Orthopaedics and neuro exam Flashcards
What classification is this?
Mx?
Weber B
Isolated malleolar fracture, short leg cast 6 weeks
What’s this?
What nerve root are affected?
Caused by what?
Erb’s palsy
C5-C6 (upper brachial plexus)
Caused by excessive lateral flexion with should dystocia
Wirst radial and ulnar devidation nerve roots?
C8, T1
Biceps reflex nerve root?
C5, C6
Radial nerve injury:
Where can it occur?
What does it cause?
Mid-shaft humeral fracture
Wrist drop
Loss of sensation of thumb and 1st web space
Elbow extension nerve roots?
C7, C8
What is this fracture?
What nerves can get injured? What artery?
What won’t the patient be able to do?
Supracondylar humerus fracture
Anterior intraseous nerve (if postero-lateral displacement of the distal humerus/proximal fragment is displaced antero-medially); ‘Ok’ sign, appositon of thumb and index finger (no sensory changes)
Radial nerve (if distal humerus is displaced postero-medially/ proximal fragment will be displaced antero-laterally)
Brachial artery
Finger reflex nerve root?
C8
Triceps reflex nerve roots?
C7, C8
Medial winging of scapula. Injury to what muscle and nerve?
Serratus anterior + long thoracic
Wrist palmar flexion nerve roots?
C6, C7
Dx and nerve injury?
Perilunate dislocation
Median nerve
Type of fracture and classificaion?
Nerve and artery that may get injured?
Supraconylar fracture of the humeus
Gartland type 3 (complete displacement)
Anterior interoseous nerve (ok sign, no sensory change)
Brachial artery
Type of fracture and classificaion?
Nerve and artery that may get injured?
Supraconylar fracture of the humeus
Gartland type 2 (diplacement but posterior cortex intact)
Anterior interoseous nerve (ok sign, no sensory change)
Brachial artery
Brachioradialis reflex nerve root?
C5, C6
What’s this fracture?
Smith’s fracture (fall onto a flexed wrist)
How to clear C spine?
NSAID
N: Neurological deficit
S: Spinal midline tenderness
A: Altered mental status
I: Intoxication
D: Distracting injury
L4 nerve root motor? Gait abnormality?
L4 nerve root: foot dorsiflexion, difficulty with heel walking
What’s this fracture?
Galeazzi fracture (radial fracture with displaced radioulnar joint)
S1 nerve root motor? Gait abnormality?
S1 nerve root: Foot eversion, plantar flexion, difficult tippy toe walking
Loss of Achilles tendon reflex
Dx and mx?
Scaphoid facture
Thumb spica cast 6 weeks
Elbow flexion nerve roots?
C5, C6
Risk factor for adhesive capsulitis?
Diabetes
Finger extension nerve roots?
C7, C8
Posterior interosseous nerve:
Branch of what?
Injury causes what?
Common injury in what?
Radial nerve
Purely motor loss (no sensory), cannot extend fingers but can extend wrist
Montaggia fracture (fracture of proximal of ulna and dislocation of radial head)
Wirst dorsiflexion (extension) nerve roots?
C7, C8
Inability to perform ‘ok’ sign is an issue with what nerve?
What fracture does it get injured?
Anterior interosseous nerve (branch of medial)
Motor not sensory
Supraconylar humetus fracture
Distal radius fracture with dislocation of the distal radioulnar joint. Dx?
Galeazzi fracture.
Type of fracture and classificaion?
Nerve and artery that may get injured?
Supraconylar fracture of the humeus
Gartland type 1 (no displacement, ft pad sign)
Anterior interoseous nerve (ok sign, no sensory change)
Brachial artery
Shoulder adduction nerve roots?
C6, C7
What’s this?
What nerve root is damaged?
What causes this?
Klumpske’s palsy
Lower brachial plexus C8-T1
Excessive shoulder abduction (pulling baby by arm, man grabs something as he falls)
What clasification is this?
Mx?
Weber A
Stable unilateral malleolar fracture: short leg walking cast for 6 weeks
L5 nerve root motor? Gait abnormality?
L5 nerve root: First toe dorsiflexion, foot drop gait
Dx?
Nerve to be damaged?
Anterior shoulder dislocation
Axillary nerve (deltoids, badge sensory loss)
What is this?
How does it happen?
Posterior shoulder dislocation (lightbulb sign)
Post seizure, electric shock
24yo F. G1P1. Had child 4 months ago and works at a computer. Presents with R hand pain over last month. Pain over dorsal aspect of R thumb, radiating to wrist. No Hx of trauma. Exacerbated by computer use/ulnar movement of hand. Lump on dorsal lateral wrist.
Dx? One differential?
Test?
De Quervain tenosynovitis
Diff dx: ganglion
Finkelstein’s test
L4 nerve root sensation?
L4 nerve root: Medial malleolus and central knee
Student studying for exams starts working at new chair. Resting elbows on chair. Complains of weeks of pain/tingling in forearm/hand and weakness of hand strength.
Cubital tunnel syndrome: compression of ulnar nerve at cubital tunnel
Shoulder abduction nerve roots?
C5, C6
S1 nerve root sensation?
S1 nerve root: Lateral foot
L5 nerve root sensation?
L5 nerve root: Lateral knee, dorsum of foot
Finger flexion nerve roots?
C7, C8
What classificaton is this?
Mx?
Weber C
If neurovascular comprimise, immediate reduction under sedation
Bimalleolar (at least, need lateral view for posterior tibia) with talar displacement: ORIF
Distal radial fracture with volar displacement and angulation. Dx?
Smith’s fracture
If there was an L5/S1 disc prolapse. which nerve root will be impinged and what deficit produced?
Lower nerve root (S1) - plantar flexion of foot
NOF. What muscle causes the external rotation?
Ilioposas attach to lesser trochanter
Pain over the lateral epicondyle on elbow?
Tennis elbow/ Lateral epicondylitis
Tendonitis of extensor carpi radialis longus
Pain over the medial epicondyle of elbow?
Golfer’s elbow/ medial epicondylitis
Tendonitis of the floxor-pronator muscles
Associated with what muscle?
ASIS avulsion fracture associated with satorius muscle.
