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PACES revision > Name the muscle, nerve root, nerve and reflex! > Flashcards

Name the muscle, nerve root, nerve and reflex! Flashcards

1
Q

Shoulder abduction- muscle, nerve root/nerve, reflex

A

Deltoid
C5 (+C6)= lateral aspect of upper arm (C5) and lat lower arm and thumb (C6)
Axillary nerve ( small band over deltoid)

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2
Q

Shoulder adduction- muscle, nerve root/nerve, reflex

A

Latissimus dorsi and pectoralis major
(C6), C7, (C8)= lateral aspect of fore arm and hand particularly middle finger (C7)

Thoracodorsal nerve (purely motor no sensory area)

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3
Q

Elbow flexion- muscle, nerve root, nerve, reflex

A

Biceps
C5, C6 = lateral aspect of upper arm (C5) and forearm, thumb and index finger (C6)

Musculocutaneous nerve (lateral aspect of forearm)
Reflex: biceps
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4
Q

Elbow extension- muscle, nerve root, nerve, reflex

A

Triceps
(C6), C7, (C8) = lateral aspect of forearm and hand particularly middle finger

Radial nerve: anatomical snuffbox and ext. aspect of forearm
Reflex: triceps +/- brachioradialis

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5
Q

Wrist extension- muscle, nerve root, nerve, reflex

A

Extensor carpi radialis longus, extensor carpi ulnaris
(C5, C6), C7, (C8)- lateral aspect of forearm, thumb and index finger

Radial and posterior interosseous nerve: lateral forearm , thumb, index finger, snuff box

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6
Q

What are the findings in a C7 radiculopathy?

A
  • weakness of shoulder adduction (but not abduction)
  • weakness of elbow extension
  • weakness of wrist ext and flexion
  • wasting of triceps and forearm
  • Loss of triceps reflex
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7
Q

How do you differentiate a high radial nerve injury from a C7 radiculopathy?

A

A radial nerve injury spares wrist flexion (C7 and C8, median and ulnar nerves)

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8
Q

Wrist flexion- muscle, nerve root, nerve and reflex

A

Flexor carpi radialis, flexor carpi ulnaris
C6, C7 : lateral aspect of forearm, thumb, 1st and middle finger

Median and ulnar nerve: thumb, index and middle finger

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9
Q

Finger extension- muscle, nerve root, nerve and reflex

A

Extensor digitorum
C7 (C8)- little finger, ring finger, middle finger

Posterior interosseous nerve (branch of radial nerve) - no sensory area

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10
Q

Finger flexion- muscle, nerve root, nerve and reflex

A

Flexor digitorum superficialis and profundus
C8: little finger and 1/2 ring finger
Reflex is finger flexion

Median: palmer aspect of lateral hand, thumb, index, middle and 1/2 ring finger
Ulnar: palmar aspect of medial side of hand, little and 1/2 ring finger

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11
Q

Index finger aBDuction

A

First dorsal interosseous
(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm

Ulnar: palmar aspect of medial side of hand, little and 1/2 ring finger

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12
Q

Little finger aBDuction

A

Abductor digiti minimi
(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm

Ulnar: palmar aspect of medial side of hand, little and 1/2 ring finger

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13
Q

Thumb aBDuction

A

Abductor pollicis brevis
(C8), T1:little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm

Median: palmar aspect of lateral hand, thumb, index, middle and 1/2 ring finger

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14
Q

Thumb opposition

A

Opponens pollicis
(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm

Median: palmar aspect of lateral hand, thumb, index, middle and 1/2 ring finger

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15
Q

Thumb flexion

A

Flexor pollucis brevis
(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm

Median: palmar aspect of lateral hand, thumb, index, middle and 1/2 ring finger

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16
Q

Finger adduction

A

Palmar interossei

(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm

Ulnar: palmar aspect of medial side of hand, little and 1/2 ring finger

17
Q

What muscles are supplied by the median nerve? How do you test?

A

LOAF: all T1 including thenar eminance

  • lateral lumbricals
  • opponens pollicus
  • Abductor pollicis brevis
  • Flexor pollicis brevis

Pronators of forearm (C6)
flexor carpi radialis- wrist flexor (C7)
Long finger flexors via anterior interosseous branch of the median nerve including flexor digitorum profundus, superficialis to index/middle fingers (C8)

Test opposition (thumb to little finger in O) or test palmar abduction

18
Q

What muscles are supplied by ulnar nerve? Whats the test?

A

All the hand muscles except LOAF

  • Hypothenar muscles
  • Medial 2 lumbricals
  • Interrosei (palmar addict & dorsal abduct the fingers)
  • Adductor pollicis (T1)
  • Medial wrist flexors (C8)

Cross index and middle fingers
Grip paper between index finger and thumb without flexing thumb IP joint (Froments sign)

19
Q

What muscles are supplied by the radial nerve? WHat is the test?

A
  • wrist extensors (C8)
  • Brachioradialis, supinator (both C6) and triceps (C7)

Posterior interosseous branch supplies extensors of fingers- wrist drop if weak

Test wrist dorsiflexion (extension) and sensation in snuff box

20
Q

HOw do you tell the difference between a median, ulnar and T1 radiculopathy?

A

Assess:

  • Abductor pollicis brevis- pointing thumb up with hand flat
  • First dorsal interosseous

APB weak and FDI normal = median nerve lesion
APB normal and FDI weak= ulnar nerve lesion
Weakness of both = T1 radiculopathy

21
Q

Hip flexion

A

Iliopsoas muscle
L1, L2, (L3) : groin and antero-medial thigh

Femoral: groin and upper thigh anteriorly (lateral cutaneous nerve of thigh). Patellar reflex.

22
Q

Hip extension

A

Gluteus maximus
L5, S1: lateral lower leg, dorsum and sole of foot

Inferior gluteal nerve: purely motor

23
Q

Knee flexion

A

Hamstrings
L5, S1: lateral lower leg and dorsum and sole of foot

Sciatic nerve: outer aspect of leg, dorsum, sole and inner aspect of foot

24
Q

Knee extension

A

Quadriceps femoris
L3, L4: anteromedial thigh and lower leg

Femoral: anteromedial thigh and inner leg

Reflex: patellar

25
Q

Ankle dorsiflexion

A

Tibialis anterior

L4, L5: lower leg and dorsum of foot

Deep peroneal: 1st interosseous web space (between big and second toe)

26
Q

Ankle plantarflexion

A

Gastrocneumius
S1: Anterolateral aspect of lower leg, little toe and sole of foot

Tibial nerve: Anterolateral aspect of lower leg, little toe and sole of foot

27
Q

Ankle inversion

A

Tibialis posterior
L4, (L5, S1): lower leg and foot

Tibial nerve:Anterolateral aspect of lower leg, little toe and sole of foot

28
Q

Ankle eversion

A

Peroneus longus and brevis
L5: lateral lower leg and top of foot except little toe

Peroneal nerve: lateral lower leg and dorsum of foot

29
Q

How can you differentiate a common peroneal palsy, sciatic nerve palsy and L5 radiculopathy?

A

Ankle inversion

  • preserved if common peroneal
  • weak if L5 or sciatic nerve palsy

If sciatic nerve palsy- absent ankle jerk, weak ankle dorsi & plantarflexion

If L5 radiculopathy- hip extension would be weak

30
Q

What is the nerve root and nerve of ankle jerk? If absent what does it indicate?

A

S1
Via tibial branch of sciatic

Absent indicates

  • lesion of tibial nerve (far less common than the peroneal nerve)
  • Complete lesion of sciatic nerve
  • S1 radiculopathy (most common cause)

PACES revision (12 decks)

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