MSK Nerves and Injuries Flashcards
Abnormal passive abduction of knee (valgus stress)
MCL Injury
Abnormal passive adduction of knee (varus stress)
LCL injury
Pain on external rotation of knee
Medial meniscus injury
Pain on internal rotation of knee
Lateral meniscus injury
Site of pudendal nerve block during delivery
Ischial spine
Location of appendix
2/3 of distance between umbilicus and ASIS
Site of lumbar puncture
Iliac crest
Rotator Cuff Muscles (4) + Main innervation
Supraspinatus, Infraspinatus, Teres Minor, Subscapularis; innervated by C5-C6
Supraspinatus (nerve + function)
Innervated by Suprascapular nerve; abducts arm, most common rotator cuff injury
Infraspinatus (nerve + function)
Innervated by Suprascapular nerve; laterally rotates arm; pitching injury
Teres minor (nerve + function)
Innervated by Axillary nerve; Adducts and laterally rotates arm
Subscapularis (nerve + function)
Innervated by Subscapular nerve, medially rotates and adducts arm.
Scaphoid
Most commonly fractured carpal bone, prone to avascular necrosis, palpated in anatomical snuff box
Lunate
Carpal bone, dislocation can cause acute carpal tunnel syndrome
Hook of hamate (clinical significance)
Falling on outstretched hand can cause ulnar nerve injury
Guyon canal syndrome
Compression of ulnar nerve (seen in cyclists from pressure from handlebars)
Erb palsy (Waiter’s tip)
Injury of upper trunk (C5-C6 roots); due to lateral track on neck during delivery (infants) or trauma (adults); Injury to Deltoid/supraspinatus (no abduction, arm hangs by side), Infraspinatus (no lateral rotation, arm medially rotated), Biceps brachii (no flexion/supination, arm hangs extended and pronated).
Klumpke Palsy
Claw hand; Injury of lower trunk (C8-T1 roots); due to upward force on arm during delivery (infants) or trauma like grabbing a tree branch to break a fall (adults); Injury to intrinsic and muscles, lumbricals, thenar, hypothenar.
Thoracic Outlet Syndrome
Compression of lower trunk and subclavian vessels; caused by cervical rib injury/Pancoast tumor, Muscle deficit same as Klumpke palsy (atrophy of intrinsic hand muscles, ischemia, pain, and edema due to vascular compression)
Winged Scapula
Lesion of long thoracic nerve, due to Axillary Node dissection after mastectomy or stab wounds, Injury to Serratus Anterior, causes inability to anchor scapula to thoracic cage, cannot abduct arm above horizontal position
Deltoid (innervation)
Axillary nerve
Rhomboid (innervation)
Dorsal scapular nerve
Teres Major (innervation)
Subscapular nerve
Fractured surgical head of humerus, anterior dislocation of humerus.
Axillary (C5-C6) nerve injury
Flattened deltoid,teres minor. Loss of arm abduction at shoulder, Loss of sensation over deltoid muscle and lateral arm
Axillary (C5-C6) nerve injury
Upper trunk compression (separation of neck and shoulder)
Musculocutaneous nerve injury
Loss of forearm flexion and supination/ Loss of sensation over lateral forearm
Musculocutaneous nerve injury
Midshift fracture of humerus/compression of axilla (due to crutches or sleeping with arm over chair, Saturday night palsy)
Radial (C5-T1) nerve injury.
Wrist drop: loss of elbow, wrist, finger extension, decreased grip strength, loss of sensation over posterior arm/forearm and dorsal hand
Radial (C5-T1) nerve injury
Supracondylar fracture of humerus (proximal lesion)
Median (C5-T1) nerve injury
Carpal tunnel syndrome and wrist laceration (distal lesion)
Medial (C5-T1) nerve injury
Ape hand or Pope’s blessing, loss of wrist and lateral finger flesion, loss of sensation over thenar eminence and dorsal and palmar aspects of hand, Tinnel sign
Medial (C5-T1) nerve injury
Fracture of medial epicondyle of humerus (funny bone)
Ulnar (C8-T1) nerve injury
Fractured hook of hamate
Ulnar (C8-T1) nerve injury
Radial deviation of wrist upon flexion, Loss of flexion of wrist and medial fingers, abduction and adduction of fingers, Loss of sensation over medial part of hand
Ulnar (C8-T1) nerve injury
Superficial laceration of palm
Recurrent branch of median nerve (C5-T1)
Loss of thenar muscle group, opposition abduction, and flexion of thumb
Recurrent branch of median nerve (C5-T1)
Atrophy of thenar eminence
Median nerve lesion
Atrophy of hypothenar eminence
Ulnar nerve lesion
Dorsal interosseous muscles
Abduct the fingers
Palmar interosseus muscles
Adduct the fingers
Lumbrical muscles
Flex at the MCP joint, extend PIP and DIP joints
Pelvic surgery, decreased thigh sensation (medial) and decreased adduction
Obturator (L2-L4 injury)
Pelvic fracture, loss of patellar reflex, decreased thigh flexion and leg extension, decreased sensation on anterior thigh
Femoral (L2-L4 injury)
Trauma or compression of lateral aspect of leg, fibular neck fracture
Common peroneal (L4-S2 injury)
Foot drop-inverted and plantarflexed at rest, loss of eversion and dorsiflexion, loss of sensation on dorsum of foot
Common peroneal (L4-S2 injury)
Knee trauma, Baker cyst, tarsal tunnel syndrome
Tibial (L4-S3 injury)
Inability to curl toes and loss of sensation on sole of foot. Foot everted at rest with loss of inversion and plantarflexion.
Tibial (L4-S3 injury)
Trendelenburg sign/gait; pelvis tilts, Lesion is contralateral to side that drops, ilsilateral to extremity on which patient stands.
Superior Gluteal (L4-S1 injury) –> due to posterior hip dislocation, polio
Difficulty climbing stairs, rising from seated position. Due to posterior hip dislocation
Inferior gluteal (L5-S2 injury.
PED and TIP
Peroneal everts and dorsiflexes (if injured, foot dropPED). Tibial inverts and plantarflexes (if injured, can’t stand on TIPtoes).
Sciatic nerve (L4-S3)
Posterior thigh
