Reattachment Surgery and Anatomy Case Essay
1. Identify at least five organ systems in this region of the arm that the surgeon would have marked for reattachment. Circulatory, skeletal, lymphatic, nervous, integumentary, and muscular 2. List the names of the specific structures that had to be reattached. Specific Bone: Humerus ; Specific Muscles: Biceps brachii, brachialis, triceps ; Specific nerves: Median nerve, ulnar nerve, radial nerve, musculocutaneous nerve, antebrachial cutaneous nerves ; Specific Blood Vessels: Brachial artery, superior and inferior collateral artery, profunda brachii artery and veins, cephalic vein, basilic vein, and other venous tributaries 3.
What organ system was most likely not reattached? Explain. Lymphatic because the vessels are very small and hard to find. 4. Why was a clean bite so important? Ragged edges would make ends of blood vessels and nerves difficult to identify and put together, while clean edges would facilitate identification and reattachment. 5. Why was the bone shortened? To cut off the damaged area and to avoid stretching severed blood vessels and nerves. 6. Identify the movements associated with the arm, forearm, wrist, and fingers.
Flexion, extension, abduction, adduction, grasping, and mobility of individual fingers. 7. Explain how the movements of the reattached arm might be altered after the reattachment. Decreased, because not all nerve fibers are reconnected or can regenerate 8. Define collateral circulation and identify the regions of collateral circulation that would be found in the upper extremity. Collateral circulation is defined as multiple circulation paths supplying a particular area.
The regions of collateral circulation in the upper extremity are around the scapula, the head of the humerus, the elbow, wrist, and hand. 9. Identify the specific vessels that provide the collateral circulation to the elbow. Specific Vessels are branches of the profunda brachii artery, inferior ulnar collateral artery, radial recurrent artery, and anterior and posterior ulnar recurrent arteries. 10. Identify specific types of activities that might cause Jim problems after recovery.
Grasping and moving individual fingers. 11. Why would full use of his arm be unlikely? Jim would not likely regain full use of his forearm and hand because not all of the nerve fibers would regenerate. 12. Assume the role of the surgeons as they explain the procedure to Jim’s parents. Write a one- to two-paragraph explanation about the surgery, paying particular attention to what you would say about regaining use of his arm, forearm, and hand. “The surgery was a success.
We shaved off some of the bone and connected all the muscles and vessels and such back together and implanted a suture into his arm to hold the two pieces of the arm together. Although the surgery was good, it is unlikely that he will ever regain full use of his arm or hand again. Your son is recovery now. We are going to keep him for a while and monitor his vital signs and see how this reattachment treats him. ” 13. Assume the surgery to reconnect blood vessels was successful and blood flow was re-established immediately throughout the arm.
Would the nerves of the arm recover as quickly and completely as the muscles? Explain why or why not. If the surgery were successful, the nerves would not recover as quickly and completely as the muscles because nerves do not grow or regenerate as well. 14. How might this situation have been different if Jim had been 80 instead of 8 years old? An 80-year-old person might have underlying medical conditions that would make reattachment difficult. A person that old might also have more difficulty regenerating nerves and having the brain understand any rewiring.