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dM Flashcards

1
Q

What is the pneumonic for the origins of the cranial nerves?

A

Ce Mi Pons Medu
- Ce(rebellum): I, II
- Mi(dbrain): III, IV
- Pons: V, VI, VII, VIII
- Medu(lla): IX, X, XI, XII

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2
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Spinal Accessory Nerve (CN XI)

A

Innervates: trapezius, SCM
Clinical Findings:
- Neck, shoulder, medial scapular pain
- Decreased cervical lordosis
- A downwardly rotated scapula
- Lateral winging of scapula (d/t loss of upward rotators)

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3
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Suprascapular nerve (C5-C6)

A

Innervates: supraspinatus, infraspinatus
Sensory: GH capsule
Clinical findings:
- Dull ache lateral shoulder
- Atrophy/weakness of supraspinatus/infraspinatus
- Increased scapula elevation during arm elevation

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4
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Long Thoracic Nerve (C5-C7)

A

Innervates: serratus anterior
Clinical findings:
- Weak scapular protraction
- Weakness w/ upward rotation of scapula
- Medial winging of medial scapula

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5
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Musculocutaneous Nerve (C5-C6)

A

Innervates: coracobrachials, brachialis, biceps brachii
Sensory: lateral forearm
Clinical findings:
- Lateral arm sensory changes
- Weakness/atrophy biceps, brachialis, coracobrachialis
- Diminished biceps reflex

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6
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Axillary Nerve (C5-C6)

A

Innervates: teres minor, deltoid
Sensory: proximal lateral arm
Clinical findings:
- Axillary pain
- Deltoid area paresthesia
- Atrophy deltoid & teres minor
- Elevation weakness
- Anterior shoulder dislocation is common MOI

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7
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Radial Nerve (C6-T1)

A

Innervates: ABEAST (abductor pollicis longus, brachioradialis, extensors, anconeus, supinator, triceps)
Sensory: dorsal arm/forearm/hand, webspace of thumb
Clinical findings:
- Triceps weakness
- Extensors of forearm weakness
- Webspace sensory loss, dorsal arm/forearm/hand sensory loss
- Crutch use —> radial nerve palsy
- Midshaft humeral fracture = common MOI
- PIN syndrome (purely motor loss of finger extension)

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8
Q

What muscles does the radial nerve innervate?

A

A BEAST

A: abductor pollicis longus
B: brachioradialis
E: Extensors
A: anconeus
S: Supinator
T: triceps

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9
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Posterior interosseus nerve

A

Innervates: extensors…, supinator, abductor pollicis longus
Sensory: proprioception of radioulnar articulation, no pain sensation
Clinical findings:
- PIN syndrome (arcade of Frohse in supinator)- purely motor loss of finger extension

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10
Q

What is one way to differentiate radial nerve versus C7 nerve root involvement?

A

Radial nerve —> Elbow extension, Wrist EXTENSION

C7 —> Elbow extension, Wrist FLEXION

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11
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Median Nerve (C5-T1)

A

Innervation: 1/2 LOAF of P/Pumpernickel (1st & 2nd lumbricals, Opponens pollicis, abductor pollicis brevis, flexors on radial side, pronator (both))
Sensory: Lateral hand
Clinical findings:
- Ape hand (thenar wasting)
- Opposition weakness
- Weak grasp (radial side)
- Pronation weakness
- Radial deviation weakness

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12
Q

What muscles does the medial nerve innervate?

A

1/2 LOAF of P/Pumpernickel

  • 1st & 2nd
  • L: Lumbricals
    -O: Opponens pollicis
  • A: Abductor pollicis brevis
  • F: Flexors on radial side
  • P/P: pronators (both)
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13
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Anterior Interosseus Nerve

A
  • Branch of median nerve
  • Innervates: flexor pollicis longus, pronator quadratus, flexor digitorum profundus (tip to tip pinch grip)
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14
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Ulnar Nerve (C8-T1)

A

Innervates: MAFIA (Medial 2 lumbricals, adductor pollicis, flexors on ulnar side, interossei (dorsal), Dorsal Q
Sensory: little finger & medial half of the hand & 4th digit
Clinical findings:
- Ulnar claw
- Inability to extend PIP and DIP (lumbricals)
- Inability to abduct fingers (interossei)
- Inability to adduct thumb
- Weakness with ulnar deviation (FCU)
- Hypothenar wasting
- Loss of sensation of 4th & 5th fingers

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15
Q

What muscles does the ulnar nerve innervate?

A

MAFIA

M: medial 2 lumbricals
A: Adductor pollicis
F: flexors on ulnar side
I: Interossei (dorsal)
A: Dorsal Q

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16
Q

If a patient presents with the inability to flex fingers 1-3 while making a fist, what other muscles are likely compromised?

A
  • Refers to median claw
  • 1/2 LOAF P/Pumpernickel (1st & 2nd lumbricals, Opponens pollicis, abductor pollicis brevis, flexors on medial side, pronators
17
Q

If a patient has a disc L4/L5 herniation, what is the most likely nerve root to be involved?

A

L5 nerve root

18
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Femoral Nerve (L2-L4)

A

Innervates: iliopsoas, sartoriusm, pecitneus, quadriceps femoris
Sensory: Anterior & medial surface of thigh, medial, knee, proximal leg saphenous nerve

Clinical findings:
- Knee buckling
- Knee extension weakness
- Anterior knee pain
- Sensory loss medial aspect of leg below knee
- Forward trunk lean during gait

19
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Obturator Nerve (L2-L4)

A
20
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Obturator Nerve (L2-L4)

A

Innervates: adductor longus/brevis, gracilis, adductor magnus, Obturator externus
Sensory: small area on medial thigh/groin
Clinical findings:
- Loss of external rotation & adduction

21
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Superior Gluteal Nerve (L4-S1)

A

Innervates: gluteus medius, gluteus minimus, TFL
Clinical findings: trendelenburg gait (contralateral hip drop)

22
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Inferior Gluteal Nerve (L5-S2)

A

Innervates: gluteus maximus
Clinical findings:
- Posterior trunk lean at initial contact (puts COM behind you so you don’t have to rely on extensors to keep you from folding in half)

23
Q

A patient with hip OA is most likely to lean towards what side? why?

A
  • Lean towards impaired side so you stack on top of the joint
  • This reduces muscle activation
  • AKA antalgic gait
24
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Tibial Nerve (L4-S3)

A

Innervates: gastroc, soleus, popliteus, tibialis posterior, flexor digitorum longus, flexor hallicus longus
Sensory: sural nerve (sensory branch of tibial n); posterolateral lower leg and lateral foot (posterior branch of tibial)

25
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Superficial peroneal (L4-S2)

A

Innervates: fibularis longus, brevis
Sensory: lower leg and dorsum of foot

26
Q

Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:

Deep peroneal

A

Innervates: Tibialis anterior, extensor digitorum longus, extensor hallicus longus
Sensory: 1st webspace of foot

27
Q

Patient presents with excessive pronation. which muscle will be most helpful to avoid excessive pronation?

A

Tibialis posterior; PF + inversion; tibial nerve
Fibularis longus; PF + eversion; superficial peroneal

28
Q

Sensory loss over webspace of thumb?

A

Radial nerve

29
Q

Ape hand deformity?

A

Median nerve

30
Q

What is one way to differentiate a peripheral nerve pathology from a spinal root pathology?

A

If multiple levels are involved —> most likely a peripheral nerve

If all deficits are accounted for with 1 spinal level —> probably a nerve root

31
Q

1+ patellar tendon reflex, weak hip flexion, loss of sensation on medial malleolus

A

Femoral nerve

31
Q

1+ patellar tendon reflex, weak hip flexion, loss of sensation on medial malleolus

A

Femoral nerve

32
Q

A patient has sustained an injury that has severed the musculocutaneous
nerve. What muscles are MOST likely to be used to assist with elbow flexion?
1. Anconeus and pronator quadratus
2. Biceps brachii and extensor carpi radialis longus
3. Brachialis and supinator
4. Pronator teres and brachioradialis

A
  1. Pronator teres & brachioradialis
33
Q

Discuss the medial & lateral pectoral nerves & how to differentiate their innervations (pneumonic)

A

Lateral = less; medial = more
Lateral only innervates pec major;
Medial innervates both pec major and pec minor

34
Q

Review the Braden scale

A
35
Q

Review the Wagnar Ulcer Classification Scale

A

Daily Master (1 decks)

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