100 Concepts (11-20)

If you flex the PIPJ, what muscle are you testing

Flexor digitorum superficialis

If you are flexing the DIPJ, what muscle are you testing

Flexor digitorum profundus

Upper brachial palsy usually is caused by

Increasing the angle between the neck and the shoulder stretching or tearing of superior parts of the brachial plexus (C5 & C6 roots or superior trunk)

Erb's palsy is due to injury to

C5&C6 spinal roots

What is affected in Erb-Duchenne palsy

Axillary, suprascapular, and musculocutaneous nerves

Loss of shoulder muscle and anterior arm function

What is the classic sign seen in Erb-Duchenne palsy

Waiter's tip hand

What happens in a waiter's tip hand

Adducted shoulder

Medially rotated arm

Extended elbow

Loss of sensation in the lateral aspect of the upper limb

What is injured in Klumpke paralysis

Inferior part of the brachial plexus C8/T1 nerve roots or inferior trunk

Causes of Klumpke palsy

Grabbing support while falling from a height

Birth injury

Thoracic outlet syndrome

What is affected in Klumpke palsy

Intrinsic muscles of the hand

Ulnar nerve (claw hand)

Median nerve (Ape hand)

Less of sensation in the medial aspect of the upper limb and medial 1,5 fingers

Horner syndrome

What is the axillary nerve component

C5 & C6

What does the axillary nerve innervate

Deltoid

Teres minor

Shoulder region's skin

Clinical sign of an axillary nerve injury

Loss of abduction

Musculocutaneous nerve components

C5, C6, & C7

What does the musculocutaneous nerve innervate

Flexors of the arm and skin of the lateral forearm

Clinical signs of a musculocutaneous nerve injury

Weakness of flexion and supination in elbow

Radial nerve components

C5 - T1

What does the radial nerve innervate

Extensors of the arm, forearm, and posterior skin of upper limb

Clinical signs of a radial nerve injury

Wrist drop (loss of wrist extension)

Median nerve components

C5 - T1

What does the median nerve innervate

Flexors of the forearm (except 1.5), 5 of the hand, 3 thenar, and 2 lumbricals

Clinical manifestations of median nerve injury

Ape hand

Hand of Benediction

Ulnar nerve components

C8 & T1

Ulnar nerve innervation

Flexors of the hand (except for 5) and 1.5 forearm (FUD + 0.5 FDP)

Clinical manifestation of ulnar nerve injury

Claw hand

Long thoracic nerve innervates

Serratus anterior

Clinical manifestation of long thoracic nerve injury

Winged scapula

Suprascapular nerve innervation

Suraspinatus

Clinical manifestation of suprascapular nerve injury

Pain and problems with initiation of abduction

In the case of superficial branch of radial nerve lesion, there will be a deficit of what area of the hand

1 & 2 digits on the dorsum of the hand

What supplies the 1.5 digits of the dorsum of the hand

ulnar nerve

What supplies the 3.5 digits of the dorsum of the hand

radial nerve

What supplies the 1.5 digits of the palmar surface of the hand

ulnar nerve

What supplies the 3.5 digits of the palmar surface of the hand

Median nerve

Thumb dermatome

C6

Fingers 2-4 dermatome

C7

5th finger dermatome

C8

Nipple dermatome

T4

Xiphoid process dermatome

T7

Umbilicus dermatome

T10

Pubis dermatome

L1

Big toe dermatome

L4

Toes 2-4 dermatome

L5

Little toe dermatome

S1

What is a dermatome

Strip of skin innervated by one dorsal root ganglion

Which artery is used for cardiac catheterization

Femoral artery

Common fracture in elderly women with osteoporosis

Femoral neck

Fractures of the femoral neck cause ____ of the lower limb

Shortness and lateral rotation

What is the best treatment in cases of femoral neck fractures

Hip replacement

Transcervical fracture of the femoral neck disrupts blood supply to the head fo the femur via what arteries

Retinacular (medial circumflex femoral)

If there is a femoral neck fracture that disrupts the blood supply to the area from the medial circumflex artery and supply through the artery to the head of the femur is inadequate, what can happen

Avascular necrosis

Most common cause of a posterior hip dislocation

Head-on collision

What can allow the joint capsule rupture inferiorly and posteriorly

Fracture of ishium

If here is a fracture of the ishium and the femur is allowed to displace posteriorly and inferiorly, what is the next structure to be torn

Ishiofemoral ligament

If the ishiofemoral ligament is torn, what happens to the limb

Shortens and medially rotates

Injury to the sciatic nerve can manifest as

Weakened hip extension and knee flexion

Foot drop

Flail foo

Foot drop is

Lack of dorsiflexion

Flail foot is

lack of both dorsiflexion and plantar flexion

Causes of sciatic nerve injury

Improperly placed gluteal injections

Posterior hip dislocation

Femoral nerve components

DDVR L2-L4

Femoral nerve innervated region

Muscles and skin of the anterior thigh

Clinical signs of femoral nerve injury

Loss of knee extension

Obturator nerve components

VDVR L2-L4

Obturator nerve innervated region

Muscles and skin of the medial thigh

Obturator nerve injury clinical sign

Loss of thigh adduction

Tibial nerve components

VDVR L4-S3

Tibial nerve innervated region

Muscles fo posterior thigh (except 0.5), leg and plantar foot

Tibial nerve injury clinical signs and symptoms

Loss of plantar flexion, everted foot

Common fibular nerve components

DDVR L4-S2

Superficial fibular nerve components

DDVR L4-S1

Common fibular nerve injury clinical signs

Foot drop

Inverted foot

Common fibular nerve innervated region

0.5 short head of biceps femoris

Superficial fibular nerve innervated region

Lateral leg muscles (evertors)

Skin of the dorsum of the foot

Superficial fibular nerve injury clinicial signs

Inverted foot

Deep fibular nerve components

DDVR L5-S2

Deep fibular nerve innervated regions

Muscles of the anterior leg and dorsum of the foot

Deep fibular nerve injury clinical signs

Foot drop

Superior gluteal nerve components

DDVR L4-S1

Superior gluteal nerve innervated regions

Gluteus medius

Gluteus minimus

Superior gluteal nerve injury signs

Trendelenburg sign

Inferior gluteal nerve components

DDVR L5-S2

Inferior gluteal nerve innervated region

Gluteus maximus

Inferior gluteal nerve injury clinical signs

Problem climbing stairs or standing from a seated position

Nerve injured in a Trendelenburg gait

Superior gluteal nerve

If the superior gluteal nerve on the right side is injured, which pelvis falls downward

left

When you see someone with a Trendelenburg gait causing the left hip to drop, which side has the nerve injury

right

Avulsion fractures of the hip bone occur where muscles attach to

Ischial tuberosity

What are the hamstring muscles

Biceps femoris

Semitendinosus

Semimembranosus

Action of the hamstring muscles

Extension of hip joint

Flexion of the knee

Innervation of the hamstring muscles

Tibial nerve

Common fibular (short head of biceps femoris)

Contents of the inguinal canal from lateral to medial side

Iliopsoas muscle

Femoral nerve

Femoral artery

Femoral vein

Femoral canal (ring)

Femoral hernia passes below the _____ and through the _____

Inguinal ligament through the femoral ring

Where is the femoral hernia located

Upper thigh inferior and lateral to the pubic tubercle

The hernial sac of a femoral hernia may protrude through the

Saphenous hiatus into the superficial fascia

Femoral hernias occur more frequently in

females

Which artery is vulnerable during femoral hernia repairs

Aberrant obturator artery

Great saphenous vein arises from

Medial side of dorsal venous arch of the foot

The great saphenous vein passes _____ to the medial malleolus

anterior

Small saphenous vein arises from

Lateral side of the dorsal venous arch of the foot

The small saphenous vein passes _____ to the lateral malleolus

posterior