Anatomy and Behavioral Science Flashcards
What is carpal tunnel syndrome? What dislocation could cause it?
Compression of median nerve as it travels through carpal tunnel.
Dislocation of lunate may cause.
What is the most commonly fractured carpal bone? Where is this bone and how is it frequently fractured?
Risks following fracture? Why?
Scaphoid bone, palpated in the anatomical snuffbox
Fracture frequently from fall onto outstretched arm for direct axial compression or wrist hyperextension – presents with persistent wrist pain and tenderness.
Prone to avascular necrosis due to its retrograde blood supply
Bones of wrist? Go from proximal thumb CCW.
Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, Trapezium
“So Long To Pinky, Here Comes The Thumb”
Pt on crutches that can’t extend wrist - damage to which nerve?
Radial nerve
weakness of all forearm, wrist, and finger extensors (“wristdrop”)
What are the three points of insertion of the sternocleidomastoid muscle? What is its function and innervation?
originates from:
medial clavicle and manubrium
inserts on:
mastoid process of the skull
function: turn the head in the opposite direction
innervation: CN XI
Pt with flattened deltoid, loss of sensation over deltoid and/or lateral arm on pinprick - what nerve damaged? Cause of this injury?
Axillary nerve damage (C5-C6)
innervates deltoid and teres minor muscles; provides sensory innervation to lateral arm, including skin overlying deltoid
fractured surgical neck of humerus; anterior dislocation of humerus
What is Trendelenburg sign? What nerve is damaged and on which side?
pt faces away from examiner while lifting each foot off ground
sign is positive when hip dips toward unaffected side while pt stands on affected leg
superior gluteal nerve (L4-S1)
weakness of gluteus medius and gluteus minimus
(function to pull the pelvis down and abduct the thigh)
Presentation of pt with damage to inferior gluteal nerve?
L5-S2
innervates the gluteus maximus muscle (damage = loss of hip extension)
difficulty rising from seated position and climbing stairs
Decreased medial thigh sensation and decreased thigh adduction?
Damage to obturator nerve (L2-L4)
pelvic surgery
Pt that cannot extend leg or flex at thigh?
Femoral nerve (L2-L4) lesion pelvic fracture
Name the rotator cuff muscles. Which is the most commonly injured and what is the presentation?
"SITS" Supraspinatus Infraspinatus Teres minor Subscapularis
Most commonly injured is supraspinatus (initial abduction of arm) - pain during abduction of humerus.
Pt with long thoracic nerve damage - what are the two signs? What muscle? What procedures do this?
- winged scapula (when press anteriorly against wall)
- inability to abduct above horizontal
serratus anterior
axillary node dissection after mastectomy and stab wounds
Lesion associated with “waiter’s tip” arm? Causes?
Erb palsy - traction/tear of upper trunk (C5-C6 roots)
violent stretch between head and shoulder:
infants - during delivery
adults - trauma
Denervation atrophy with loss of the thenar eminence? Hypothenar eminence?
“ape hand deformity” / unopposable thumb
seen in median nerve lesions
hypothenar eminence - ulnar nerve lesions
Course of the median nerve? Ulnar nerve?
median:
- courses between humeral and ulnar heads of pronator teres muscle
- runs between flexor digitorum superficialis and flexor digitorum profundus muscles before entering wrist and hand within carpal tunnel
ulnar:
- courses between flexor carpi ulnaris and flexor digitorum profundus in forearm