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ESA 2 > MSK > Flashcards

MSK Flashcards

1
Q

How do you remember the brachial plexus, root to branch?

A 
Label roots as fingers c5-T1
Three muscateers C5,6,7 musc
Assasinated C5,6 axil
Five rates C5-t1 radial
Five mice c5-T1 median
Two unicorns C8-t1 ulnar
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2
Q

What are the roots in the brachial plexus

A

C5,6,7,8,T1

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3
Q

What are the trunks, what are they formed from?

Where does this occur?

A

Superior C5,6
Middle C7
Inferior c8, T1
Base of neck moving towards posterior triangle of neck

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4
Q

What are the divisions of the brachial plexus?
Formed from what trunks and therfore what roots?
Where does the formation occur?

A

Anterior division of superior trunk- from superior C5,6 and middle C7
Posterior- from superior, middle and inferior trunk C5-T1
Anterior division of inferior trunk- inferior- C8-T1
Occurs leaving posterior triangle of neck

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5
Q

What are the cords of the brachial plexus?

From what divisions are they formed and therefore what trunk and therefore what route?

A

The lateral cord from the anterior superior division, formed from the superior and middle trunk which originate from C5,C6 and C7

The posterior cord which arises from posterior division which takes trunks from superior, middle and inferior C5-T1

The medial cord which arises from the anterior inferior division which is coming from the inferior trunk C8-T1

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6
Q

What are the 5 major branches of the brachial plexus, what are there roots?

A

Musculocutaneous from the lateral cord only C5,6,7
Axillary from the posterior cord but superior trunk, C5,6
Median from the anterior inferior and anterior superior cords c5-t1
Radial from posterior cord C5-T1
Ulnar from the anterior inferior cord C8-T1

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7
Q

How do you remember the 5 sections of the brachial plexus

A

rugby teams drink cold beers

Roots trunks division cord branch

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8
Q

What does LOAF stand For?

A

Lateral 2 lumbricals
Opponens Pollicis
Anbductor pollicis brevis
Flexor pollicis brevis

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9
Q

What 2 words make you think median nerd

A

Flex

LOAF

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10
Q

What is the nerve root for the MSK nerve?

A

C5/6/7

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11
Q

What is the sensory distribution for the MSK nerve?

A

Lateral forearm

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12
Q

What is the motor distribution for the MSK nerve?

A

Bicep brachii
Brachiallis
Coracobrachialis

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13
Q

When is the MSK nerve injured?

A

Very rare due to protection from biceps, stab wound to upper arm

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14
Q

What sensory loss, motor deficit and deformity would be seen with a injury to the MSK nerve?

A

Numb lateral forearm
Weak elbow flexion, supination
Wasting biceps
Also absent biceps reflex

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15
Q

What is the nerve root of the axillary nerve?

A

C5/6

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16
Q

What course does the MSK nerve take?

A

Pierces coracobrachialis
Passes down anterior arm under biceps
Becomes lateral cutaneous nerve of forearm

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17
Q

What course does the axillary nerve take

A

Passes beneath shoulder into posterior arm, wraps around the surgical neck of humerus

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18
Q

What sensory area does the axillary nerve supply

A

Regimental badge area

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19
Q

What is the motor supply of the axillary nerve?

A

Deltoid

Teres minor

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20
Q

When can injuries to the axillary nerve be seen?

A

Fracture of surgical neck
Compression via shoulder dislocation
Stab wound to posterior shoulder

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21
Q

What sensory deficit, motor deficit and deformity is seen in axillary nerve damage?

A

Sensory- regimental badge
Motor- weak ABDuction 15-90 degrees, weak flexion, shoulder extension and external rotation
Deformity- wasting of deltoid

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22
Q

What nerve root does the radial nerve arise from?

A

C5-T1

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23
Q

Describe the route of the radial nerve?

A

Winds around spiral groove of humerus
Passes through anterior cubical fossa
Divides into superficial and deep

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24
Q

What is the sensory distribution of the radial nerve?

A

Lower posterior arm and posterior forearm, lateral 2/3 of hand dorsum, proximal dorsal aspect of lateral 3 and 1/2 fingers

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25
Q

What motor supply does the radial nerve have3

A 
Triceps brachii
Wrist extensor 
Finger extensor
Brachioradiallis
Supinator
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26
Q

When can injuries to the radial nerve occur?

A

Fractures of humerus proximally and at the shaft level
Fractures of proximal radius
Compression from tight plastercast or tourniquet
Stab wounds to cubical fossa, wrist and forearm

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27
Q

What would be the sensory deficit, motor deficit and deformity seen following radial nerve damage?

A

Sensory- numb posterior arm and forearm, numb radial lateral 2/3 of hand dorsum
Motor- weak elbow extension, wrist extension and MCPJ extension
Deformity- wrist drop

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28
Q

What’s the nerve root for the median nerve?

A

C5-T1

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29
Q

Describe the route of the median nerve

A

Down the back of the arm with the brachial artery
Through the cubital fossa
Divides into 3 terminal branches- anterior interosseous, deep and superficial

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30
Q

What does “really need booze to be at my nicest” tell you

A 
Cubital fossa lateral-> medial structures
Radial Nerve
Bicep Tendon
Brachial Artery
Median Nerve
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31
Q

What’s the sensory distribution of the median nerve?

A

Thenar eminence
Lateral 2/3 palm
Palmar lateral 3.5 fingers
Distal dorsal aspects of lateral 3.5

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32
Q

What is the motor control of the median nerve?

A

All of the anterior compartment apart from flexor carpi ulnaris and .5 dig profundus
LOAF-lateral 2 lumbricals, opponens pollcis, abductor pollicis brevis, flexor pollicis brevis

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33
Q

What are some common injury mechanisms for the median nerve?

A

Supracondylar fracture of humerus
Carpal tunnel
Stab wound to cubital fossa, forearm, wrist (eg self harm)

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34
Q

What is the resultant sensory deficit, motor deficit and deformity seen in median nerve injury

A

Sensory- numb thenar eminence, lateral 2/3 palm and distal dorsal 3.5 lateral
Motor- weak pronation, weak wrist flexion, weak finger flexion, *flexion of ring and little finger DIPJ preserved @ ulnar nerve
Deformity- Hand of benediction on attempted finger flexion

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35
Q

What’s the nerve root for ulnar nerve?

A

C8/T1

36
Q

What is the route of ulnar nerve

A

Down arm with brachial artery, behind medial epicondylitis, into anterior compartment with ulnar artery, enter palm via guyons canal

37
Q

What’s the sensory area of ulnar nerve?

A

Hypothenar eminence, medial 1/3 palm, palmar aspect of medial 1.5 fingers. Dorsal aspec of medial 1.5 fingers

38
Q

What are the motor components of the ulnar nerve?

A 
Flexor carpi ulnaris and .5 FDP
HILA
Hypothenar eminence
Interossei
Lumbricals (medial 2)
Adductor Pollicis
39
Q

How can the ulnar nerve become damaged?

A

Supracondylar fracture of humerus or medial epicondylar fracture
Compression at cubital tanner or guyons canal
Stab wound to wrist/forearm

40
Q

What sensory deficit, motor deficit and deformity is seen with ulnar nerve damage

A

Sensory- hypothenar eminence and medial side of hand numb (1.5)
Motor- weak wrist flexion, weak wrist adduction, weak flexion of ring and little finger MCPJ, DIP and weak extension of the IPJ
Weak finger abduction, adduction and opposition
Clincal- claw hand on attempted finger flexion

41
Q

What is the difference between hand of benediction and claw hand?

A
  1. Hand of benediction is a median nerve issue and is seen on finger flexion
  2. Claw hand is an ulnar nerve issue seen on finger extension
42
Q

Damage to nerves supplying the illiopsoas would present with what?

A

No pelvic swing on walking

43
Q

Damage to the femoral nerve would result in what?

A

Loss of hip flexion and knee extension

Loss of sensation to anterior thigh and medial leg

44
Q

Damage to the obturator nerve would result in what

A

Loss of adduction of thigh, loss of sensation to inner thigh

45
Q

Damage to the superior gluteal nerve would result in what?

A

Loss of abduction- pelvic dip when walking

46
Q

Loss of the inferior gluteal nerve would result in what?

A

Loss of extension at hip- buttock wasting

47
Q

Damage to the sciatic nerve would result in what?

A

Loss of all motor except adduction + flexion of thigh, extension of knee.
Loss of sensation to the lower leg and foot

48
Q

A high tibial nerve injury would result in what?

A

Loss of flexion of toes and inversion of foot

Loss of sensation to sole of foot and inferior aspect of toes and nail bed

49
Q

A high injury t the common fibulae nerve would result in what?

A

Foot drop- loss of extension of toes and foot

Loss of sensation of lateral liver leg and upper foot

50
Q

A prolapsed intervertebral disk in the lumbar region affects what nerve root?

A

The nerve that emerges from the next intervertebral foramen e.g l4/5 catches L5 nerve root.

51
Q

L4/5 disk prolapse will affect what nerve and give symptoms where?

A

L5 nerve

Sensation to mid shin and big toe and loss of big toe extension

52
Q

L5/S1 prolapse will affect what nerve and give symptoms where

A

S1 nerve
Sensation to little toe
Motor to plantarflexion

53
Q

An l3/l4 disk prolapse will affect what nerve giving symptoms where?

A

L4
Ankle Doris flexion
Medial lower leg sensation

54
Q

What is the nerve root for the MSK nerve?

A

C5/6/7

55
Q

What is the sensory distribution for the MSK nerve?

A

Lateral forearm

56
Q

What is the motor distribution for the MSK nerve?

A

Bicep brachii
Brachiallis
Coracobrachialis

57
Q

When is the MSK nerve injured?

A

Very rare due to protection from biceps, stab wound to upper arm

58
Q

What sensory loss, motor deficit and deformity would be seen with a injury to the MSK nerve?

A

Numb lateral forearm
Weak elbow flexion, supination
Wasting biceps
Also absent biceps reflex

59
Q

What is the nerve root of the axillary nerve?

A

C5/6

60
Q

What course does the MSK nerve take?

A

Pierces coracobrachialis
Passes down anterior arm under biceps
Becomes lateral cutaneous nerve of forearm

61
Q

What course does the axillary nerve take

A

Passes beneath shoulder into posterior arm, wraps around the surgical neck of humerus

62
Q

What sensory area does the axillary nerve supply

A

Regimental badge area

63
Q

What is the motor supply of the axillary nerve?

A

Deltoid

Teres minor

64
Q

When can injuries to the axillary nerve be seen?

A

Fracture of surgical neck
Compression via shoulder dislocation
Stab wound to posterior shoulder

65
Q

What sensory deficit, motor deficit and deformity is seen in axillary nerve damage?

A

Sensory- regimental badge
Motor- weak ABDuction 15-90 degrees, weak flexion, shoulder extension and external rotation
Deformity- wasting of deltoid

66
Q

What nerve root does the radial nerve arise from?

A

C5-T1

67
Q

Describe the route of the radial nerve?

A

Winds around spiral groove of humerus
Passes through anterior cubical fossa
Divides into superficial and deep

68
Q

What is the sensory distribution of the radial nerve?

A

Lower posterior arm and posterior forearm, lateral 2/3 of hand dorsum, proximal dorsal aspect of lateral 3 and 1/2 fingers

69
Q

What motor supply does the radial nerve have3

A 
Triceps brachii
Wrist extensor 
Finger extensor
Brachioradiallis
Supinator
70
Q

When can injuries to the radial nerve occur?

A

Fractures of humerus proximally and at the shaft level
Fractures of proximal radius
Compression from tight plastercast or tourniquet
Stab wounds to cubical fossa, wrist and forearm

71
Q

What would be the sensory deficit, motor deficit and deformity seen following radial nerve damage?

A

Sensory- numb posterior arm and forearm, numb radial lateral 2/3 of hand dorsum
Motor- weak elbow extension, wrist extension and MCPJ extension
Deformity- wrist drop

72
Q

What’s the nerve root for the median nerve?

A

C5-T1

73
Q

Describe the route of the median nerve

A

Down the back of the arm with the brachial artery
Through the cubital fossa
Divides into 3 terminal branches- anterior interosseous, deep and superficial

74
Q

What does “really need booze to be at my nicest” tell you

A 
Cubital fossa lateral-> medial structures
Radial Nerve
Bicep Tendon
Brachial Artery
Median Nerve
75
Q

What’s the sensory distribution of the median nerve?

A

Thenar eminence
Lateral 2/3 palm
Palmar lateral 3.5 fingers
Distal dorsal aspects of lateral 3.5

76
Q

What is the motor control of the median nerve?

A

All of the anterior compartment apart from flexor carpi ulnaris and .5 dig profundus
LOAF-lateral 2 lumbricals, opponens pollcis, abductor pollicis brevis, flexor pollicis brevis

77
Q

What are some common injury mechanisms for the median nerve?

A

Supracondylar fracture of humerus
Carpal tunnel
Stab wound to cubital fossa, forearm, wrist (eg self harm)

78
Q

What is the resultant sensory deficit, motor deficit and deformity seen in median nerve injury

A

Sensory- numb thenar eminence, lateral 2/3 palm and distal dorsal 3.5 lateral
Motor- weak pronation, weak wrist flexion, weak finger flexion, *flexion of ring and little finger DIPJ preserved @ ulnar nerve
Deformity- Hand of benediction on attempted finger flexion

79
Q

What’s the nerve root for ulnar nerve?

A

C8/T1

80
Q

What is the route of ulnar nerve

A

Down arm with brachial artery, behind medial epicondylitis, into anterior compartment with ulnar artery, enter palm via guyons canal

81
Q

What’s the sensory area of ulnar nerve?

A

Hypothenar eminence, medial 1/3 palm, palmar aspect of medial 1.5 fingers. Dorsal aspec of medial 1.5 fingers

82
Q

What are the motor components of the ulnar nerve?

A 
Flexor carpi ulnaris and .5 FDP
HILA
Hypothenar eminence
Interossei
Lumbricals (medial 2)
Adductor Pollicis
83
Q

How can the ulnar nerve become damaged?

A

Supracondylar fracture of humerus or medial epicondylar fracture
Compression at cubital tanner or guyons canal
Stab wound to wrist/forearm

84
Q

What sensory deficit, motor deficit and deformity is seen with ulnar nerve damage

A

Sensory- hypothenar eminence and medial side of hand numb (1.5)
Motor- weak wrist flexion, weak wrist adduction, weak flexion of ring and little finger MCPJ, DIP and weak extension of the IPJ
Weak finger abduction, adduction and opposition
Clincal- claw hand on attempted finger flexion

85
Q

What is the difference between hand of benediction and claw hand?

A
  1. Hand of benediction is a median nerve issue and is seen on finger flexion
  2. Claw hand is an ulnar nerve issue seen on finger extension

ESA 2 (10 decks)

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