anatomy poll everywhere + high yield review

absence of pedal pulse is most likley associated w compression of

ANTERIOR TIBIAL

during physical exam its noted the pt had a foot drop, sensation was present over the dorsum of the foot and the skin of the posterior calf. WHICH NERVE IS INJURED

DEEP FIBULAR / PERONEAL NERVE

superficial fibular = sensory

femoral nerve is involved in _______ of the knee

extension

a pt is admitted to the hospital and a laceration of the achilles tendon is dx. WHICH BONE SERVES AS AN INSERTION FOR ACHILLES TENDON

CALCANEUS /heel of foot

swollen and painful left foot of a 23 year old female long distance runner is examined. EM sx is ordered to deal w her tarsal tunnel syndrome. the tarsel tunnel is occupied normally by tendons, vessels and nerves that pass beneath the flexor retinaculum on the medial side of the ankle. what is the most anterior of the sturctures that pass thru this tunnel

hint :TDANH

THINK OF TOM DICK AND NERVE HENRY

- tibialis posterior longus

24 yo woman received a small caliber bullet that severed the tibial nerve. such an injury would most likely result in

Foot would be dorsiflexed and everted

NOTE - POSTERIOR CHAMBER RESPONSIBLE FOR PLANTAR FLEXION AND INVERSION soooooo damage here = the opposite bc theres no balance/pull to equal

skipped: which bony landmark corresponds to the l4 vertebral level and is used to identify the safe interspace for lumbar puncture

ILIAC CREST

technically skipped but ans if you wanted

which nerve exits the greater sciatic foramen ABOVE the piriformis muscle

SUPERIOR GLUTEAL NERVE

NOTE = PIRIFORMIS IS THE SX LANDMARK FOR GLUTEAL REGION

which nerve exits the greater sciatic foramen BELOW the piriformis muscle

sciatic and inferior gluteal nerve

which posterior thigh muscle is the ONLY one innervated by the common fibular division of the sciatic nerve

SHORT HEAD OF THE BICEPS FEMORIS

which strutcure lies lATERAL to the femoral artery in the femoral triangle

FEMORAL NERVE

NOTE F' VAN

medial to artery is the vein

lymphatics >>> vein >>> artery >>> nerve

a patient has loss of BOTH dorsiflexion and foot eversion after a fibular head fracture. what nerve is injured

COMMON FIBULAR NERVE

fibular head and neck = always think common fibular nerve

which hip joint ligament is considered the strongest ligament in the human body

ILIOFEMORAL LIGAMENT

only ligament to remember

also think our FEMUR is our largest bone ... the ligament should prob be the strongest to contribute to that fact

which structure is MOST ANTERIOR in tarsal tunnel

TIBIALIS POSTERIOR TENDON

TDANH MNEMONIC

FYI -- can skip: which artery provides the PRIMARY blood supply to the femoral head in adults

medial femoral circumfelx artery

which reflex tests the femoral nerve and the L3-L4 nerve roots

PATELLAR RELFEX

only reflex to remember

note babinski is when looking at neural tracts

a patients pelvis drops on the LEFT when standing on the right leg - is this a positive or negative trendelenburg test

POSITIVE

a patients pelvis drops on the LEFT when standing on the right leg. WHICH MUSCLE IS WEAK

RT SIDE IS EFFECTED

RT GLUTE MEDIUS

NOTE ITS ALWAYS THE OPPOSITE OF THE LEG THAT DROPS - the other side has to be able to stabilize the hips when standing on just one leg so if theres a drop on the other side while standing on x leg. then X side is the side that is weak, not the side thats elevated bc the muscle is suspended in the air if you think about it so it cant do anything.

A 32 yo woman learning to play tennis practiced daily for approx two weeks. she reported to her coach that she was experiencing pain over the elbow. the coach compressed the common extensor tendon and she again experienced intense pain. what does she present with

LATERAL EPICONDYLITIS AKA TENNIS ELBOW

you can do a COZEN TEST

Golfer elbow is affecting what nerve and is is called

ulnar nerve

medial epicondylitis

an 18 yo boy is cut severely on the lateral wall of his right chest during a knife fight. after healing, his scapula moves away from the thoracic wall when he leans on his rt hand, giving the appearance indicated in the given photo. which nerve is likely damage

ACCESSORY NERVE

note this is describing LATERAL winging which will be accessory nerve damage

if there is medial winging of the scapula what nerve is expected to be damaged

long thoracic nerve

what nerve supplies the latissimus dorsi

THORACODORSAL

what nerve supplies serratus anterior

long thoracic

what nerve supplies the supraspinatous and infraspinatous muscles

subscapular

what nerve supplies the trapezius and SCM

spinal accessory

what nerve supplies the rhomboids and levator scapulae

dorsal scapular

what is the action of the latissimus dorsi

what muscle is the lats twin brother

extension of the arm, ADduction, medial rotation and extension

teres major as well

trapezius and rhomboids __________ the scapula

ADDUCT

trapezius and levator scapula __________ the scapula

elevate

elevation from 0 to 15 degrees

supraspinatous

elevation from 15 to 90 degrees

deltoid

>90 degree elevation

trapezius and serratus anterior

meemaw had a mastectomy and finds out after healing she cant comb her hair anymore, what nerve is likely damaged

thoracic nerve

which is the sensory innervation of the median nerve

lateral 2 /3 of the palm of the hand

what is the sensory innervation of ulnar nerve

median 1 /3 of the palm

lateral 2 /3 of DORSAL hand

if its not the lateral 2 /3 of the dorsal or palm of hand, OR the 1/ 3 palm of the hand..... what is the rest of the hand innervated by

radial nerve

what muscle is paralyzed by excessive traction on upper part of the brachial plexus

what is the upper part of the brachial plexus

deltoid and teres MINOR

C5-C6

deltoid and teres minorare paralyzed by excessive traction on upper part of the brachial plexus

what nerve innervates these muscles and what can you no longer do with your arm

aaxillary nerve -- note it dives into the quadangular space w the posterior circumfelx humeral artery

damage = you cant lift arm to 15-90 degrees

Paralysis of trapezius would indicate

damage to spinal accessory nerve

paralysis of triceps brachii indicates damage to

radial nerve

a 12 yo boy fell off his skateboard and hits his rt elbow on the sidewalk. boy says i fell on my funny bone and right away my little finger tingled.

the boy shows no repsonse to pinpricks on his rt little finger and medial border of palm. considerable displacement of epuphysis of medial epicondyle of the humerus and probbaly nerve stretching and compression are evident

what nerve is injured

ulnar nerve

damage to ____ and ____ can cause ulnar claw hand

flexor carpi ulnaris and flexor digitorum profundus

damage to _______ can cause wrist drop

shaft of humerus, radial nerve

radial nerve palsy

a pro golfer consulted a PA abiyt aching pain in his elbow and along the anterior surface of his forearm. the PA detected extreme tenderness and some pain when forearm flexor-pronator group of muscles was compressed. the golfer said the pain usually subsided after he finished his game but that its become more severe and constant. radiographs of the elbow were normal. WHAT HAS GOLFER SUSTAINED

medial epicondylitis = golfers elbow

if this was tennis elbow itd be .....lateral epicondylitis!

which of the following is affected due to damage of the ulnar nerve

loss of SENSATION from the MEDIAL 1/ 3 of the hand

median and lateral vs ulnar and radial orientation on dorsal hand

dorsal

ulnar = medial

radial = lateral

inability to extend the thumb is damage to

extensor pollicus longus - radial innervation

which muscle may be injured in a radical mastectomy

what nerve

serratus anterior

long thoracic nerve can also be damaged -> medial winging

which is the major artery supplying the breast

internal thoracic artery

during hard birth, PA pulled on a babys head while the shoulder was still in the birth canal. this caused a traction injury of the superior trunk of the brachial plexus. which anterior rami of the brachial plexus were prob injured

WHATS THE RESULT OF BABY

C5 AND C6

axillary, suprascapular, musculocutaneous -> think WAITERS TIP

PT CANNOT FLEX OR SUPINATE BICEP

main bone in hand to remember ... also choose this if confused on exam and its an option

remember the scaphoid in the carpal bones!!!

what is most likley assocaited w compression of inferior trunk of brachial plexus

claw hand

paralysis of biceps brachii is most likely assocaited w which additional defect

loss of supination of the forearm

can also have a loss of sensory of lateral forearm or loss of flexion

IMP!!!

a 45 yo woman is told she has synovitis of her glenohumeral jiont

which jiont classification does the glenohumeral joint represent

DIARTHROSIS = FREELY MOVEABLE SYNOVIAL JOINT!!!!

a 25 yo cyclist falls on an outstrectched hand and has focal tenderness in the wrist. x-ray is negative. which bone must be presumed fractures until proven otherwise

SCAPHOID BONE !!!!!!!

literally if its a wrist bone just guess scaphoid

after a posterior shoudler dislocation, a patient has numbness over the lateral deltoid patch and weak deltoid contractio. which structure passes thriu the quadrangular space and is most likley injured

axillary nerve

IMP!!

DIARTHROSIS / SYNOVIAL JOINT TYPE !!

freely movable joint

articular cartilage + synovial membrane + joint capsule

lateral epicondyle is aka the common _____ origin

_____ elbow

EXTENSOR

tennis elbow

PA PEARL - MEDIAL WINGING

serratus anterior paralysis bc of long thoracic nerve damage (c5-c7)

- cant raise arm above 90 degrees

PA PEARL -LATERAL WINGING

trapezius paralysis = cn 11

PA PEARL - DORSAL SCAPULAR NERVE // RHOMBOIDS

lateral winging from rhomboid weakness if damaged dorsal scapular nerve

CLAVICLE AND RISK OF FRACTURE

most commonly fractured bone in upper limbs

at the junction of middle and lateral thirds

CLAVICLE SEGMENTS IN FRACTURE

result in shoulder = SHOULDER DROP

SCM elevates medial fragment

trapezius FAILS to hold the lateral fragment

pec major pulls lateral fragment medially