Musculoskeletal

Question 1

What lesion would cause this?

Answer 1

Traction/tear of upper trunk = Erb Palsy

C5-6 nerve roots

Question 2

What lesion would cause this?

Answer 2

Traction/tear of lower trunk = Klumpke palsy

C8-T1

Question 3

What MS deficit might a pancoast tumor cause?

Answer 3

Compression of lower trunk = atrophy of intrinsic hand muscles, ischemia, and pain

Thoracic outlet syndrome

Same muscles as klumpke palsy

Question 4

What lesion would cause this?

Answer 4

Long thoracic nerve

Winged scapula

Axillary node dissection/stab wound

Question 5

What deficit would this cause?

Answer 5

Ant dislocation/fx surgical neck of humerus

Axillary nerve

Flattened deltoid, loss of arm abduction > 15˚, LOS over deltoid and lateral arm

Question 6

Upper trunk compression can hit the musculocutaneous nerve and cause what symptoms?

Answer 6

Loss of forearm flexion/supination

Loss of sensation over lateral forearm

Question 7

What injury might this cause?

Answer 7

Radial nerve damage - loss of elbow, wrist and finger extension

Wrist drop

↓ grip strength

LOS posterior arm/forarm, dorsal hand

**also axilla compression - arm over chair, crutches*

Question 8

What deficit would this cause?

Answer 8

Supracondylar humerus fx - Median n.

Pope’s blessing - can’t flex lateral digits

LOS over thenar eminence nad dorsal/palmar aspects of lateral 3.5 fingers

Question 9

What might this cause?

Answer 9

Proximal ulnar nerve lesion - OK gesture

Can’t flex medial two digits

Radial deviation of wrist upon flexion

Question 10

What might a superficial laceration of the palm lead to?

Answer 10

Laceration of recurrent branch of median nerve

Loss of thenar muscle group - opposition, abduction, & flexion

**No LOS**

Question 11

Clawing is best seen with ________ lesions.

Answer 11

Distal - present at rest

Can’t extend

Question 12

Injury to the obturator nerve via pelvic surgery leads to what deficits?

Answer 12

↓ Medial thigh sensation

↓ adduction

Question 13

Injury to the femoral nerve via pelvic fx leads to what deficits?

Answer 13

↓ thigh flexion and leg extension = Quads

Question 14

Injury to the common peroneal n. leads to what deficits?

Answer 14

Foot drop

Loss of eversion and dorsiflexion

LOS on dorsum of foot

Question 15

What might this injury cause?

Answer 15

Common peroneal/fibular nerve injury = Foot drop

fibular neck fx

Question 16

Tibial nerve injury can lead to what deficits?

Answer 16

Inability to curl toes & LOS on sole of foot

Proximal = loss of plantarflexion/inversion

Question 17

The trendelenburg sign/gait

Answer 17

Weakness of side opposite drop to ABduct

Superior gluteal nerve

Medius and minimus

Question 18

Difficulty climbing stairs, rising from seated position, and loss of hip extension are indications of what?

Answer 18

Inferior gluteal n. = gluteus maximus

Posterior hip dislocation

Question 19

A posterior hip dislocation can damage whta two nerves?

Answer 19

Superior gluteal = minimus and medius

Inferor gluteal = maximus

Question 20

What nerve runs along the surgical neck of the humerus?

Answer 20

Axillary nerve - Posterior circumflex artery

Question 21

What nerve runs along the midshaft of the humerus?

Answer 21

Radial nerve & deep brachial artery

Question 22

What nerve runs along the distal humerus/cubital fossa?

Answer 22

Median nerve and brachial artery

Question 23

What nerve is in the the popliteal fossa?

Answer 23

Tibial nerve and popliteal artery

Question 24

What nerve is posterior to the medial malleolus?

Answer 24

Tibial nerve and Posterior tibial artery