball. Wanting to impress his teammates, Matt tried to pitch the baseball as fast as he could. He immediately felt a snapping sensation in his shoulder and had sudden, intense pain in his upper arm. Upon a visit to an orthopedic physician, it was confirmed that he had a complete tear of one or more muscles in his right shoulder. Which group of muscles did Matt most likely tear? What are the individual names of the muscles comprised in this group? What is the function of these muscles and what are their attachment sites? Out of this group of muscles, which individual muscle is most often torn?
What is Maria's Diagnosis?
What is Matt's Diagnosis?
Explanation / Answer
Maria’s most likely diagnosis is carpal tunnel syndrome. Carpal tunnel syndrome is a condition in which there is excessive pressure on the median nerve. This is the nerve in the wrist that allows feeling and movement to parts of the hand. Carpal tunnel syndrome can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.
Cause of maria’s symptom is: The condition is linked with repetitive work that involves lifting, typing, or using equipment that vibrates the hand.
Mechanism: Carpal tunnel syndrome (CTS) is caused predominantly by compression of the median nerve at the wrist because of hypertrophy or edema of the flexor synovium. Pain is thought to be secondary to nerve ischemia rather than direct physical damage of the nerve.
The median nerve provides feeling and movement to the thumb side of the hand. This includes the palm, thumb, index finger, middle finger, and thumb side of the ring finger.The area in wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow. Any swelling can pinch the nerve and cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome. Carpal tunnel syndrome can also be caused by making the same hand and wrist motion over and over. Using hand tools that vibrate may also lead to carpal tunnel syndrome.
Matt is suffering from Rotator cuff tear
Individual name of muscles comprised in this group are Subscapularis, Supraspinatus, Infraspinatus, and Teres minor muscles.
Function of these muscles: The rotator cuff muscles are important in shoulder movements and in maintaining glenohumeral joint (shoulder joint) stability. These muscles arise from the scapula and connect to the head of the humerus, forming a cuff at the shoulder joint. They hold the head of the humerus in the small and shallow glenoid fossa of the scapula.
Function and attachment:
Muscle
Origin on scapula
Attachment on humerus
Function
Innervation
Supraspinatus muscle
supraspinous fossa
superior[2]facet of the greater tubercle
abductsthe humerus
Suprascapular nerve (C5)
Infraspinatus muscle
infraspinous fossa
middle facet of the greater tubercle
externally rotates the humerus
Suprascapular nerve (C5-C6)
Teres minor muscle
middle half of lateral border
inferior facet of the greater tubercle
externally rotates the humerus
Axillary nerve(C5)
Subscapularis muscle
subscapular fossa
lesser tubercle
internally rotates the humerus
Upper and Lowersubscapular nerve (C5-C6)
most affected muscle is supraspinatus.
Muscle
Origin on scapula
Attachment on humerus
Function
Innervation
Supraspinatus muscle
supraspinous fossa
superior[2]facet of the greater tubercle
abductsthe humerus
Suprascapular nerve (C5)
Infraspinatus muscle
infraspinous fossa
middle facet of the greater tubercle
externally rotates the humerus
Suprascapular nerve (C5-C6)
Teres minor muscle
middle half of lateral border
inferior facet of the greater tubercle
externally rotates the humerus
Axillary nerve(C5)
Subscapularis muscle
subscapular fossa
lesser tubercle
internally rotates the humerus
Upper and Lowersubscapular nerve (C5-C6)