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Spring A 2025 > anatomy midterm > Flashcards

anatomy midterm Flashcards

1
Q

what nerve does a lateral lumbar disc protrusion affect?

A

normally affects the nerve root below
ex. protrusion at L4/5 affects L5 nerve root

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2
Q

what nerve does a medial lumbar disc protrusion affect?

A

medial protrusion at L4/5 rarely affects L4 nerve root but may affect L5 nerve root and S1-4 nerve roots

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3
Q

etiology of a herniation of nucleus pulposus

A

extreme/sudden hyper-flexion of vertebral column
repeated strain or compression of vertebral column
can be idiopathic or asymptomatic

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4
Q

characteristics of HNP

A

most common location is lumbar spine
esp L4/5 IVC

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5
Q

symptoms of HNP

A

pain in the lower back, radiating to one or both LE

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6
Q

what is the most typical spinal level if IVD herniation?

A

in lumbar spine because WB is the highest
L4/5 or L5/S1 are most common

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7
Q

what vertebral level is best for lumbar puncture?

A

L4/5 or L5/S1
ensures that conus medullaris and cauda equina are missed

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8
Q

borders of the suboccipital triangle

A

superomedial: rectus capitis posterior major
superolateral: obliquus capitis superior
inferolateral: obliquus capitis inferior
floor: posterior AO membrane, posterior arch of C1
roof: semispinalis capitis

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9
Q

contents of the suboccipital triangle

A

vertebral artery
suboccipital nerve
suboccipital venous plexus

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10
Q

borders of the quadrangular space

A

superior - teres minor
inferior - teres major
medial - long head of the triceps brachii
lateral - surgical neck of the humerus

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11
Q

innervation of serratus anterior muscle

A

long thoracic nerve (C3,4,5)

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12
Q

action of serratus anterior

A

protraction
upward rotation
stabilization of scapula

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13
Q

what does damage to the long thoracic nerve do?

A

weaken serratus anterior

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14
Q

what causes winging of the scapula?

A

complete severing of the long thoracic nerve
inactivation of SA inhibits scapula from being held into the thoracic wall

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15
Q

what 4 muscles perform internal rotation of GH?

A
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16
Q

a lesion of suprascapular nerve would likely result in what motor deficits?

A
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17
Q

what are the contents of the carpal tunnel

A

flexor digitorum profundus tendons
flexor digitorum superficialis tendons
flexor pollicis longus tendon
median nerve

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18
Q

boundaries of carpal tunnel

A

posterior/floor - carpal bones
anterior/roof - flexor retinaculum

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19
Q

what is carpal tunnel syndrome?

A

synovial sheaths become inflamed with overuse, expanding against the other structures in the tunnel

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20
Q

axillary nerve sensory innervation

A

upper half of upper arm

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21
Q

radial nerve sensory innveration

A

lower lateral half of upper arm and most of posterior arm

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22
Q

musculocutaneous nerve sensory innervation

A

lateral side of anterior forearm and lateral posterior forearm

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23
Q

median nerve sensory innervation

A

anterior lateral hand and digits 1-lateral half of 4 and posterior tips of digits 1-4

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24
Q

ulnar nerve sensory innervation

A

medial hand and medial half of digit 4 and digit 5

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25
Q

division 1 of axillary artery

A

1 rib is landmark for transition from subclavian to axillary
branch: superior thoracic a.

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26
Q

division 2 of axillary artery

A

deep to pectoralis minor
branches: thoracoacromial a., lateral thoracic a.

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27
Q

division 3 of axillary artery

A

inferior to pec minor and anterior to teres major
branches: subscapular a. (circumflex scapular a. and thoracodorsal a.), posterior humeral circumflex a., anterior humeral circumflex a.

28
Q

what four muscles make the anterior abdominal wall?

A

rectus abdominis
external abdominal oblique
internal abdominal oblique
transversus abdominis

29
Q

what does an abdominal hernia occur?

A

when an organ pushes through a weakness in abdo wall muscle or CT
groin is another common place

30
Q

common sites of abdominal hernias

A

umbilicus
incisional
hiatal

31
Q

what is the treatment of a hernia?

A

surgical repair
small ones can be monitored, but will get worse over time

32
Q

where is the ansa cervicalis nerve?

A

loop sitting anterior to scalene

33
Q

hypoglossal CN XII

A

inferior to mandible

34
Q

phrenic nerve location

A

C3-5 to the diaphragm

35
Q

where does the vagus nerve run?

A

medially to common carotid artery

36
Q

boundaries of the anatomical snuffbox

A

extensor pollicis longus
extensor pollicis brevis
abductor pollicis longus

37
Q

floor of the snuffbox

A

scaphoid
trapezium

38
Q

contents of the snuffbox

A

radial artery
superficial radial nerve
cephalic vein

39
Q

what is nurse maid’s elbow?

A

head of radius displaced from annular lig

40
Q

what causes nurse maid’s elbow?

A

common in children following pulling movement
swinging by hands

41
Q

how to correct nursemaid’s elbow?

A

elbow and wrist held with forearm in 90 deg flexion
forearm rapidly hyperpronated
radial head should click back into place

42
Q

upper roots injury (C5,C6): Erb-Duchenne’s paralysis

A

excessive increase in angle between head and shoulder
paralysis of shoulder and arm muscles supplied by C5 and C6
Erb-duchenne palsy - waiter’s tip: arm add and hangs by side in medial rotation

43
Q

what deficits are associated with erb-duchenne’s palsy?

A

loss of abd - delt
loss of IR - infra, T minor
weak forearm flexors - biceps, brachialis
weak supination - biceps

square shoulder due to delt atrophy

44
Q

lower roots injury (C7, C8, T1): Klumpke’s paralysis

A

sudden stop when upper limb raised over head
intrinsic muscles of hand deficits
claw hand

45
Q

what deficits are associated with claw hand?

A

loss of thenar and hypothenar innervation
loss of lumbricals and interossei
hyperextension of MCP joints
loss of extension of IPs

46
Q

axillary nerve lesion (C5, C6)

A

humeral surgical neck fracture
improper use of crutches
posterior dislocation of GH

square shoulder sign

47
Q

what deficits are associated with square shoulder sign?

A

severe weakness of shoulder abd
weakness in lateral rotation of shoulder

48
Q

lesions to suprascapular nerve

A

loss of supra and infra
weak abd and LR

49
Q

lesions to upper and lower subscapular nerve

A

loss of subscap and t major
weak add and MR

50
Q

lesions to long thoracic

A

loss of serr ant
winged scap

51
Q

lesions to pectoral nerve

A

weak pec major/minor
weak MR, add

52
Q

lesions to thoracodorsal nerve

A

loss of lats
weak arm ext, add, MR

53
Q

lesions to dorsal scapular

A

loss of rhomboids
weak scap retraction

54
Q

injury to spinal accessory nerve

A

most common surgery related nerve injury
paralysis of trap

signs:
shoulder drop
cannot shrug against resistance

55
Q

musculocutaneous nerve lesion C5-7

A

rare to injure only musculo
stab or puncture
similar to upper brachial plexus injury
severe weakness of elbow flexion and supination

56
Q

median nerve lesion C5-T1

A

deep perforating wounds, cuts at wrist, carpal tunnel

57
Q

median nerve lesion proximal to elbow

A

loss of pronation
weak wrist flexion and abd
loss of IP flexion and 2-3
weak Ip flexion in 4-5
impaired thumb

sign of benediction
1-3 remain extended when trying to make a fist
forearm supination
wrist ulnar deviated

58
Q

median nerve lesion at wrist

A

loss of intrinsic thumb muscles

ape hand:
wasting thenar
thumb slightly extended

59
Q

ulnar nerve lesion C8-T1

A

gunshot wound, fracture of med epi

60
Q

ulnar nerve lesion proximal to elbow

A

weak wrist flex and add
loss of flex in dip of 4-5
loss of flexion of mcp of 4-5
loss of extension of ip of 4-5
loss of abd and add of digits
loss of thumb add
loss of digit 5 abd and flex

partial claw hand

61
Q

deficits with partial claw hand

A

flexion of PIP of 4-5
hyperextension of 4-5 mcp
impaired wrist add, hand in radial deviation

62
Q

ulnar nerve lesion at wrist

A

exaggerated partial claw hand

same as partial claw hand but additional flexion in dip

63
Q

radial nerve lesion - axilla (C5-T1)

A

compression due to crutches
loss of forearm ext
weak forearm flexion
weak supination

wrist drop

64
Q

deficits with wrist drop

A

wrist in flexe position

65
Q

radial nerve lesion in spiral/radial groove

A

fracture to humeral shaft

wrist drop

66
Q

radial nerve lesion in cubital fossa

A

laceration
wrist ex weakened
loss of mcp ext
loss of thumb ext
weak supination

difficulty holding pen and writing

Spring A 2025 (6 decks)

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