Musculoskeletal

Question 1

Erb Palsy

Answer 1

• Injury to C5-C6 nerve root
• presentation: arm extended, wrist flexed
• shoulder ABD, Flex, and rotation weakness
• sensory deficits: posterior and lateral aspect of arm
• common during birth

Question 2

Klumpke Palsy

Answer 2

• Injury to C8-T1 nerve roots
• presentation: forearm supinated, wrist and finger flexion (“claw hand”)
• weakness in hand intrinsics
• sensory deficits to ulnar side of forearm and hand
• common during birth
• T1 involvement may result in Horner’s Syndrome

Question 3

Thoracic Outlet Syndrome

Answer 3

• Compression of neurovascular structures in Cervical-axillary region
• causes: clavicle fx, 1st rib fx, congenital bony abnormalities, poor posture, mass lesions, cervical strain, tight muscles, hypertrophy

Question 4

Burner Syndrome

Answer 4

• due to stretch or compression of brachial plexus
• usually result of traction injury in young athletes or compression due to cervical disc disease/stenosis
• Symptoms: immediate, severe burning; prickling sensation followed by muscle weakness

Question 5

Parsonage-Turner Syndrome

Answer 5

• rapid onset of severe shoulder pain followed by atrophy of the affected areas
• immune mediated attack on brachial plexus
• symptoms depend on nerves affected

Question 6

Femoral Nerve Injury

Answer 6

• results in denervation of hip flexors and knee extensors

- rare

Question 7

Common peroneal nerve injury

Answer 7

• may lead to foot drop, supination, and steppage gait

- causes: tibial plateau fx, multi-ligamentous knee injury, osteotomies, tight bracing/splinting, compression

Question 8

Tibial Nerve

Answer 8

• results in: poor plantar sensation and PF during gait
• causes: distal femur, tibial, calcaneal fx; ankle or knee arthroscopic surgery, TKA, or direct penetrating injury.
• rare

Question 9

Median Nerve Motor Innervations

Answer 9

• pronator Teres
• flexor carpi radialis
• palmaris longus
• flexor carpi digitorum superficialis

Question 10

Ulnar Nerve Motor Innervations

Answer 10

• hand intrinsic muscles (except the area and 2 lateral lumbricals)
• flexor carpi ulnaris
• medial half of flexor digitorum profundus

Question 11

Deep Peroneal Nerve Motor Innervations

Answer 11

• Tibialis anterior
• extensor digitorum longus
• extensor hallucis longus
• fibular is tertius

Question 12

Superficial Peroneal Nerve Motor Innervation

Answer 12

• Fibularis longus

- Fibularis brevis

Question 13

Tibial Nerve Motor Innervations

Answer 13

• Gastrocnemius
• soleus
• plantaris
• popliteus

Question 14

Median Nerve sensory innervation

Answer 14

• Lateral 2/3 of palm
• dorsal fingertips of digits 1-3
• parts of anterior forearm

Question 15

Ulnar Nerve sensory innervation

Answer 15

• medial 1/3 of hand (dorsal and palmar)

Question 16

Superficial Radial Nerve Sensory Innervation

Answer 16

• skin not the posterior aspect of forearm
• dorsal surface of lateral side of palm
• dorsal surface of lateral 3.5 digits

Question 17

Sural Nerve Sensory Innervation

Answer 17

• skin of lower posterolateral leg

Question 18

Superficial Peroneal Nerve Sensory Innervation

Answer 18

• majority of the skin over the dorsum of the foot

- anterior and lateral aspect of the inferior 1/2 of the leg