GS and CQ - Exam 2 Flashcards
All muscles on anterior aspect of forearm are innervated by median n. except
flexor carpi ulnaris & 2 tendons on ulnar side of flexor digitorium profundus which are innervated by ulnar n.
(C.P.) an ulnar (medial) collateral ligament injury in a sprain may lead to?
abnormal abduction of the forearm
(C.P.) a radial (lateral) collateral ligament injury in a sprain may lead to?
abnormal adduction of the forearm
(C.P.) Colle’s fracture
falling on the hand with the arm extended. The radius is fractured with posterior displacement, giving a dinner fork shape to the forearm. May have injury to median and ulnar n.
(C.P.) Fractures of the carpal bones
70% scaphoid fractures
10% all hand fractures
14% triquetral fractures (2nd most common)
(C.P.) Carpal tunnel syndrome is a pathologic condition of the anterior region of the wrist caused by?
Compression of the median nerve in the carpal tunnel.
Most common cause is repetitive movement of the wrist
(C.P.) radial n. injury
wrist drop
(C.P.) median n. injury
ape hand
(C.P.) ulanr n. injury
claw hand
(C.P.) large hematomas may develop in the scalp following head injuries due to?
a loose subaponeurotic layer, and inections reaching this layer may spread widely to the dura by means of emissary veins
(C.P.) mandibular nerve block can be achieved by?
injection of local anesthesia around the mandibular nerve in the infratemporal fossa
(C.P.) coniotomy involves puncturing the cricothyroid ligament to?
allow air through the airways artificially, when there is an obstruction of the glottis or glottal edema
(C.P.) cleft palate occurs when?
the lateral palantine processes, the nasal septum, and/or the median palatine process fail to fuse, and there are a number of possible causes.
Posterior cleft is more common than anterior cleft
(C.P.) macroglassia
enlargement of the tongue, often seen in hypothyroidism, amyloidosis, and cretinism
(C.P.) Dupuytren’s contracture
Progressive fibrosis; the thickening and shortening of the palmar aponeurosis that leads to the partial flexion of the ring and small finger
(C.P.) Coniotomy
Puncturing the cricothyroid ligament to allow air through the airways artificially, when there is an obstruction of the glottis or glottal edema
(C.P.) Tracheotomy
A procedure used to create an adequate airway in patients with an upper respiratory tract obstruction or respiratory failure.
Emergency tracheotomy might be necessary when the laryngeal opening (rima glottidis)
(C.P.) Sprain
Stretching or tearing of the ligaments that reinforce a joint. Sprains can be very painful, and the complete rupture of the ligaments requires surgical repair or removal
*(Sprain to ligament as strain to muscle)
(C.P.) Dislocation (luxation)
Bones of the joint are forced out of alignment
(C.P.) Subluxation
The partial or incomplete dislocation of the joint
(C.P.) Bursitis and tendinitis
Inflammation of the bursa or tendon
(C.P.) Housemaid’s knee
Patellar bursitis
(C.P.) Student’s elbow or olecranon bursitis
The development of a bursa on the posterior aspect of the elbow
(C.P.) Arthritis
Inflammation or degeneration of the joints accompanied by pain, swelling, and stiffness
(C.P.) Rheumatoid arthritis
An autoimmune disease resulting in severe inflammation of the joints
(C.P.) Ankylosing spondylitis
A kind of rheumatoid arthritis, seen mainly in males, that affects the sacroilliac joints and vertebrea
(C.P.) Osteoarthritis
A degenerative condition involving articular cartilages, primarily in the weight-bearing joints
(C.P.) Lyme disease
Arthritis caused by bacteria transmitted via tick bites
If long thoracic nerve is damaged then it may cause winged scapula
if the arm can not be lifted then serratus anterior may be damaged
if arm can be lifted then it may be rhomboid muscle
short head and long head of biceps, brachialis, and coracobrachialis
I: Musculocutaneous N.
Knee jerk/patella reflex
L3/L4
hitting the patella tendon makes leg jump
Biceps jerk
C5/C6
Triceps jerk
C7/C8
Triceps brachii is strongest
extensor of elbow
all muscles of the posterior aspect of the arm and forearm are
extensors
all the muscles of the anterior aspect of the forearm(palm up) are innervated by the MEDIAN nerve EXCEPT
flexor carpi ulnaris and 2 tendons on ulnar side of the flexor digitorum profundus that are innervated by the ULNAR nerve
MEDIAN nerve injury leads to papal benediction sign and ape hand
papal benediction sign keeps ring and pinky finger flexed
Thenar eminence
hypothenar eminence
mostly by the medial nerve
“Ape hand”
the Thenar eminence becomes flat and atrophies
what is the common head? Medial and lateral epicondyle
The medial epicondyle of the humerus is the common head for the flexors in forearm
The lateral epicondyle of the humerus is the common head for the extensors in forearm
Medial epicondylitis
golfers elbow
inflammation of the elbow from one way motion
Lateral epicondylitis
tennis elbow
inflammation of the elbow from forward and backward motions
Flexor Digitorum Profundus
I: Median and Ulnar n.
palpal benediction sign keeps middle and pointer finger paralyzed by ring and punky can flex
Ape hand
median nerve paralyzed causing the thenar area to become stagnant
Guyon’s canal
transmits ulnar artery, vein, and nerve
between the two layers of flexor rentinaculum not in the carpal tunnel
Superficial radial nerve
goes to skin of thumb side of hand
dorsal side
Deep radial nerve
innervates most of muscles on dorsal of forearm
Brachioradialis
I: radial nerve before branching to deep/superficial
Extensor capri radialis brevis
I: deep radial n
Extensor carpi radialis longus
I: radial n before branching
Close to elbow the radial nerve divides
superficial and deep
Ulnar nerve injury leads to flexion of fingers
extension at metacarpal joints
flexion at interfalangial joints
CLAW HAND – due to interosseous unique extensor/flexor functionality
Interosseous muscles
I: ulnar n.
A: abduction and adduction of digits
Mid shaft injury may still have extension of elbow
if above mid shaft then extension of elbow may be compromised as well
Wrist drop in both scenarios
Radial nerve injury
Saturday night palsy
injury to radial nerve
looks like wrist drop but temporary from compression on radial nerve(someone sleeping on upper arm over night)
Honeymoon palsy
radial nerve injury from compression like Saturday night palsy but longer term
Thenar Innervation
Median N.
Adductor pollicis brevis
I: Ulnar N.
Opposition
pinky and thumb touch
Reposition
pinky and thumb not touching
Flexion
thumb to mid palm
Adduction
Thumb to index finger
Abduction
thumb away from index finger
Extension
thumb away from mid palm
Dorsal interossei
abduction
For hand: 7 and 3
each finger has 2 nerve on back and front of finger
in palm of hand
70% by median n
30% by ulnar n
on back of hand 70% by 30% by ulnar
Claw hand
C8-T1
Tips of fingers innervated by
median nerve
Palpal benediction sign
not seen injury is low in forearm
8, 9, 10 innervated by ulnar nerve
part of ring finger and pinky finger
Lateral thoracic artery is
blood supply to breast
Lymphangitis
The thoracic duct has 75% of the lymphatic system go through it
The lymphatic system speed is about 20 meters per day
Carry larger material the Venus system can not
Radial and ulnar arteries joint two times
deep palmar arch(higher of the two towards wrist)
superficial palmar arch(lower towards fingers)
Laryngeal muscles are innervated by
CN 10(Vagus n.)
superior laryngeal nerve inferior laryngeal nerve Recurrent laryngeal nerve innervates all laryngeal except cricothyroid
The buccinator muscle is pierced by the
carotid duct for salivary gland
Hypoglossal nerve
CN 12
Innervates all muscles of tongue
Lymph node, especially on left side
sentinel lymph node can be a side of cancer
at root of neck
intraabdominal or intrathoracic cancer
Occipito frontalis
when contracted – astonishment
Corrugator supercilli
thinkers brow
pulls down the brow
Risorius
can elevate the mouth
laughing and smiling
Platysma
brings the angle of the mouth down
expression of sadness
Muscles of mastication
Masseter
Temporalis
Lateral Pterygoid
Medial Pterygoid
Put wrinkles on the face
after 40-45 years wrinkles can become permanent
CV5/3 mandibular nerve
Lateral pterygoid inserts inside the TMJ(temporal mandibular joint)
greater occipital nerve in back of head(migraine relief)
figure 8-33
pterygopalatine fossa
*read paragraph and be familiar with it
know ganglion(migraine relief)
Mental nerve, infraorbital nerve, supraorbital nerve are the
sensory innervation of the face
3 terminal branches of the trigeminal nerve
1 inch from midline
Migraine relief
Palmaris brevis and platysma are the only
cutaneous muscles left in the human body
Contraction brings the angles of the mouth down resulting in the sadness look
Cervical Ansa(C1, C2, C3)
Innervates all hyoid muscles
Branchial(pharyngeal) nerves(arches)
1st arch Trigeminal nerve (CN 5) 2 CN 7(Facial) 3 CN 9(glossopharyngeal) 4 CN 10(vagus) 5 degenerates in humans 6 Vagus nerve(CN 10)
Cervicle ansa
C1, C2, C3, C4
GS: innervates all infrahyoid muscles
Herings nerve is part of
CN 9(glossopharyngeal)
Lumbral sacral plexus
L1-S3
Brachial Plexus C5-T1
Cervicle Ansa
C1-C4
Lumbral sacral plexus
L1-S3
Brachial Plexus C5-T1
Cervicle Ansa
C1-C4
