USMLE World Additional Flashcards
Discuss a “winged scapula” and what it looks like clinically.
The Serratus Anterior serves to fix the scapula against the posterior chest wall and rotate the scapula to allow abduction of the arm over the head. Paralysis of this muscle occurs with injury to the long thoracic nerve and results in a winged scapula
We do cricothyrotomy when a patient needs a patent airway. What do we pass through to get there?
It passes through the superior cervical fascia, pretracheal fascia, and the cricothyroid membrane.
Trauma or sustained pressure to the neck of the fibula can cause injury to the ______ leading to foot drop
Common fibular/peroneal nerve
Radial head subluxation can lead to this neurological finding
The deep branch of the radial nerve arises near the lateral epicondyle of the humerus where the humerus articulates with the head of the radius. Radial Head subluxation can damage the deep branch of the radial nerve, causing weakness of the forearm and hand extensors but no sensory defects.
This artery runs with the radial nerve along the shaft of the humerus
Deep Brachial Artery
The Axillary artery becomes the brachial artery, but not before giving off first the anterior and posterior circumflex humeral arteries as well as the deep brachial artery, which runs with the radial nerve. The brachial artery breaks off into the ulnar and radial arteries after the elbow.
Discuss, post trauma, what may cause a patient to lose fine motor skills in their hand
Lower trunk of the brachial plexus being injured.
These feed from C8 - T1 nerves leading to the median and ulnar nerves, which control the intrinsic hand muscles.
Sciatica can present with varying symptoms depending on what nerve root is affected. L4 - S1 are all culprits, with L5 and S1 being the most common.
Differentiate between L5 and S1 issues
L5 - Posterior and lateral thigh and leg pain shooting down to the inner foot
S1 - Strictly posterior thigh and leg shooting to the foot, accompanied by weakness with plantar flexion and loss of the ankle jerk reflex.
What muscles do we use when sitting up from a supine laying position?
- External abdominal obliques
- Rectus abdominis
- Hip flexors (Illiopsoas, Rectus Femoris, Tensor Fascia Lata)
The musculocutaneous nerve innervates the flexors of the arm. What sensory innervation does it provide?
Lateral forearm sensory input
What are the wrist bones?
lateral-to-medial in the proximal row and then the distal row:
Some Lovers Try Positions That They Cannot Handle
- Scaphoid, Lunate, Triquetrium, Pisiform
- Trapezium, Trapezoid, Capitate, Hamate
Prolonged irritation to a bursa can lead to bursitis.
What bursitis do we worry about in folks with constant knee pressure?
Prepatellar bursitis
Discuss the etiology behind cauda equina syndrome vs. conus medullaris syndrome
In an adult, the spinal cord terminates in a tapering fashion at the conus medullaris at approximately the L2 vertebral level, spreading out to the cauda equina.
Conus medullaris syndrome refers to lesions at L2. Symptoms include flaccid paralysis of the bladder and rectum, impotence, and saddle anesthesia (S3 - S5 roots). Usually caused by herniated disc, tumors, or spinal fractures.
Cauda equina is due to a massive rupture of an intervertebral disc that is capable of causing compression of two or more of the 18 spinal nerve roots at the cauda equina. Low back pain, saddle anesthesia, reflex losses, bladder/sphincter control loss with plantar flexion issues, etc are all common symptoms, involving typically S2 - S4 nerve roots.
Injection at what point in the glutes will yield a positive trendelenburg sign?
Superomedial quadrant of the left buttock
