NPTE ALL OF IT Flashcards
Rotator Cuff Muscles “SITS”
Supraspinatus, infraspinatus, teres minor and Subscapularis
How much elevation occurs at GH joint?
120 degrees
How much elevation occurs at Scapulothoracic ?
60 degrees
The ratio of scapular to humeral motion for elevation
1 to 2
Upward rotation of Scapula with elevation?
traps and serratus anterior
Downward rotation with purposeful extension
rhomboids, levator scap, pec minor
Scapular protaction
serratus anterior and pec minor
scapular retraction
rhomboids, middle and lower trap
Depression of scapula
pectoralis minor and latissimus dorsi
Long thoracic Nerve
C5, C6, C7
innervates the serratus anterior
injury can cause scap winging
Dorsal scapular Nerve
C5, C6
innervates leavtor scapulae and rhomboids
Injury can affect scapular retraction and downward rotation
What nerve roots pass through the first rib?
C8 and T1
Suprascapular Nerve
C5, C6
innervates the supraspinatus and infraspinatus
if injured it will cause pain/ decreased shoulder abduction and ER limitations.
Carrying angle for men vs women
men: 10-15 deg
women: 20-25 deg
Axillary Nerve off the posterior cord
Supplies: Teres minor whats the action?
Supplies Deloid whats the action?
Nerve Root: C5-C6
Teres: shoulder ER, Extension, abduction and horizontal abduction
Deltoid: anterior: shoulder IR, flexion
Posterior: shoulder ER, extension, horizontal abduction
Axillary nerve sensory
Upper lateral cutaneous nerve of arm supples the skin covering the lower half of deltoid and upper part of long head of triceps
Axillary Nerve injury
Shoulder dislocation, fracture at the surgical neck
Square shoulder from deltoid atrophy
sensory loss over lower half of deltoid
Radial nerve comes off the posterior cord
Supplies triceps tell me action
Supplies anconeus tell me action
Supplies brachioradialis tell me action
Supplies supinator tell me action
Nerve root: C5-T1
Triceps
- Elbow extension
Anconeus
- Weak elbow extensor
Brachioradialis
- Elbow Flexion especially
in mid-prone position
Supinator
- Supination of forearm
Radial nerve Supplies all the extensors tell me actions
Extensor Carpi Radialis Longus
- Action: Wrist EXT, Radial Deviation
Extensor Carpi Radialis Brevis
- Action: Wrist EXT, Radial Deviation
Extensor Carpi Ulnaris
- Action: Wrist EXT, Ulnar Deviation
Extensor Digitorum
- Action: 2-5
th digits EXT a MCP, IP, Wrist
Extensor Digiti Minimi
- Action: 5th digit EXT at MCP, IP
Radial nerve Supplies all the extensors tell me actions
Extensor Pollicis Longus
- Action: 1st digit EXT at CMC, IP
Extensor Pollicis Brevis
- Action: 1st digit EXT at MCP, IP
Extensor Indicis
- Action: 2nd digit EXT, wrist extension
Abductor Pollicis Longus
- Action: 1st digit ABD and extension at
CMC joint
Radial Nerve Sensory supply
Skin of lower half of lateral side of arm
skin of back of arm
skin of back of forearm
skin of lateral half of dorsum of hand, lateral two and half digits including thumb
Radia tunnel syndrome
Radial nerve is compressed at the tunnel. Pain 1/2 down arm under the supinator
Posterior interosseous nerve syndrom
Radial nerve compression at the arcade of frohse
Lateral epicondylitis
Inflammation of the extensors at the lateral epicondyle of the humerus. The main muscle affected is the extensor carpi radialis brevis
What motions provoke pain for lateral epicondylitis?
Repeated extension and supination cause it. The pain will increase with wrist flexion with elbow extension, resisted extension and resisted radial deviation.
Medial epicondylitis affects what muscles?
Affects the flexor carpi radialis, humeral head of pronator teres
Medial epicondylitis increases in pain with what motions?
Pain with resisted wrist flexion and resisted pronation
Ulnar Nerve comes off the medial cord
Supplies the Doral interossei Tell me action
Supplies the Palmar interossei Tell me action
Supplies the adductor pollics Tell me action
Supplies the opponens digiti minimi and abductor digiti minimi
Nerve root: C8-T1
Doral interossei : DAB = abduction
Palmar interossei: PAD = adduction
Adductor pollicis: adduction of thumb
Opponens digiti mimini: opposition of 5th digit
Abductor digiti minimi: abduction of 5th finger
Ulnar nerve supplies
Flexor pollicis brevis
Flexor digitorum profundus
Flexor digiti minimi
Flexor carpi ulnaris
what are their actions?
Flexor Pollicis Brevis
- Action: Flexion of thumb
Flexor Digitorum Profundus (Medial half)
- Action: Flexion of DIP, Secondary –Flexion
of joints of digits, finger, wrist
Flexor Digiti Minimi
- Action: Flexion of little finger
Flexor Carpi Ulnaris
- Action: Wrist flexion, Ulnar Deviation
What is the sensory supply for the ulnar nerve?
- Supplies medial 1⁄2 of palm
Supplies skin of dorsal aspect of medial
two and half fingers
Supplies 1⁄2 of 4th, 5th digit
Cubital tunnel syndrome
Compression at cubital tunnel at elbow
- Paralysis of Flexor Carpi Ulnaris, Flexor
Digitorum Profundus (Ulnar half), hypothenar eminence, interossei, and the
third and fourth lumbrical muscles
- All sensations affected
- Inability to grip paper
Guyon’s canal syndrome
Sensory changes and progressive
weakness of muscles innervated distal to
the site
Ulnar Claw hand
- Hyperextension at 4th,5th MCP, Flexion at 4th, 5th IP due to Flexor Digitorum Profundus
Median Nerve comes from the medial and lateral cord
supplies the abductor pollicis brevis tell me action
supplies the opponens pollicis tell me action
supplies the lumbricals 1,2
Nerve roots: C5-T1
Abductor Pollicis Brevis
- Action: Abduction of thumb at MCP, CMC joint
Opponens Pollicis
- Action: Opposition of thumb
Lumbricals 1,2
- Action: Flexion of MCP and extension of IP
Median nerve supplies almost all of the flexors what are their actions?
Flexor digitorum profundus
Flexor pollicis longus
Flexor carpi radialis
Flexor digitorum superficialis
Flexor pollicis brevis
Flexor Digitorum Profundus (Radial half)
- Action: Flexion of DIP, Secondary –Flexion
of joints of digits, finger, wrist
Flexor Pollicis Longus
- Action: Flexion of distal phalanx of thumb
Flexor Carpi Radialis
- Action: Wrist flexion, Radial deviation
Flexor Digitorum Superficialis
- Action: Flexion of PIP joint
Flexor Pollicis Brevis
- Action: Flexion of thumb
Median nerve sensory supply
Palmar Cutaneous Branch
- Skin of lateral two-thirds of palm
Palmar Digital Branches
- Supplies dorsal tips of 1st, 2nd, & 3rd finger,
palmar skin of lateral three and half fingers
Pronator teres syndrome what nerve is affected and what is the issue?
Hypertrophy of pronator teres muscle can compress the median nerve. Pronator teres
remains normal, but the other muscles supplied
by the median nerve are affected, as is its
sensory distribution
Carpal tunnel syndrome
Median nerve is compressed under the flexor
retinaculum at the wrist