Passmed MSK Questions Flashcards
Erb’s palsy- presentation
Flexion of the wrist with a medial rotated and extended forearm.
Foot drop (loss of dorsiflexion and eversion) and loss of sensation to lateral aspect of foot
This presentation is caused by damage to which nerve?
Common peroneal nerve which winds around the fibula neck. Damage causes foot drop and loss of sensation to the lateral and posterior aspect of leg, injury usually occurs at the fibula head.
Role of plantar extensor muscles
Dorsiflexion of foot
Where do sciatic nerve injuries typically occur?
Near the hip joint
Presentation of radial nerve injury?
Wrist drop and difficulty extending the wrist or fingers
Which nerve is important for dorsiflexion?
Common peroneal nerve which innervates the anterior leg compartment.
What is the cutaneous innervation to the lateral and posterior surfaces of the thigh?
Lateral sural cutaneous nerve
Extensor pollucis brevis vs extensor pollucis longus
Extenso pollucis longus attaches at the distal hallux
Extensor pollucis brevis attaches at the MCP joint
Psoas minor origin and insertion
Arises from the vertebral fasicles to insert onto the T12 and L1.
Which nerve is responsible for thumb adduction?
Thumb adduction is carried out by the adductor pollucis, innervated by the Ulnar nerve
Which intrinsic muscles of the hand are not innervated by the ulnar nerve?
LOAF
Lateral 2 lumbar Ickes
Oppones pollucis
ABductor pollucis brevis
Flexor pollucis brevis
What is wrist drop?
Inability to extend the wrist
What is the cutaneous innervation to the foot laterally?
Sural nerve
What is the innervation to the sole of the foot?
Terminal branches of the tibial nerve, from the medial and lateral plantar nerve.
What is the innervation to the dorsal of the foot?
Superficial fibular nerve, a branch of the common fibular nerve
What is the innervation between the 1st and 2nd toe?
Deep fibular nerve.
Nerve innervation arm abduction
Axillary nerve
Presentation of Klumpke’s Palsy
Affects the intrinsic muscles of the hand and causes claw hand with hyperextended wrist.
Pins and needles around thumb and index
Paraesthesia caused by nerve compression of median nerve in carpal tunnel
(Radial nerve injury would present as wrist drop)
Which nerve innervates triceps?
Radial nerve innervates all 3 heads
Which fracture type is common in children
Supracondylar fracture of humerus
Muscles responsible for foot inversion
Tibialis posterior
+
Tibialis anterior
+ extensor hallucs longus
Which nerve follows the path of the sapphenous vein?
Sural nerve which is most superficial
Which muscle initiates shoulder abduction?
Supraspinatous
What is the contents of the adductor canal?
Sapphenous nerve and superficial femoral branch of femoral artery and vein.
Which muscles adduct the shoulder?
Lattisimus dorsi
Pectoralis major
Teres major
Coracobrachialis
What muscles abduct the shoulder?
Deltoid muscle
Roots of the radial nerve
C5-C8
What connects the radial head to the notch of the ulna?
Annular ligament.
Flexed wrist and fingers
Wrist drop due to radial nerve lesion
Contents of antebrachial fossa
Radial nerve
Brachial tendon
Brachial artery
Median nerve
Inability to flex, abduct or adduct medial 2 digits of right hand
Affects digit 4 and 5 of right hand, due to claw deformity caused by ulnar nerve lesion.
Where does the biceps femoris attach?
To fibular head.
Which artery lies between submandibular gland and parotid gland?
Facial artery
Mid-humeral shaft fracture affects.
Radial nerve
What are the boundaries of the femoral canal?
Located within the femoral triangle:
Anteriorly: Inguinal ligament
Laterally: Lacunar ligament
Posteriorly: Pectineal ligament
Medially: Femoral vein
It has an opening for the Saphenous vein.
What does the femoral canal contain?
Femoral lymphatic vessels
Connective tissue
Deep lymph node
—> THe femoral canal is located within the femoral triangle next to the femoral vein, and has empty space to allow for distention of the vessel.
Which structures are present in the carpal tunnel?
Flexor pollucis longus
Flexor digitorum profundus
Flexor digitorum superficialis
Median nerve
Which nerve is found near the medial epicondyle?
Ulnar nerve. Damage causes radial deviation at the wrist
What is the innervation to the adductor pollucis?
Ulnar nerve. Adductor pollucis has a transverse and oblique head.
Nerve commonly injured in a supracondylar fracture
Median nerve
What i
How do proximal ulnar nerve injuries present?
Proximal ulnar nerve injuries cause the denervation of flexor digitorum profundus, causing decreased flexion of the finger. This has a less severe appearance of claw hand compared to distal injuries.
Where are lumbar punctures taken?
Subarachnoid space, where CSF is present.
What mainly forms the deep palmar arch?
Radial artery
What mainly forms the superficial palmar arch?
Ulnar artery
Which muscles are innervated by median nerve?
LOAF
Lumbricals (first and second)
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
What is present in the carpal tunnel?
Flexor pollucis longus
Flexor digitorum superficialis
Flexor digitorum profundus
Which myotome is affected in reduced ankle reflex?
S1- this is also responsible for plantarflexion
Myotome for knee reflex?
L3
What is Cauda Equina syndrome?
Sudden onset back pain due to compression of nerve roots below L1.
Can cause urinary dysfunction, reduced perianal sensation and anal tone.
Causes weakness in straight leg test.
