Clinical Cases Flashcards
A patient shows a positive trendelenberg sign. What is the nerve damaged? And which muscles were affected? What happened to the muscles?
- Superior Gluteal Nerve
- gluteus medius and the gluteus minimus.
- muscles are paralyzed and the pelvis becomes unsteady.
A patient shows an unsteady pelvis. What is the nerve and muscle damaged ? Which test would you do?
- superior gluteal nerve
- gluteus medius and the gluteus minimus.
- Trendelenberg sign
characteristic finding of gluteal muscle weakness?
Trendelenberg sign
The apex of the axilla has beeen damaged , the nerves and vessels that pass have been compressed between the bones
What is the syndrome ?
Thoracic Outlet Syndrome
A patient raises his arm and the medial border and inferior angle of the scapula pull markedly away from the posterior thoracic wall,
What is this deformation? What is the injury ? Which muscle is paralyzed ?
winged scapula
the long thoracic nerve .
serratus anterior
During abduction inflammation
of the tendons of the rotator cuff muscles. Occurred
What is the condition? And what is the most effected muscle?
Rotator Cuff Tendonitis
supraspinatus
? pulls the
4th and 5th fingers into partial
flexion.
What condition? And how?
Dupuytren contracture:
progressive shortening,
thickening, and fibrosis of the
palmar aponeurosis
progressive shortening, thickening, and fibrosis of the palmar aponeurosis. It pulls the 4th and 5th fingers into partial flexion. ?
Dupuytren contracture
Inflammation of the tendon and synovial sheath, the digit swells and movement becomes painful.
Condition? And explain spread?
Tenosynovitis/ Tenosynovitis in (5) little finger may spread to the common sheath and thus through the palm and carpal tunnel to the anterior forearm.
Pressure on median nerve because of tightly packed flexor digitorum tendons?
CARPAL TUNNEL SYNDROME
is a compression neuropathy of the median nerve at the elbow between the two sections of the pronator teres muscle in the forearm. ?
PRONATOR TERES SYNDROME
Median nerve territory in hand is affected leading to sensory motor symptoms and Weak pronation ?
=PRONATOR TERES SYNDROME
develops when swelling or bleeding occurs within a compartment. ?
COMPARTMENT SYNDROME
It is a painful condition that occurs when pressure within the muscles builds to dangerous levels and the Blood supply is disrupted and nerve compression can lead to abnormal sensations, muscular weakness and loss?
COMPARTMENT SYNDROME
Because the fascia does not stretch , this can cause increased pressure on the vessels, nerves, and muscles in the compartment .
acute compartment syndrome, unless the pressure is relieved quickly ?
permanent disability and tissue death may result. =Injury, severe trauma, fracture and tight plaster cast are common predisposing factors.
medial epicondylitis, is tendinosis of the medial epicondyle ? Which muscles ? Most common for?
Golfer’s elbow
The flexor compartemnt muscles come together at the medial epicondyle of the humerus . These include: pronator teres, flexor carpi radialis , flexor carpi ulnaris, flexor digitorum superficialis , and palmaris longus
is the most common elbow injury for rock climbers, construction and plumbing, golfers etc.
Occur after fracture of the distal third of the radius. Roughening of the dorsal tubercle of the radius by the fracture line can cause excessive friction on the tendon, which can then rupture .
?
Rupture of the Extensor Pollicis Longus
caused by a partial tearing or degeneration of the origin of the superficial extensor muscles from the lateral epicondyle of the humerus. It is characterized by pain and tenderness over the lateral epicondyle of the humerus, with pain radiating down the lateral side of the forearm; ?
Tennis Elbow
Sudden severe tension on a long extensor tendon may avulse
part of its attachment to the phalanx. • This deformity results from the distal interphalangeal joint
suddenly being forced into extreme flexion leading to avulsion
of extensor expansion tendon from base of the distal phalanx.
As a result,?
Mallet or Baseball Finger
result, the person cannot extend the distal interphalangeal
joint.
a patient came from a motorbike accident
which plexus is damaged? what happened to the limb?
Damage to the whole plexus
it is rare
It can occur with : motorbike accidents
If all roots are damaged : the whole limb is immobile and anesthetic
what condition Leads to paralysis of:
Abductors (deltoid& supraspinatus) and lateral rotators (teres minor& infraspinatus) of the shoulder and supinators are paralyzed? and which roots are injured ?
Traction injury to the upper roots (C5& C6) and trunk (Erb’s paralysis) (Erb-Duchenne paralysis)
It is the most common traction injury
It includes Birth injury
Person fall on shoulder with undue separation of head and shoulder
Leads to paralysis of:
Person fall on shoulder with undue separation of head and shoulder resulted in sensory loss over lower part of deltoid (supplied by axillary) which condition? and what deformity will be displayed ?
Erb’s
Deformity: (policeman’s tip hand) or Waiter taking tip
In which the arm hangs by the side(adducted) and is rotated medially. The forearm is extended and pronated at the elbow
Femoral Hernia
Explain
• It is more common in women than in men (possibly because of their wider pelvis and femoral canal). • The hernial sac passes down the femoral canal, it expands to form a swelling in
the upper part of the thigh deep to the deep fascia • The neck of the sac always lies below and lateral to the pubic tubercle • The neck of the sac is narrow and lies at the femoral ring • The femoral vein lies lateral to the hernial sac • femoral hernia is a dangerous condition and should always be treated
surgically.
Middle Foot pain
Muscle ?
peroneus longus
pain, swelling and heat with a visual or feeling of popping or snapping of the tendon by the outside at the ankle. Pain isolated to the lateral aspect of the heel can be difficult to diagnose, particularly in the growing child. Patients can complain of their ankle feeling unstable, or just severely painful on activity
What problem?
PERONEAL TENDON PROBLEMS
condition diagnosed? X-Rays can sometimes show a flake of bone from the ankle bone if the tendon has dislocated or calcium build up around the tendon
Name of ?
peroneal tubercle.
/ PERONEAL TENDON PROBLEMS
Injuries of Radial Nerve?
Motor; • Triceps, anconeus and long extensors of the wrist are paralyzed • Unable to extend the elbow joint, wrist joint and fingers • Wrist drop • Unable to flex the fingers firmly for gripping • sensory • Sensory loss on the lateral part of dorsum of the hand • Sensory loss on the dorsal surface of the roots of the lateral 3 & ½ fingers
LESION OF ULNAR NERVE ABOVE ELBOW
?
Motor deficit: • loss of flexion of the 4th and 5th digits • Atrophy of hypothenar muscles. • Loss of adduction of hand & thumb • Sensory deficit: • Loss of sensation in ulnar half of the palm and dorsum of hand, and the medial 1½ digits on both palmar and dorsal aspects of the hand
LESION OF ULNAR NERVE ABOVE WRIST
?
• 1- Inability to adduct thumb • 2- Inability to put the hand in writing position • - Sensory loss to fingers only • - Partial claw hand deformity is more prominent
Adducting the fingers to grasp an object placed between
them are innervated by the ?
deep branch of the ulnar nerve
The ability to grasp an object between the pad of the thumb
and the pad of one of the fingers depends on normal
functioning of the thenar muscles, which are innervated by
the ?
recurrent branch of the median nerve
