Anatomy & Physiology Flashcards
Contraction of which muscle causes Ankle Clonus ??
Gastronemius (plantar flexion of foot)
(UMN lesion)
Name the muscles causing the following actions
- Extension of lateral 4 toes ??
- Foot Abduction ??
- Evert & Plantar flex the Ankle
- Dorsiflex & Invert the Foot ??
- Extensor Digitorum Longus
- Fibularis brevis
- Peroneus longus
- Tibialis anterior
What is the expected blood volume in ml/kg for a healthy 25 yr old man & woman & Neonate ??
75 ml/kg & 65 ml/kg & 85 ml/kg respectively.
- It is determined by muscle mass, fat mass & TBSA
- Increased in pts. with heart failure related to salt & H2O retention
- Reduced in cases of Renal/ GI loss
Which organ drives most of the response to Hypoxia ??
Carotid body
- Found near bifurcation of carotid artery; contains Glomus cells
- Type 1 glomus cells detect O2 partial pressure.
- When partial pressure falls < 8kPa, output from glomus increases via afferent fibres of Glossopharyngeal N
How does Aortic arch baroreceptor work ??
They are Stretch receptors
- Decreases firing rate when arterial BP decreases => Autonomic response from the Medulla => results in Increase in Sympathetic outflow & Decreases Parasympathetic outflow
How does the Left Atrial stretch receptors work ??
Low pressure => (+) ADH production from Hypothalamus
Increased volumes within atria => ANP production => Increases Na= & H2O excretion
How to calculate Osmolality ??
Osmolality = (2 * serum[Na]) + [Glucose, in mmol/l] + [Urea, in mmol/l]
Define Osmolarity & Osmolality
OsmolaRity : No. of Solute particles per litre of Solvent
OsmolaLity : No. of Solute particles in 1 kg of solvent
Is there a difference b/w Osmolarity & Osmolality ??
Dilute solutions : Insignificant
Conc. solutions [eg. high glucose] : Significant & the difference b/w the 2 is calculated
What is the normal S. Osmolality ??
275 to 295 mOsm (solute)/Kg (of solvent)
What drives the initial generation of action potential in Muscle cells ??
Na+ influx (ACh opens ACh- gated cation channels => large quantities of Na+ to diffuse to the interior of muscle fibre memb. => Depolarization
What is the main pathology seen in Cystic Fibrosis ??
Defective Cl- channels known as [CF Transmemb. Conductance Regulator]
- When Cl- cannot be extruded on to the cell surface => secretion becomes abnormally thickened
What is Osmosis ??
Passage of SOLVENTS towards a higher conc. of solutes across a semi-permeable membrane
What is Reverse Osmosis ??
Passage of SOLUTES from a high to a low conc. across a Semi-permeable memb.
What is Diffusion ??
Movt. of molecules from a high conc. to a low conc. in a solvent pool
What is the commonest cause of transfusion-associated morbidity in the UK ??
Transfusion Associated Circulatory Overload (TACO)
- It is important to consider fluid balance, with appropriate use of DIURETICS when required
2nd MC is TRALI
Which is the primary stimulator of Resp. Chemoreceptors in brain ??
Increased H+ ions
- Medullary chemoreceptors are sensitive to H+ conc. in CSF
- causes increases in RR
In COPD pts., these central receptors can become desensitized to decreases in pH over time => causes CO2 retention in COPD
What changes in the blood are detected by Peripheral chemoreceptors ??
Aortic bodies: O2 & CO2 changes
Carotid bodies: O2, CO2 & pH changes
Anatomical relations of Kidneys ??
BOTH Kidneys- Posterior: Q lumborum, Diaphragm, Psoas maj., Transversus abdominis
Right Kidney
- Anterior: Hepatic flexure of Colon
- Superiorly: Liver, Adrenal gland
Left Kidney
- Anterior: Stomach, Pancreas tail
- Superiorly: Spleen, Adrenal gland
Features of Kidney anatomy ??
11cm long, 5cm wide & 3cm thick
- Located in deep gutter alongside the vertebral projections on the anterior surface of Psoas major
- Left is placed 1.5cm higher then Rt.
- Upper pole: is at 11th rib level (beware of Pneumothorax during nephrectomy)
Hilum:
- Left: L1 level
- Right: L1- L2 level
Lower border = L3 level
Name the fascial coverings of Kidney ??
[Kidney + Suprarenals] is enclosed within a common layer- Investing Fascia derived from Transversalis fascia
- It is divided into Anterior & Posterior layers (Gerotas fascia)
Name the tissues that are in direct contact with Rt. & Left kidneys respectively ??
Direct contact: Rt. Suprerenal gland, Duodenum, Colon
Layer of peritoneum b/w: Liver, Distal part of Small Intestine
DIrect contact: Lt. Suprarenal gland, Pancreas, Colon
Layer pf peritoneum b/w: Stomach, Spleen, Distal part of SI
What are the main composition of
- ICF ??
- ECF ??
- K+, Mg2+, Organic phosphates (eg. ATP)
- Na+, Cl-, HCO3-, Albumin
S. Osml= 275- 295 mOsm/Kg H2O
Plasma Vol.= TBV * [1- Hct]
Explain the fluid compartment ??
Total body mass = [55- 60%] Water + [40- 45%] non-water mass
Out of [55- 60%] Water
- 1/3rd ECF + 2/3rd ICF
Out of 1/3rd ECF
- 75% Interstitial fluid
- 25% Plasma
Out of 2/3rd ICF
- 10% id RBCs
Blood vol.- Plasma + RBCs (6l)
Structures at Renal Hilum ??
[Anterior ===> Posterior]
Renal vein => Renal artery => Ureter
Str. of Glomeruli ??
Responsible of filtration of plasma by Size & Charge selectivity
Composed of
- Fenestrated capillary endothelium
- BM with Type 4 collagen & Heparan sulfate
- Visceral epithelial layer has Podocyte Foot processes
Explain the Features of
- Charge barrier
- Size barrier
1)- GF barrier has (-)ve charged glycoproteins that prevent entry of (-)ve charged molecules (eg. Albumin)
2)- Fenestrated capillary endothelium (prevents entry of >100nm molecules /blood cells; Podocyte foot processes interpose with GBM; Slit diaphragm (prevents entry of molecules > 40- 50nm)
What is the Effect of
- PGs ??
- Angiotensin II ??
‘PDA ACE’
- PGs Dilate Afferent arteriole
- A-II Constricts Efferent arteriole
Elaborate the Arterial & Venous system of Kidneys
Receives 25% of resting Cardiac O
Renal A => Segmental A => Interlobar A => Arcuate A => Interlobular A => AFFERENT arteriole => Glomeruli => Efferent Arteriole => Peritubular capillaries & Medullary Vasa recta =========> Interlobular V => Arcuate V => Interlobular V => Renal Vein
Hallmark of Kidney blood supply ??
Left Renal Vein receives 2 additional veins
- Lt. Suprarenal vein
- Lt. Gonadal vein
Left Kidney is taken during live donor transplant as it has a LONGER renal vein
Which part of Kidney is very sensitive to Hypoxia ??
Renal MEDULLA (as it receives significantly less blood flow than cortex)
- TUBULAR Cells are more prone to Ischaemia
How does Kidneys regulate its Blood flow ??
Myogenic control of arterial tone
- By Sympathetic input & Hormones (eg. Renin)
- Cortical blood flow»_space; Medullary blood flow (ie Tubular cells more prone to ischaemia)
What is Renal Clearance ??
Vol. of Plasma from which a substance is removed per minute by the kidneys
How is GFR calculated ??
Total vol. of plasma per unit time leaving the capillaries & entering the Bowman’s capsule.
- Assuming that solute is freely diffused eg.- Inulin
In practice, CREATININE is used as it is subjected to little PCT secretion
normal GFR = 125ml/min
What features should a substance have in order to use it for GFR calculation ??
- Inert
- Free filtration from plasma at the glomerulus (not protein bound)
- Neither Absorbed nor Secreted at tubules
- Plasma conc. constant during urine collection
Eg.- Inulin, Creatinine
GFR formulae ??
Urine conc.*Urine Vol./ Plasma conc. (mmol/l)
- Clearance of a substance is dependent not only on its Diffusivity across BM but also on Tubular secretion &/or reabsorption
Which substance is used to measure Renal Plasma flow & why ??
Solutes like Para-AminoHippuric Acid is used as they are cleared with a single passage through the kidneys
Transport physiology of PCT ??
Early PCT- contains brush borders
- Reabsorbs ALL Glucose & AminoA
- Most HCO3-, Na+, Cl-, PO4-, K+, H2O & Uric acid
- Generates & Secretes NH3, which enables kidney to excrete (via secretion) more H+
PTH= (-) Na+/PO4- co-transport => Increased PO4- excretion
AT-II = (+) Na+/H+ exchange => Increased Na+, H2O & HCO3- reabsorption (permits Contraction Alkalosis)
65-70% Na+ & H2O is reabsorbed
Transport physiology of Thin Descending L of H ??
Reabsorbs H2O (passively) via Medullary Hypertonicity (IMPERMEABLE to Na+)
- Concentrating segment => makes urine Hypertonic
Transport physiology of Thick Ascending L of H ??
- Reabsorbs Na+, K+ & Cl-
- Indirectly induces reabsorption of Mg2+ & Ca2+ through (+) lumen potential generated by K+ backleaks
- IMPERMEABLE to H2O
- Makes urine LESS conc. as it ascends
- 10- 20% of Na+ reabsorbed
Transport physiology of Collecting Duct ??
- Reabsorbs Na+ in exchange for K= & H+ secretion (regulated by ALDOSTERONE)
- ADH- acts at V2 receptors => insertion of Aquaporin H2O channels on APICAL side
- 3- 5% of Na+ is reabsorbed
Transport physiology of DCT ??
Early DCT
- Reabsorbs Na+, Cl-
- IMPERMEABLE to H2O
- Makes urine fully dilute
- PTH = increase Ca2+/Na+ exchange => increased Ca2+ reabsorption
- 5- 10% of Na+ reabsorbed
Name to what substance is the following part of nephron is impermeable to
- Thin Descending L of H ??
- Thin Ascending L of H ??
- Thick Ascending L of H ??
- Early DCT ??
- Impermeable to Na+ & is the Concentrating segment
- Impermeable to H2O but highly permeable to Na+ & Cl- ions
-Impermeable to H2O & makes urine less conc. as it ascends up. Energy dependent reabsorption of Na+ & Cl- helps to maintain osmotic gradient
-Impermeable to H2O & makes urine fully dilute
In which parts of kidney does PTH act & on what transporters ??
Early PCT
- (-) Na+/PO4 co-transport => Increased PO4- excretion
Early DCT
- Increases Ca2+/Na+ exchange => Increases Ca2+ reabsorption
Mention the MC types of Urinary Casts
RBC Cast : Glomerulonephritis, Renal Ischaemia & Infarction
WBC Cast : Acute Pyelonephritis, Interstitial nephritis
Granular (Muddy brown) Cast : ATN
Epithelial Cast : ATN
Hyaline Cast :
- Common & Non-specific;
- may be seen after Exercise or Dehydration
Waxy Cast : Advanced CKD
Fatty Cast : Nephrotic Syndrome
Name on which receptors does the following substances act
- SGLT-2 inhibitor
- Angiotensin II
- Acetazolamide
- Loop Diuretics
- Thiazide
- Amiloride
- Triamterene
- ADH
- Aldosterone (K+ sparring D inhibits this receptors)
- (-) Na+/Glucose transporter at PCT
- (+) Na+/H+ at PCT
- (-) CA
- (-) Na+/K+/2Cl- at Thick Ascending L
- (-) Na+/Cl- at DCT
- (-) Na+ channels at CD
- (-) Na+ channels at CD
- acts at V2 receptors at CD => inserts Aquaporin H2O channels on Apical side
- Increases Epithelial Na+ channel (ENaC) activity at CD => Lumen negativity => K+ secreted; & in Alpha-intercalated cells at CD => Lumen (-)vity => Increase H+ ATPase activity => Increases H+ secretion => Increase HCO3-/Cl- exchanger activity
What is the effect of Urinary pH on Stone formation ??
Urine pH varies from 5 to 7
- Post-prandially, pH falls as Purine metabolism will produce Uric acid; later it becomes more alkaline (Alkaline tide)
Stone type = U acidity = Mean U pH.
- Uric Acid. = Acid = pH 5.5
- Cystine = Normal = pH 6.5
- CaPO4 = Normal-Alkaline = pH >5.5
- Struvite = Alkaline = pH > 7.2
- Ca Oxalate= Variable.= pH 6
MCC of AKI ??
ATN: Necrosis of renal tubular epithelial cells, severely affects the functioning of the kidney
2 causes: Ischaemia & Nephrotoxins
- Ischaemia- Shock & Sepsis
- Nephrotoxins: Aminoglycosides, Myoglobin secondary to rhabdomyolysis, Radiolucent agents, Lead
Phases of ATN & HP features of ATN ??
- Oliguric
- Polyuric
- Recovery
HP features - Tubular epithelial necrosis: Loss of nuclei & detachment of tubular cells from BM
- Dilatation of Tubules
- Necrotic cells obstruct the tubule lumen
What is Collagen & its main types ??
Main structural protein found in connective tissue & is the MC protein found in body; synthesised by FIBROBLASTS
Type 1: Bone, Skin, Tendon
Type 2: Hyaline cartilage, Vitreous humour
Type 3: Reticular fibre, Granulation tissue
Type 4: Basal lamina, Lena, Basement membrane
Type 5: Most Interstitial tissue, Placental tissue
What are the Associated pathological conditions with Collagen defect ??
Type 1: Osteogenesis Imperfecta
Type 3: Vascular variant of Ehler- Danlos syndrome
Type 4: Alport & Goodpasture synd.
Type 5: Classical variant of Ehler- Danlos syndrome
What is the structure of Collagen ??
Composed of 3 polypeptide strand, woven into helix; a combination of Glycine + Proline/Hydroxyproline + another Amino Acid
- Additional strength: H+ bonds
- MC type is Type 1
- Tissue with increased level of flexibility have increased Type 3
- Vit C is imp. for cross-linking
What is Homocystinuria ??
Rare A R disease caused by deficiency of Cystathionine Beta Synthase
- Leads to severe elevation in Plasma & Urine Homocysteine conc.
Rx.
- Vit B6 (PYRIDOXINE) supplements
Features & of Homocystinuria ??
Fine fair hairs
Musculoskeletal
- Marfanoid body habitus
- Osteoporosis. - Kyphosis
CNS: Learning difficulty & Seizures
Ocular: Infranasal lens dislocation, severe myopia
Increased risk of Arterial & V TE
Malar flush, Livedo reticularis
Vit B6 & the consequences of deficiency ??
Water soluble vitamin; which is converted to Pyridoxol phosphate (PLP) which is a co-factor for many reactions including
- Transamination, Deamination, Decarboxylation
Peripheral Neuropathy, Sideroblastic anaemia
Ix. of Homocystinuria ??
Increased Homocysteine levels in serum & urine
Cyanide-Nitroprusside test: also (+)ve for Cystinuria
What is Vit. B1 called ??
Thiamine is a water soluble vit. One of its phosphate derivatives, Thiamine Pyrophosphate (TPP) is a co-enzyme in various aerobic reactions
- Imp. for Catabolism of Sugars & Amino acids
- Deficiency are therefore seen in HIGHLY Aerobic tissues like Brain (Wernickes-Korsakoff) & Heart (Wet beri-beri)
Vit. B3 & the consequences of its deficiency ??
Niacin is a H2) soluble vit.
Is a precursor of NAD+ & NADP+ & plays an essential metabolic role
- HARTNUP’S disease: Hereditary disease which reduces absorption of Tryptophan
- Carcinoid Synd.- Increased Tryptophan metabolism to Serotonin
Deficiency causes PELLAGRA
- Dermatitis, Diarrhoea, Dementia
Angular cheilitis is caused by which vit. deficiency ??
Riboflavin (Vit. B2)
- Is a cofactor of Flavin adenine dinucleotide (FAD) & Flavin Mono- nucleotide (FMN)
Consequences of B1 deficiency ??
- Wernicke’s E: Nystagmus, Ataxia, Ophthalmoplegia
- Korsakoff’s: Wernocke’s + Amnesia + Confabulations
- Dry beriberi: Peripheral neuropathy
- Wet beriberi: Dilated Cardio-M
Iron distribution in Body ??
Total Body Iron: 4g
Hb : 70%
Ferritin & Haemosiderin : 25%
Myoglobin : 4%
Plasma Fe : 0.1%
Tell the following about Fe
- Absorption ??
- Transport ??
- Storage ??
Upper SI (Duodenum)
10% of dietary Fe absorbed
Fe2+ (Ferrous) absorbed much better than Fe3+ (Ferric)
Transport:- Bound to Transferrin as Fe3+
Storage form :- Ferritin
Excretion: via Intestinal tract De-squamation
Mechanism of Met. Alkalosis ??
RAAS activation is the key factor
ECF depleted (Vomiting, Diuretics) => Na+ & Cl- loss => RAAS activation => Raised Aldosterone levels => Reabsorption of Na+ in exchange for H+ in DCT
In Hypo K+, K+ shifts from cells to ECF => H+ moves into cell to maintain Neutrality => Alkalosis
What are the Vomiting centres ??
NTS in Medulla => receives inf. from
- CTZ located in area Postrema in 4th ventricle
- GI tract via Vagus. - CNS
- Vestibular system.
CTZ & adjacent vomiting centre nuclei receive input from 5 receptors
- H1 , M1, NK-1 (Neurokinin), D2, 5-HT3 (Serotonin)
Name against which receptors doe the following drugs
- Chemotherapy- induced vomiting
- Motion sickness
- Hyperemesis gravidarum
- 5-HT3 (Serotonin), D2, NK-1 antagonists
- H1 & M1 antagonists
- H1 antagonists
What are the stages of Sleep cycle ??
Sleep occurs in 4-6 cycles per night; each lasting 90 min + 2 main stages
- NREM sleep. - REM sleep (duration of REM increases through the night)
Circadian rhythm is driven by Suprachiasmatic Nucleus (SCN) of Hypothalamus
- Low light => decrease SCN activity => increase NE from Superior Cervical Ganglion => Increase Melatonin from Pineal gland
Mention the Sleep stages & the waves a/w it.
AWAKE:
- Eye open- Beta (high freq. low amp.)
- Eye closed- Alpha
N-REM Sleep
- N1 (5%): Light sleep; THETA
- N2 (45%) Deeper; Sleep Spindles & K complexes; Bruxism occurs
- N3 (25%): Deepest NREM (slow-wave ; DELTA; Bedwetting, Sleep walking. & Night TERROR
REM Sleep
- Loss of Motor tone, Increased brain O2 use
- Extraocular eye movt. due to activity in PPRF
- Memory Processing function
- Dreaming, NightMARES
- Penile/ Clitoral tumescence
In which phase of sleep do we see the following waves
- Beta wave ??
- Alpha wave ??
- Theta wave ??
- Sleep spindles & K complex ??
- Delta wave ??
- Night terrors ??
- Nightmares ??
- Bruxism ??
- Eyes Open (Highest freq. & Lowest amp.)
- Eyes Closed
- NREM- N1
- NREM- N2
- NREM- N3 (Lowest freq. & Highest amp.)
- NREM- N3
- REM
- NREM- N2
Which phase of Sleep cycles does the following affect ??
- [-OH], BZPs, Barbiturates ??
- Aging ??
- Depression ??
- Narcolepsy ??
- Decrease N3 & REM
- Decrease N3 & REM, increase sleep-onset latency, Early morn. awakening
- Decrease N3 & Increase REM sleep & Decrease REM latency; repeated nighttime awakenings & early morn awakening (Terminal Insomnia)
- Decrease REM latency
Functions of Hypothalamus ??
Maintain homeostasis by regulating
“TAN HATS”
- Thirst & water balance
- Adenohypophysis control (Anterior Pituitary)
- Neurohypophysis control (Poste. P)
- Hunger. - Autonomous Nervous S
- Temperature. - Sexual urges
Function of Thalamus ??
Major RELAY for all Sensory information except Olfaction
What are the parts of Cerebellum ??
Modulates movt., aids in Coordination & Balance
- Medial (eg Vermis) controls Axial & Proximal limb muscles B/L
- LATERAL (ie. hemisphere) controls Distal limb muscles I/L
Tests: Rapid alternating movt. (Pronation/Supination), Finger-to-nose, Heel-to-shin, Gait, Look for Intention tremors
Functions of Basal Ganglia ??
Voluntary functions & Adjusting posture
- Striatum = Putamen (motor) + Caudate nucleus (cognitive)
- Lentiform nucleus = Putamen + Globus pallidus
From what level does the CNs exits from ??
CN 1, 2, 3, 4: arise from Above Pons (3 & 4 exits from Midbrain)
CN 5, 6, 7, 8: exits from Pons
CN 9, 10, 11, 12: Medulla
4 CNs are positioned Medially
- 12, 3, 4, 6
Where are the CNs nuclei located ??
Located in TEGMENTUM portion of Brainstem (b/w Dorsal & Ventral portions)
- Midbrain: Nuclei of CN 3, 4
- Pons: CN 5, 6, 7, 8
- Medulla: CN 9, 10, 12
- Spinal Cord: CN 11
Lateral nuclei = SENSORY (aLar plate)
Medial nuclei = MOTOR (Basal plate)
Functions of Superior & Inferior Colliculi ??
Superior C : Direct eye movt. to stimuli (noise, movt.) or Objects of interest
Inferior C : Auditory
Name the blood supplies of CNs
MEDIAL CNs
- CN 3, 4 : PCA
- CN 6 : Basilar
- CN 12 : Anterior Spinal
LATERAL CNs
- CN 5, 7, 8 : Labyrinthine & AICA
- CN 9, 10, 11 : Vertebral & PICA
Name the following about CNs
- Sensory CNs ??
- Motor CNs ??
- Mixed ??
- CN 1, 2, 8 (Olfactory, Optic, Vestibulo-cochlear)
- CN 3, 4, 6, 11, 12 (Oculomotor, Trochlear, Abducens, Accessory, Hypoglassal)
- CN 5, 7, 9, 10 (Trigeminal, Facial, Glossopharyngeal, Vagus)
Name the Afferent & Efferent CNs of the following reflexes respectively
Accommodation & Pupillary : 2 === 3
Corneal: V1 Ophthalmic (Nasociliary branch) == B/L 7 (temporal & zygomatic branches- Orbicularis oculi
JAW Jerk: V3 (sensory- Masseter muscle spindle) == V3 Motor- Masseter)
LACRIMATION: V1 (loss of reflex does not preclude emotional tear) == CN 7
Cough: CN-10 == CN-10 + Phrenic & Spinal nerves
GAG: CN-9 == CN-10
Name the Mastication muscles
3 muscles close the jaw
- Masseter, Temporalis, Medial Pterygoid
Jaw Protrusion
- Lateral Pterygoid
ALL are supplied by CN- V3
How may Spinal nerves are there in our body ??
31 pairs of Spinal nerves
- Cervical: 8. - Thoracic: 12
- Lumbar: 5. - Sacral: 5
- Coccygeal: 1
Nerves C1 to C7 exit ABOVE the corresponding Vertebrae (eg., C3 exits above 3rd C vertebrae)
C8 nerve exits from BELOW C7 & ABOVE T1
ALL other nerves exit BELOW (eg., L2 exits below the 2nd L vertebrae)
Layers the LP needle has to pass through to reach the Subarachnoid space ??
Adults: S Cord ends at lower border of L1- L2 vertebrae
Site of LP: L3- L4 or L4- L5
- Skin
- Fascia & fat
- Supraspinous ligament
- Interspinous ligament
- Ligamentum flavum
- Epidural space: Epidural anaesthesia needle stops here)
- Dura mater
- Arachnoid mater
- Subarachnoid space: CSF collection occurs here
What is Conus medullaris syndrome & Cauda equina syndrome ??
COMPRESSION of
- Terminal end of S Cord C medularis: Conus medullaris syndrome
- Lumbosacral nerve roots: Cauda E
C/F
- Radicular low back pain, Saddle/ Perianal anaesthesia, Bladder & Bowel dysfunction & LL weakness
LL weakness
- Symmetric + UMN signs: Conus M
- Asymmetric + LMN signs: Cauda E
Erb-Duchenne paralysis
Damage to C5, C6 roots
- Winged Scapula
- Caused by BREECH Presentation
Klumpke’s Paralysis
Damage to C8, T1 root
- Loss of Intrinsic muscles of hand
- caused by TRACTION (ABDucted arm pulled away from body)
- Adults: Hanging from tree
Proximal Median Nerve injury ??
Distal Median N Injury ??
- Sensory loss over Thenar eminence + Motor loss of
- Wasting of thenar eminence (sensation preserved) & sensory loss over 2nd & 3rd finger tips
Proximal Radial Nerve injury ??
Distal Radial N Injury ??
- Humerus # : Wrist drop + Weakness of thumb & finger extension
- At wrist: Loss of sensation over Dorsal & radial portion of the hand, dorsal thumb & dorsum of index finger. Motor function is intact
Cervical Spondylolysthesis ??
Forward displacement of vertebrae (often after a Trauma)
- Dorsal column features seen: Loss of vibration & joint proprioception
