MSK/CT Flashcards
drawer signs are for?
ACL (anterior)
PCL (posterior)
valgus vs varus force?
valgus –> lateral force
varus –> medial force
McMurray test?
patient supine, knee rotated internally/externally
–> meniscus tears!
pain on external rotation = medial
pain on internal rotation = lateral
unhappy triad?
lateral force –> planted leg
classic triad: ACL, MCL, medial meniscus
lateral meniscus more commonly affected
repeated trauma, lots of kneeling, knee pain?
prepatellar bursitis
aka housemaid’s knee
popliteal fluid collection?
Baker’s cyst
often related to chronic jt dz
what are the rotator cuff mm?
SITS
supraspinatus (suprascapular n) - abducts
infraspinatus (suprascapular n) - ext rotates
teres minor (axillary n) - ext rotates
subscapularis (upper and lower subscapular n) - int rotates
medial vs lateral epicondylitis?
medial = golfer's = repeated flexion lateral = tennis = repeated extension
most commonly fractured carpal bone, prone to avascular necrosis?
scaphoid
** in snuffbox
dislocation of this carpal bone may cause carpal tunnel?
lunate
FOOSH damages this carpal bone?
hook of hamate
** may injure ulnar n
dz assoc with carpal tunnel?
pregnancy (not really a disease, but you get it)
RA
hypothyroidism
guyon canal syndrome?
compression of ulnar n at wrist or hand
classically in cyclists
flattened deltoid, loss of abduction after 15deg, loss of sensation over deltoid?
axillary n (C5-C6) runs with post circumflex humeral artery
** injured with fx of surgical neck or anterior humeral dislocation
loss of forearm flexion and supination, loss of sensation over lateral forearm?
musculocutaneous n (C5-C7)
** injured with upper trunk compression - mostly trauma (birth or adult)
wrist drop, decreased grip, loss of sensation over posterior arm/forearm/dorsal hand?
radial n (C5-T1) runs with deep brachial a
** injured with midshaft fx of humerus, compression of axilla (Saturday night palsy, crutches)
Pope’s blessing, loss of wrist/lateral finger flexion, thumb opposition, 2nd/3rd lumbricals, loss of thenar eminance/lateral finger sensation?
median n (C5-T1) runs with brachial a
** injured with supracondylar fx of humerus, carpal tunnel, wrist laceration
loss of wrist flexion, medial finger flexion, finger abduction/adduction; loss of sensation over medial 1 1/2 fingers and hypothenar eminence?
ulnar n (C8-T1) runs with ulnar a
- injured with fx of medial epicondyle of humerus, fractured hook of hamate
- if proximal lesion, get radial deviation of wrist upon flexion
i can’t oppose my thumbs! what nerve did i hurt?
recurrent branch of median nerve via superficial laceration of palm
loss of thenar mm group
NO sensory loss
what are the divisions of the brachial plexus?
Randy Travis Drinks Cold Beer roots trunks (upper/middle/lower) divisions cords (lateral/posterior/medial) branches
Erb palsy?
= waiter’s tip
upper trunk lesion (C5-C6) - lateral neck traction during birth, other trauma
loss of deltoid and supraspinatus –> arm adducted
loss of infraspinatus –> arm internally rotated
loss of biceps –> arm extended and pronated
Klumpke palsy?
= total claw hand
lower trunk lesion (C8-T1) - upward force on arm in delivery, grabbing branch to break fall
loss of intrinsic hand mm –> MCP jts extended, PIP and DIP jts flexed
Klumpke palsy + atrophy, pain and edema?
thoracic outlet syndrome 2/2 cervical rib, pancoast
lower brachial trunk and subclavian vessels compressed
winged scapula?
lesion of long thoracic n (C5-C7)
2/2 stab wound or mastectomy
loss of serratus anterior –> can’t abduct arm past horizontal
what lesion/action combinations give you an ulnar claw/pope’s blessing?
distal ulnar lesion + trying to extend fingers
prox medial lesion + trying to make a fist
what lesion/action combinations give you a median claw/ok gesture?
distal median lesion + trying to extend fingers
proximal ulnar lesion + trying to make a fist
what do the interossei do?
dorsal abduct fingers
palmar adduct fingers
what do the lumbricals do?
flex MCP jt
extend PIP and DIP jt
decreased medial thigh sensation and decreased adduction?
obturator n (L2-L4)
** injured in pelvic surgery
decreased thigh flexion and leg extension?
femoral n (L2-L4)
** injured in pelvic fx
footdrop, loss of sensation on dorsum of foot?
common peroneal n (L4-S2)
** injured in compression of lateral leg, fibular neck fx
inability to curl toes, loss of sensation on sole of foot?
tibial n (L4-S3)
- injured in knee trauma, Baker cyst (proximal), tarsal tunnel syndrome (distal)
- proximal lesion –> loss of inversion and plantarflexion
Trendelenburg?
superior gluteal n (L4-S1)
(to medius and minimus –> can’t abduct hip well)
** injured during IM injct to upper medial gluteal region
can’t climb stairs, rise from seated?
inferior gluteal n (L5-S2)
(to maximus –> can’t extend hip)
** injured in post hip dislocation
components of sciatic nerve?
L4-S3, to posterior thigh
splits into common peroneal and tibial nn
pudendal n?
S2-S4
perineum
childbirth- use ischial spine as landmark for nerve block
weakness of knee extension, decreased patellar reflex?
L3-L4 herniation (–> L4 nerve root)
weakness of dorsiflexion, difficulty heel-walking?
L4-L5 herniation (–> L5 nerve root)
weakness of plantarflexion, difficulty toe-walking, decreased Achilles reflex?
L5-S1 herniation (–> S1 nerve root)
