MSK Flashcards
what nerve root is the biceps reflex?
C5-C6
what nerve root is the triceps reflex?
C7-C8
what nerve root is the knee reflex?
L3-L4
what nerve root is the ankle reflex?
S1-S2
what nerve is the deltoid muscle innervated by?
C5
what nerve is the triceps muscle innervated by?
C7
what nerve is the quadriceps muscle innervated by?
L3
what nerve are the long flexors innervated by?
L8
what nerve is the gastrocnemius innervated by?
S1
Lateral epicondylitis:
- AKA
- what illicits pain?
- how long do episodes last for?
tennis elbow
• Pain and tenderness localized to the lateral epicondyle
• Pain worse on resisted wrist extension with the elbow extended or supination of the forearm with the elbow extended also there is pain on middle finger extension
• Episodes typically last between 6 months and 2 years. Patients tend to have acute pain for 6-12 weeks
Medial epicondylitis:
- AKA
- what illicits pain
- where can numbness/tingling be felt?
Golfers elbow
Features
• Pain and tenderness localized to the medial epicondyle
• Pain is aggravated by wrist flexion and pronation
• Symptoms may be accompanied by numbness / tingling in the 4th and
5th finger due to ulnar nerve involvement
Radial tunnel syndrome
- what is this most commonly due to?
- where is the pain
- what movements worsen pain?
Most commonly due to compression of the posterior interosseous branch of the radial nerve. It is thought to be a result of overuse.
Features
• Symptoms are similar to lateral epicondylitis making it difficult to diagnose
• However, the pain tends to be around 4-5 cm distal to the lateral epicondyle
• Symptoms may be worsened by extending the elbow and pronating the forearm, not like tennis elbow where supinating is the problem
what is cubital tunnel syndrome?
- where is tingling felt
- what may worsen symptoms
Due to the compression of the ulnar nerve.
Features
• Initially intermittent tingling in the 4th and 5th finger
• May be worse when the elbow is resting on a firm surface or flexed for extended periods
• Later numbness in the 4th and 5th finger with associated weakness
what is olecranon bursitis?
Swelling over the posterior aspect of the elbow. There may be associated pain, warmth and erythema. It typically affects middle-aged male patients.
what is de-quervains tenosynovitis?
-who does this typically affect?
De Quervain’s Tenosynovitis is a common condition in which the sheath containing the extensor pollicis brevis and abductor pollicis longus tendons is inflamed. It typically affects females aged 30 - 50 years old
what are the features of de-quervains tenosynovitis?
- where is pain? where is tender?
- what movement is particularly painful?
- what is finkelstein’s test?
Features
• Pain on the radial side of the wrist
• Tenderness over the radial styloid process
• Abduction of the thumb against resistance is painful
• Finkelstein’s test: with the thumb is flexed across the palm of the hand, pain is reproduced by
movement of the wrist into flexion and ulnar deviation
what is the management of de-quervains tenosynovitis?
Management
• Analgesia
• Steroid injection
• Immobilization with a thumb splint (SPICA) may be effective
• Surgical treatment is sometimes required
lateral epicondylitis: what activities typically cause this? who does it most commonly affect? which arm?
Lateral Epicondylitis typically follows unaccustomed activity such as house painting or playing tennis (‘tennis elbow’). It is most common in people aged 45-55 years and typically affects the dominant arm.
what is the management of lateral epicondylitis?
Management options • Advice on avoiding muscle overload • Simple analgesia • Steroid injection • Physiotherapy
what is carpal tunnel syndrome caused by?
Carpal Tunnel Syndrome is caused by compression of MEDIAN NERVE in the carpal tunnel
what is the typical history of carpal tunnel syndrome?
History
• Pain/pins and needles in thumb, index, middle finger e.g. At night
• Patient flicks hand to obtain relief
what is found on examination in carpal tunnel syndrome?
Examination
• Weakness of thumb abduction
• Wasting of thenar eminence (NOT
HYPOTHENAR)
• Tinel’s sign: tapping causes paraesthesia
• Phalen’s sign: flexion of wrist causes symptoms
what are the causes of carpal tunnel syndrome?
Causes: pregnancy, premenstrual, edema (CCF), lunate fracture, RA
what is seen on electrophysiology studies in carpal tunnel syndrome?
Electrophysiology
• Motor + sensory: prolongation of the action potential