Primer 3

Question 1

Which Gram positive organisms are associated with the following:

1. infant with poor muscle tone
2. diarrhea after ABX use
3. respiratory distress in postal worker
4. otitis media in kiddos
5. cellulitis

Answer 1

1. clostridium botulinum
2. clostridium difficile
3. bacillus anthracus (sp?)
4. strep pneumo (but commonly viral!)
5. staph aureus, strep pyo (GAS)

Question 2

What is the classic presenting symptom in Lyme Disease?

Answer 2

Erythema Chronica Migrans:

expanding bull’s eye rash with central clearing

Question 3

Describe the function of MQs in the spleen:

Answer 3

clear bacteria and dysfunctional cells

Question 4

Long Thoracic N:

Innervates? Action of mm?

Answer 4

“SALT”

Serrates Anterior: holds the scapula to the thorax

Question 5

Suprascapular N:

Innervates? Action of mm?

Answer 5

Infraspinatus: external rotation
Supraspinatus: abduction of forearm

Question 6

Lateral Pectoral Nerve:

Innervates? Action of mm?

Answer 6

Pectoralis major: flexion, adduction, medial rotation

Question 7

Upper Subscapular N:

Innervates ? Action of mm?

Answer 7

Subscapularis: Internal rotation

Question 8

Thoracodorsal N:

Innervates? Action of mm?

Answer 8

Latissimus Dorsi:
extension, adduction, transverse extension
flexion from extended position, internal rotation

Question 9

Lower Subscapular Nerve:

Innervates ? Action of mm?

Answer 9

Teres Major: medial rotation, adduction

Question 10

Musculocutaneous Nerve:

Innervates ? Action of mm?

Answer 10

1. Biceps
2. coracobrachialis
3. brachialis

Major flexors of the arm

Question 11

Axillary N:

Innervates ? Action of mm?

Answer 11

1. Deltoid: abduction

2. Teres Minor: Lateral rotation of humerus

Question 12

Radial N:

Innervates ? Action of mm?

Answer 12

1. Triceps
2. Extensors

Extend arm and forearm

Question 13

Median N:

Innervates ? Action of mm?

Answer 13

1. Pronators
2. Thenar muscles

Pronate the arm

Question 14

Ulnar N:

Innervates ? Action of mm?

Answer 14

1. Interosseous mm.
2. Hypothenar mm.

Flex and adduct the hand

Question 15

Describe Injury to the C5-C6 Nerve roots; how does this most commonly occur?

Answer 15

Erb Duchenne Palsy (Waiter's tip): 
Complete or partial paralysis of upper arm due to bruising/ stretching of the following nn. 
1. suprascapular 
2. musculocutaneous 
3. axillary 

CAN NOT: Abduct, laterally rotate, flex, or supinate arm

#1 Cause = dystocia during delivery of LARGE  BABY
Other causes: neonatal clavicle fracture

Question 16

Describe Injury to the C8-T1 Nerve roots; how does this commonly occur? Clinical presentation? Common Causes?

Answer 16

Klumpke’s Palsy (Thoracic Outlet Syndrome):

1. Atrophy thenar + hypothenar eminences, interosseous mm. w/ claw hand
2. Sensory loss @ medial forearm and medal side of hand
3. loss of radial pulse with head moving due to compression of subclavian a.

#1 Cause: cervical rib compression 
Other causes: hypertrophy of anterior scalene m.

Question 17

Boarders and Contents of the posterior triangle of the neck

Answer 17

Boarders: Trapezius, clavicle, SCM

1. Brachial plexus
2. Subclavian v.
3. EJV
4. Inferior omohyoid

Question 18

Boarders and contents of the anterior triangle of the neck

Answer 18

Boarders: Trachea (midline), SCM, Mandible

1. Sternohyoid
2. Sternothyroid
3. Superior omohyoid
4. Posterior belly of digastric m.