Primer 4

Question 1

Ulnar nerve:

Motor and sensory distribution

Answer 1

Motor: 1/2FCU, FDP and a bunch of hand muscles (Hypothenar muscles, Interosseous muscles, 3-4th lumbricals)

Sensory: 4th-5th digits and palmar/dorsal sides of medial hand

Question 2

Median nerve:

Motor and sensory distribution

Answer 2

Motor:

• -pronators and flexors of forearm/wrist/thumb except FDP& 1/2 of FCU (which have ulnar innervation)
• remember palmaris longus is a forearm flexor, just not appropriately named.
• -1&2 lumbricals

Sensory: lateral palm and first 3.5 digits

Question 3

What is “ape hand deformity”?

Answer 3

Median nerve pathology. Loss of thumb abduction.

Question 4

Compare hand of benediction and ulnar claw:

Answer 4

Ulnar claw:
Abnormality that is present at rest
(Digits 4-5 are hyperextended at MCP/ hyperflexed at IP)

Hand of benediction:
Median nerve pathology, present when patient attempts to make a fist
(Digits 1-3 are unable to flex, while 4-5 remain functional/can flex)

Question 5

Hallmark symptom of carpal tunnel:

Answer 5

Numbness of the first 3.5 digits

Question 6

Musculocutaneous nerve:

Muscle and sensory innervation

Answer 6

Motor: coracobrachialis, brachialis, biceps
Sensation: lateral forearm

Question 7

Axillary nerve:
Motor distribution 
Sensory distribution 
Artery with which it travels 
(2) related pathologies

Answer 7

Motor: Deltoid and teres minor
Sensory: lateral shoulder
Artery: posterior circumflex
Related pathologies: anterior shoulder dislocation and fracture of surgical neck of humerus

Question 8

Function of teres minor?

Relevant in what pathology?

Answer 8

External rotation of the arm

Axillary nerve damage

Question 9

Long thoracic nerve

Motor distribution and related pathology

Answer 9

Serratus anterior

Winged scapula

Question 10

Two causes of long thoracic nerve damage

Answer 10

Radical mastectomy

Blow to neck/shoulder

Question 11

Loss of elbow flexion and forearm supination would be seen in damage to what terminal branch of the brachial plexus?

Answer 11

Musculocutaneous

Question 12

Loss of ability to abduct and adduct digits would be caused by damage to what nerve/ loss of innervation to what muscles?

Answer 12

Ulnar nerve damage –> denervation of interosseous muscles

Question 13

What are degmacytes

Answer 13

“Bite cells”- cells that have been damaged by splenic macs

Question 14

What nerves are responsible for these reflexes:

Achilles
Patellar
Biceps
Triceps

Answer 14

Achilles-S1
Patellar-L4
Biceps-C5
Triceps- C7

Question 15

Who is susceptible to Listeria infection?

Notable sequelae?

Answer 15

Neonates and Immunocompromised patients

May cause neonatal meningitis or spontaneous abortion via alteration of amniotic fluid

Question 16

Radial Nerve:
Motor and sensory distribution
+(2) key related pathological conditions

Answer 16

Motor- BEST: brachioradialis, extensors, supinators, triceps
Sensory- posterior arm and dorsal hand

Saturday Night Palsy, fracture of shaft of humerus