UE Facts

Question 1

Rotator cuff msucles

Answer 1

C5-6

supraspinatus, infraspinatus, teres minor, subscapularis

Question 2

Supraspinatus

Answer 2

Suprascapular n. initial arm abduction

Most commonly injured (tendinopathy)

Question 3

Infraspinatus

Answer 3

Suprascapular n., lateral arm rot. pitching injury

Question 4

Teres minor

Answer 4

Axillary n. - adduct and laterally rotate arm

Question 5

Subscapularis

Answer 5

Upper/lower subscapular nn. medially rotates and adducts arm

Question 6

Muscles of arm abduction and nerves

Answer 6

Supraspinatus- suprascapular n.
Deltoid- axillary n.
Trapezius- CN XI
Serratus anterior- long thoracic n.

Question 7

Medial epicondylits

Answer 7

Golfer’s elbow, repetitive flexion, pain is medial

Question 8

Lateral epicondylits

Answer 8

Tennis elbow, repetitive extension, pain is lateral

Question 9

Wrist bones

Answer 9

Scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezoid, trapezium

Scaphoid is in anatomical snuff-box, broken in FOOSH leading to avasc. necrosis

Dislocation of lunate can lead to CTS

Question 10

Carpal tunnel syndrome

Answer 10

Entrapment of median nerve in CT leading to thenar wasting, but sensory sparing (palmar cutaneous branch)
Assoc. with pregnancy, RA, hypothyroidism, diabetes, acromegaly, dialysis-related amyloidosis, or repetitive use.
Tinel sign/ Phalen maneuver (percussion/flexion)

Question 11

Guyon canal syndrome

Answer 11

Ulnar n. compressed, cyclists

Question 12

Axillary n.

Answer 12

C5-6
Fx of surg. neck of humerus, disloc. of humerus
Present: flattened deltoid, loss of arm abduction, loss of sensation over deltoid

Question 13

Musculocutaneous n.

Answer 13

C5-7
Upper trunk compression
Loss of forearm flexion and supination
Loss of sensation over lateral forearm

Question 14

Radial n.

Answer 14

C5-T1
Midshaft humeral fx (deep brachial a.)
Axillary compression
Wrist drop (loss of elbow, wrist, finger extension)
Decreased grip strength
Loss of sensation over posterior arm/forearm and lateral dorsal hand

Question 15

Median n.

Answer 15

C5-T1
Supracondylar fracture of humerus (prox.)
CTS/ wrist laceration (distal)
Ape hand and sign of benediction
Loss of wrist flexion and 2LOAF
Loss of sensation over dorsal and palmar lateral 3.5 fingers with prox. lesion

Question 16

Ulnar n.

Answer 16

C8-T1
Fx of medial epicondyle of humerus (prox) or hamate (distal)
On extension -> ulnar claw
radial deviation on wrist flexion (prox lesion)
loss of wrist flexion, flex of medial digits (interossei), medial 2 lumbricals
Loss of sensation in medial 1.5 fingers and hypothenar eminence

Question 17

Recurrent branch of median n.

Answer 17

C5-T1
Ape hand
loss of thenar muscles (OAF)
no sensation loss

Question 18

Erb’s palsy (waiter’s tip)

Answer 18

Upper trunk C5-6, lateral traction on neck during delivery or in adults, trauma
muscles effected: deltoid, supraspinatus (no abd.), infraspinatus (arm medially rotated), biceps (arm stuck extended and pronated)

Question 19

Klumpke palst

Answer 19

Lower trunk (C8-T1) delivery, grabbing during a fall
Deficit in intrinsic hand muscles, lumbricals, interossei, thenar and hypothenar musc.
Total claw hand
Ptosis

Question 20

Thoracic outlet

Answer 20

Compression of lower trunk and subclavian vessels
Cervical rib or Pancoast tumor
Klumpke and edema

Question 21

Winged scapula

Answer 21

Lesion of long thoracic nerve (axillary dissection)

Serratus anterior, cannot raise arm above horizontal

Question 22

Ulnar claw

Answer 22

at rest/or during extension 4th and 5th digits can’t extend due to a distal ulnar nerve injury (hamate fx)

Question 23

Sign of benediction

Answer 23

while making a fist, can’t contract 1st, 2nd and 3rd digits from a proximal median nerve injury

Question 24

Median claw

Answer 24

while trying to extend fingers, 1st, 2nd and 3rd digit can’t extend
From a distal median nerve injury (CTS/ wrist laceration)

Question 25

OK sign

Answer 25

While trying to make a fist, 3rd and 4th digits can’t

from a prox. ulnar n. injury

Question 26

Ape hand

Answer 26

thenar wasting leading to unopposable thumbs in median n. lesions

Question 27

Hypothenar atrophy

Answer 27

ulnar lesion