Musculoskeletal Flashcards
Erb palsy
upper trunk (C5, C6 roots); deltoid, supraspinatus; infraspinatus; biceps brachii; waiter’s tip
Klumpke palsy
lower trunk (C8-T1 root); intrinsic hand muscles: lumbricals, interossei, thenar, hypothenar; total claw hand
winged scapula
lesion of long thoracic nerve (C5,6,7) roots; serratus anterior–>cannot abduct arm above horizontal position
axillary nerve lesion caused by:
fractured surgical neck of humerus; anterior dislocation of humerus
axillary nerve lesion deficits;
flattened deltoid, loss of arm abduction at shoulder greater than 15 degrees; loss of sensation over deltoid muscle and lateral arm
musculocutaneous nerve lesion caused by:
upper trunk compression
musculocutaneous nerve deficits:
loss of forearm flexion and supination; loss of sensation over lateral forearm
radial nerve injury caused by:
midshaft fracture of humerus; compression of axilla (due to crutches) or saturday night palsy;
radial nerve deficits:
wrist drop: loss of elbow, wrist and finger extension; decreased grip strength (wrist extensors are necessary for maximal action of flexors); loss of sensation over posterior arm/forearm and dorsal hand
median nerve injury caused by:
supracondylar fracture of humerus (proximal lesion); carpal tunnel syndrome and wrist laceration (distal lesion)
median nerve injury deficit:
Ape hand and Pope blessing; loss of wrist and lateral finger flexion, thumb opposition, lumbricals of 2nd/3rd digits; loss of sensation over thenar eminence and dorsal/palmar aspects of lateral 3.5 fingers w/ proximal lesion
ulnar nerve injury caused by:
fracture of medial epicondyle of humerus “funny bone” (proximal lesion); fractured hook of hamate (distal lesion);
ulnar nerve deficit:
ulnar claw on digit extension; radial deviation of wrist upon flexion (proximal lesion); loss of sensation in hand according to ulnar distribution
recurrent branch of median nerve damage caused by: deficit?
superficial laceration of palm; ape hand; loss of thenar muscle group: opposition, abduction, flexion of thumb; no loss of sensation
ulnar claw vs pope’s blessing
ulnar claw when extending fingers at rest–distal lesion of ulnar nerve; pope’s blessing when making a fist–proximal median nerve lesion
median claw vs OK gesture
median claw when extending fingers at rest–distal median nerve; OK gesture when making a fist–proximal ulnar nerve
obturator nerve injury
L2-L4; decreased medial thigh sensation, decreased adduction
femoral nerve injury
L2-L4; decreased thigh flexion and leg extension
common peroneal nerve injury caused by:
L4-S2; trauma or compression of lateral aspect of leg; fibular neck fracture
common peroneal nerve deficit:
foot drop–inverted and plantarflexed at rest; loss of eversion/dorsiflexion; steppage gait; loss of sensation on dorsum of foot
Tibial nerve injury caused by:
L4-S3: knee trauma, baker cyst (proximal lesion); tarsal tunnel syndrome (distal lesion)
tibial nerve deficit:
inability to curl toes and loss of sensation on sole of foot; in proximal lesions (baker cyst) foot is everted at rest with loss of inversion and plantaflexion
superior gluteal nerve injury caused by:
L4-S1: posterior hip dislocation, polio
superior gluteal nerve deficit:
trendelenburg sign/gait (superior nerve innervates gluteus medius/minimus); lesion is contralateral to the side of the hip that drops; ipsilateral to extremity on which patient stands
inferior gluteal nerve deficit:
difficulty climbing stairs, rising from seated position, loss of hip extension (inferior nerve innervates gluteus maximus)
Artery/nerve running in axilla/lateral thorax:
long thoracic nerve; lateral thoracic artery
A/N running in surgical neck of humerus
axillary; posterior circumflex artery
AN running in midshaft of humerus
radial nerve; deep brachial a
A/N running in distal humerus/cubital fossa
median nerve; brachial artery
A/N running in popliteal fossa
tibial nerve; popliteal a
A/N running posterior to medial malleolus
tibial nerve; posterior tibial
