dM Flashcards
(36 cards)
What is the pneumonic for the origins of the cranial nerves?
Ce Mi Pons Medu
- Ce(rebellum): I, II
- Mi(dbrain): III, IV
- Pons: V, VI, VII, VIII
- Medu(lla): IX, X, XI, XII
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Spinal Accessory Nerve (CN XI)
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)
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Suprascapular nerve (C5-C6)
Innervates: supraspinatus, infraspinatus
Sensory: GH capsule
Clinical findings:
- Dull ache lateral shoulder
- Atrophy/weakness of supraspinatus/infraspinatus
- Increased scapula elevation during arm elevation
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Long Thoracic Nerve (C5-C7)
Innervates: serratus anterior
Clinical findings:
- Weak scapular protraction
- Weakness w/ upward rotation of scapula
- Medial winging of medial scapula
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Musculocutaneous Nerve (C5-C6)
Innervates: coracobrachials, brachialis, biceps brachii
Sensory: lateral forearm
Clinical findings:
- Lateral arm sensory changes
- Weakness/atrophy biceps, brachialis, coracobrachialis
- Diminished biceps reflex
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Axillary Nerve (C5-C6)
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
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Radial Nerve (C6-T1)
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)
What muscles does the radial nerve innervate?
A BEAST
A: abductor pollicis longus
B: brachioradialis
E: Extensors
A: anconeus
S: Supinator
T: triceps
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Posterior interosseus nerve
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
What is one way to differentiate radial nerve versus C7 nerve root involvement?
Radial nerve —> Elbow extension, Wrist EXTENSION
C7 —> Elbow extension, Wrist FLEXION
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Median Nerve (C5-T1)
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
What muscles does the medial nerve innervate?
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)
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Anterior Interosseus Nerve
- Branch of median nerve
- Innervates: flexor pollicis longus, pronator quadratus, flexor digitorum profundus (tip to tip pinch grip)
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Ulnar Nerve (C8-T1)
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
What muscles does the ulnar nerve innervate?
MAFIA
M: medial 2 lumbricals
A: Adductor pollicis
F: flexors on ulnar side
I: Interossei (dorsal)
A: Dorsal Q
If a patient presents with the inability to flex fingers 1-3 while making a fist, what other muscles are likely compromised?
- Refers to median claw
- 1/2 LOAF P/Pumpernickel (1st & 2nd lumbricals, Opponens pollicis, abductor pollicis brevis, flexors on medial side, pronators
If a patient has a disc L4/L5 herniation, what is the most likely nerve root to be involved?
L5 nerve root
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Femoral Nerve (L2-L4)
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
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Obturator Nerve (L2-L4)
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Obturator Nerve (L2-L4)
Innervates: adductor longus/brevis, gracilis, adductor magnus, Obturator externus
Sensory: small area on medial thigh/groin
Clinical findings:
- Loss of external rotation & adduction
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Superior Gluteal Nerve (L4-S1)
Innervates: gluteus medius, gluteus minimus, TFL
Clinical findings: trendelenburg gait (contralateral hip drop)
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Inferior Gluteal Nerve (L5-S2)
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)
A patient with hip OA is most likely to lean towards what side? why?
- Lean towards impaired side so you stack on top of the joint
- This reduces muscle activation
- AKA antalgic gait
Discuss motor &/or sensory components of the following nerve, as well as clinical findings when it is impaired:
Tibial Nerve (L4-S3)
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)
