415-416 - Hands, lower extremities, neuromuscular pairing Flashcards

1
Q

Is clawing more pronounced with proximal or distal lesions? Which nerves can cause it?

A

distal lesions of median or ulnar nerves

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2
Q

When do deficits present with proximal lesions?

A

during voluntary flexion of the digits (i.e. making a fist)

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3
Q

When would you see an ulnar claw?

A

In patients with a distal ulnar nerve lesion when extending fingers or at rest

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4
Q

When would you see a Pope’s blessing?

A

In patients with a proximal median nerve injury when they try to make a fist

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5
Q

When would you see a median claw?

A

In patients with a distal median nerve lesion when extending fingers

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6
Q

When would you see an “OK gesture”?

A

In patients with a proximal ulnar nerve injury when trying to make a fist

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7
Q

Match these findings according to what they look like: ulnar claw, median claw, OK gesture, Pope’s blessing

A

Ulnar claw = Pope’s blessing

Median claw = OK gesture

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8
Q

What nerve lesion can lead to atrophy of the thenar eminence?

A

median

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9
Q

What nerve lesion can lead to atrophy of the hypothenar eminence?

A

ulnar nerve

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10
Q

What three muscles make up the thenar (median) eminence?

A
  1. Opponens pollicis
  2. Abductor pollicis brevis
  3. Flexor pollicis brevis

OAF: Oppose, Abduct, Flex

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11
Q

What three muscles make up the hypothenar (ulnar) eminence?

A
  1. Opponens digiti minimi
  2. Abductor digiti minimi
  3. Flexor digiti minimi brevis

OAF: Oppose, Abduct, Flex

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12
Q

Which muscles abduct the fingers?

A

Dorsal interosseous muscles

DAB = Dorsals ABduct

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13
Q

Which muscles adduct the fingers?

A

Palmar interosseous muscles?

PAD = Palmars ADduct

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14
Q

What do the lumbrical muscles do?

A

Flex at the MCP

Extend PIP and DIP joints

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15
Q

What is a common cause of injury to the obturator nerve?

A

pelvic surgery

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16
Q

What spinal roots contribute to the obturator nerve?

A

L2-L4

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17
Q

A patient has ↓ medial thigh sensation and ↓ adduction. Which nerve is implicated?

A

Obturator (L2-L4)

18
Q

What are the roots of the femoral nerve?

A

L2-L4

19
Q

What injury often causes injury to the femoral nerve? What symptoms would you check for?

A

pelvic fracture; ↓ thigh flexion and leg extension

20
Q

What are the roots of the common peroneal nerve?

A

L4-S2

21
Q

Which injuries would make you concerned about common peroneal nerve damage?

A
  1. Trauma or compression of lateral aspect of leg

2. Fibular neck fracture

22
Q

What signs would indicate peroneal nerve damage?

A
  1. Foot drop - inverted and plantarflexed at rest, loss of eversion and dorsiflexion
  2. “Steppage gait”
  3. Loss of sensation on dorsum of foot
23
Q

What are the roots of the tibial nerve?

A

L4-S3

24
Q

What are three injuries/conditions that can injury the tibial nerve?

A
  1. Knee trauma
  2. Baker cyst (proximal lesion)
  3. Tarsal tunnel syndrome (distal lesion)
25
Q

How does a tibial nerve injury present?

A
  1. Inability to curl toes
  2. loss of sensation on sole of foot
  3. Proximal lesions: foot everted at rest with loss of inversion and plantarflexion
26
Q

What are the roots of the superior gluteal nerve?

A

L4-S1

27
Q

What are two injuries/conditions that can lead to superior gluteal nerve damage?

A
  1. Posterior hip dislocation

2. Polio

28
Q

What are the signs of a superior gluteal nerve injury?

A

Trendelenburg sign/gait – pelvis tilts because weight-bearing leg cannot maintain alignment of pelvis through hip abduction (superior nerve → gluteus medius and minimus)

29
Q

In the trendelenburg sign/gait, is the lesion ipsilateral or contralateral to the side of the hip that drops? Ipsi- or contralateral to the extremity on which the patient stands?

A

Lesion is contralateral to the side of the hip that drops; ipsilateral to the extremity on which the patient stands

30
Q

What are the roots of the inferior gluteal nerve?

A

L5-S2

31
Q

What is an injury that often leads to inferior gluteal nerve damage?

A

Posterior hip dislocation

32
Q

How does an inferior gluteal nerve lesion present?

A
  1. Difficulty climbing stairs, rising from seated position

2. Loss of hip extension (inferior nerve → gluteus maximus)

33
Q

What does the peroneal nerve do?

A

Peroneal Everts and Dorsiflexes; if injured, foot dropPED

34
Q

What does the tibial nerve do?

A

Tibial Inverts and Plantarflexes; if injured, can’t stand on TIPtoes

35
Q

What are the roots of the sciatic nerve?

A

L4-S3

36
Q

What is the distribution of the sciatic nerve?

A

posterior thigh, splits into common and peroneal tibial nerves?

37
Q

What artery runs with the long throracic nerve in the axilla/lateral thorax?

A

Lateral thoracic artery

38
Q

What artery runs with the axillary nerve at the surgical neck of the humerus?

A

Posterior circumflex artery

39
Q

What artery runs with the radial nerve at the midshaft of the humerus?

A

Deep brachial artery

40
Q

What artery runs with the median nerve at the distal humerus/cubital fossa

A

Brachial artery

41
Q

What artery runs with the tibial nerve at the popliteal fossa?

A

Popliteal artery

42
Q

What artery runs with the tibial nerve posteriorly to the medial malleolus?

A

Posterior tibial artery