Anatomy

Question 1

Median Nerve

Answer 1

Intrinsics

• abductor pollicis brevis - palmar abduction
• opponens pollicis - opposition
• flexor pollicis brevis - mcp flexion
• radial lumbricals - mcp flexion/extension of IP joints

Extrinsics

• flxr digitorum superficialis - flxn of PIP joints
• flxr digitorum profundus - flxn of DIP digits II and III
• flxr pollicis longus - flxn of IP thumb joint

Wrist Flexors

• flxr carpi radialis - wrist flxn/radial deviation
• palmaris longus - flxn of wrist

Volar forearm

• pronator teres - forearm pronation
• pronator quadratus - forearm pronation

Question 2

Ulnar Nerve

Answer 2

Intrinsic
-abductor digiti minimi - abduction of 5th digit
-opponens digiti minimi - opposition of 5th digit
-flxr digiti minimi - flxn of MCP/Opposition of 5th digit
-adductor - adducts CMC joint
-ulnar lumbricals - MCP flxn, IP extension of digits IV & V
-Palmar Interossei - adduction/assistance with MCP flxn,
extension of IP joints of digits II - V
-Dorsal Interossei - abduction/assistance with MCP flxn &
IP extension of digits II - V

Intrinsic flexors
-flxr digitorum profundus - flexion DIP digits IV & V

Wrist flexors
-flxr carpi ulnaris - wrist flexion and ulnar deviation

Question 3

Radial N

Answer 3

Extrinsic Extensors

• extnsr digiorum communis - extn of MCP, helps ext IP jts
• extnsr digitus minimi - extn of MCP 5th digit, helps extn IP jts
• extnsr indices proprius - ext MCP 2nd digit, and IP joints
• extnsr pollicis longus - ext of thumb IP
• extnsr pollicis brevis - ext of CMC & MCP jts of thumb
• abductor pollicis longus - abduction and ext of CMC jt

Wrist Extensors

• ext carpi radialis brevis - wrist extn and radial deviation
• ext carpi radialis longus - wrist extn and radial deviation
• ext carpi ulnaris - wrist extn and radial deviation

Dorsal Forearm
-supinator- forearm supination

Elbow

• brachioradialis - elbow flxn with forearm neutral
• tricips- elbow extn
• anconeus - elbow extension

Question 4

Musculocutaneous Nerve

Answer 4

Elbow

• bicep - elbow flxn/forearm supinated
• brachialis - elbow flxn/forearm pronated

Shoulder

• coracobrachialis - shoulder flexion
• supraspinatus- shoulder flexion

Question 5

Subscapular Nerve

Answer 5

Shoulder

• posterior deltoid - shoulder extension
• teres major - shoulder extension
• subscapularis - rotator cuff internal rotation

Question 6

Suprascapular Nerve

Answer 6

• supraspinatus - shoulder abduction and flexion

- infraspinatus - external rotation

Question 7

Axillary Nerve

Answer 7

• Teres Minor - external rotation
• anterior deltoid - shoulder flexion
• middle deltoid - shoulder abduction
• posterior deltoid - horizontal abduction

Question 8

Lateral Pectoral Nerve

Answer 8

-Pectoralis Major - horizontal adduction

Question 9

Thoracodorsal Nerve

Answer 9

-Latissimus Dorsi - shoulder extension

Question 10

Rotator Cuff Muscles

Answer 10

SITS
Subscapularis
infraspinatus
teres minor
suprapinatus

Question 11

Muscles of Scapula

Answer 11

Trapezius
Serratus Anterior
Levator Scapulae
Rhomboids
Serratus Anterior
Latissimus Dorsi
Middle Trap/Rhomboid Major
Serr

Question 12

Trapezius

Answer 12

CN XI - spinal accessory
upper - foramen magnum-C8 Scap elevation
middle - T1-T5 Scap Adduction
Lower - T6-T12 Scap Depression

Question 13

Serratus Anterior

Answer 13

Long Thoracic N
Ribs 1-8
Scap abduction and outward rotation

Question 14

Levator Scapulae

Answer 14

C3-C4 nerves

elevate the scap

Question 15

rhomboids

Answer 15

dorsal scapular N

downward rotation, pull toward spine

Question 16

Latissimus Dorsi

Answer 16

Dorsal Scapular N

Downward rotation, shoulder extension, medial internal rotation

Question 17

Dupuytren’s

Answer 17

Fascia of Palm and digits (scar tissue, nodes)

Extension splint

Question 18

Skier’s Thumb

Answer 18

Ruptured UCL of thump MCP

Thump splint pinch strength

Question 19

Complex Regional Pain Syndrome

CRPS

Answer 19

Type I -former - reflex sympathetic dystrophy
Type II - Causalgia
pain, edema, discoloration, osteoporosis, sudomotor changes, temp/trophic changes, vasomotor instability.
** abnormal vasomotor reflex. idiopathic
** avoid PROM

Question 20

Comminuted Fracture

Answer 20

break/splinter of bone into more than 2 pieces

usually forceful injury MVA, etc

Question 21

closed fracture

Answer 21

cast/brace

Question 22

open fracture

Answer 22

ORIF

Question 23

arthrodesis

Answer 23

fusion

Question 24

arthroplasty

Answer 24

joint replacement

Question 25

Common Fractures

Answer 25

Colles’ - distal radius/dorsal displacement
Smith’s - distal radius/volar displacement
carpal - 60% = scaphoid. low blood supply, necrosis
MCP - boxers fx - 5th MCP - Ulnar Gutter Splint
Proximal Phalanx - most common digits are: thumb/index
middle phalanx - not common
distal phalanx - most common. Mallet finger
Elbow - radial head involvement = lim forearm rotation

Question 26

Humerus Fx’s

Answer 26

Fx of greater tuberosity = rotator cuff injuries
Humeral shaft fx - injur Rad Nerve = wrist drop
tx - begin w passive or AAROM

Question 27

Cumulative Trauma Disorders

CTDs

Answer 27

De Quervain’s - stenosing tenosynovitis (APL&EPB)
Thumb Spica Splint

Lateral/Medial Epicondylitis - degeneration of tendon at elbow
Lateral - tennis elbow. overuse wrist extensors (ECRB)
Medial - golfer’s elbow. Overuse wrist flexors .
Tx - both - elbow strap, wrist splint. ice massage stretch

Trigger Finger - Like DQ, but Finger Flexors. A1 pulley tenosynovitis. Trigger Finger Splint (MCP ext, IP free)
tendon glides, massage, work mod.