Musculoskeletal

Question 1

Erb palsy

Answer 1

upper trunk (C5, C6 roots); deltoid, supraspinatus; infraspinatus; biceps brachii; waiter’s tip

Question 2

Klumpke palsy

Answer 2

lower trunk (C8-T1 root); intrinsic hand muscles: lumbricals, interossei, thenar, hypothenar; total claw hand

Question 3

winged scapula

Answer 3

lesion of long thoracic nerve (C5,6,7) roots; serratus anterior–>cannot abduct arm above horizontal position

Question 4

axillary nerve lesion caused by:

Answer 4

fractured surgical neck of humerus; anterior dislocation of humerus

Question 5

axillary nerve lesion deficits;

Answer 5

flattened deltoid, loss of arm abduction at shoulder greater than 15 degrees; loss of sensation over deltoid muscle and lateral arm

Question 6

musculocutaneous nerve lesion caused by:

Answer 6

upper trunk compression

Question 7

musculocutaneous nerve deficits:

Answer 7

loss of forearm flexion and supination; loss of sensation over lateral forearm

Question 8

radial nerve injury caused by:

Answer 8

midshaft fracture of humerus; compression of axilla (due to crutches) or saturday night palsy;

Question 9

radial nerve deficits:

Answer 9

wrist drop: loss of elbow, wrist and finger extension; decreased grip strength (wrist extensors are necessary for maximal action of flexors); loss of sensation over posterior arm/forearm and dorsal hand

Question 10

median nerve injury caused by:

Answer 10

supracondylar fracture of humerus (proximal lesion); carpal tunnel syndrome and wrist laceration (distal lesion)

Question 11

median nerve injury deficit:

Answer 11

Ape hand and Pope blessing; loss of wrist and lateral finger flexion, thumb opposition, lumbricals of 2nd/3rd digits; loss of sensation over thenar eminence and dorsal/palmar aspects of lateral 3.5 fingers w/ proximal lesion

Question 12

ulnar nerve injury caused by:

Answer 12

fracture of medial epicondyle of humerus “funny bone” (proximal lesion); fractured hook of hamate (distal lesion);

Question 13

ulnar nerve deficit:

Answer 13

ulnar claw on digit extension; radial deviation of wrist upon flexion (proximal lesion); loss of sensation in hand according to ulnar distribution

Question 14

recurrent branch of median nerve damage caused by: deficit?

Answer 14

superficial laceration of palm; ape hand; loss of thenar muscle group: opposition, abduction, flexion of thumb; no loss of sensation

Question 15

ulnar claw vs pope’s blessing

Answer 15

ulnar claw when extending fingers at rest–distal lesion of ulnar nerve; pope’s blessing when making a fist–proximal median nerve lesion

Question 16

median claw vs OK gesture

Answer 16

median claw when extending fingers at rest–distal median nerve; OK gesture when making a fist–proximal ulnar nerve

Question 17

obturator nerve injury

Answer 17

L2-L4; decreased medial thigh sensation, decreased adduction

Question 18

femoral nerve injury

Answer 18

L2-L4; decreased thigh flexion and leg extension

Question 19

common peroneal nerve injury caused by:

Answer 19

L4-S2; trauma or compression of lateral aspect of leg; fibular neck fracture

Question 20

common peroneal nerve deficit:

Answer 20

foot drop–inverted and plantarflexed at rest; loss of eversion/dorsiflexion; steppage gait; loss of sensation on dorsum of foot

Question 21

Tibial nerve injury caused by:

Answer 21

L4-S3: knee trauma, baker cyst (proximal lesion); tarsal tunnel syndrome (distal lesion)

Question 22

tibial nerve deficit:

Answer 22

inability to curl toes and loss of sensation on sole of foot; in proximal lesions (baker cyst) foot is everted at rest with loss of inversion and plantaflexion

Question 23

superior gluteal nerve injury caused by:

Answer 23

L4-S1: posterior hip dislocation, polio

Question 24

superior gluteal nerve deficit:

Answer 24

trendelenburg sign/gait (superior nerve innervates gluteus medius/minimus); lesion is contralateral to the side of the hip that drops; ipsilateral to extremity on which patient stands

Question 25

inferior gluteal nerve deficit:

Answer 25

difficulty climbing stairs, rising from seated position, loss of hip extension (inferior nerve innervates gluteus maximus)

Question 26

Artery/nerve running in axilla/lateral thorax:

Answer 26

long thoracic nerve; lateral thoracic artery

Question 27

A/N running in surgical neck of humerus

Answer 27

axillary; posterior circumflex artery

Question 28

AN running in midshaft of humerus

Answer 28

radial nerve; deep brachial a

Question 29

A/N running in distal humerus/cubital fossa

Answer 29

median nerve; brachial artery

Question 30

A/N running in popliteal fossa

Answer 30

tibial nerve; popliteal a

Question 31

A/N running posterior to medial malleolus

Answer 31

tibial nerve; posterior tibial