Block 3: GL 25 Gray's Questions

Question 1

Describe “winged scapula”

what is it?
what causes it?

Answer 1

winged scapula: the medial border of the scapula lifts off the chest wall when the patient pushes against resistance & the inferior portion will visibly protrude

cause: loss of innervation of the serratus anterior (long thoracic nerve issues)

Question 2

Erb’s Palsy

injury type
common sign
what is lost?

Answer 2

injury: upper brachial plexus
sign: waiters tip hand
loss of: abduction, flexion, & lateral rotation of the arm (arm will be adducted, extended @ medially rotated)

Question 3

What happens with “Saturday Night Palsy”

Answer 3

usually happens when people fall asleep over the back of a chair and compress the nerve in the spiral groove of the humerus (radial nerve)

Question 4

What happens if the spinal accessory nerve is injured?

Answer 4

the trapezius muscle will be paralyzed, leading to drooping of the shoulder

Question 5

Which spinal cord level makes the most significant contributions to the radial nerve?

Answer 5

7th cervical nerve

Question 6

Function of the supraspinatus muscle

Answer 6

abduction from 0-15 degrees

Question 7

What nerve root is the source of motor supply to the intrinsic hand muscles?

Answer 7

T1

Question 8

Describe the innervation of the pectoralis major near the clavicular head

Answer 8

the 1st branch of the lateral pectoral nerve is typically the supply to the clavicular head of the pectoralis major

if that nerve is cut, you can expect to see some atrophy of the muscle due to lack of innervation

Question 9

Serratus anterior f(x)

Answer 9

rotation of the scapula & raising the arm above the level of the shoulder

Question 10

Describe the course of the axillary nerve and how it can be affected by injury

Answer 10

the axillary nerve wraps around the surgical neck of the humerus to innervate the teres minor and the deltoid muscle

when the head of the humerus is injured or dislocated, the nerve is usually in danger

Question 11

During childbirth, downward traction applied on the shoulders and upper limb leads to

Answer 11

a traction injury of the upper brachial plexus

Question 12

What nerve would be the cause of the following symptoms:

weak supination
weak hand grasping
wrist drop

Answer 12

radial nerve

Question 13

Pectoralis Major f(x)

Answer 13

adduction, anteriorly rotating the scapula, medially rotating the upper limb

Question 14

F(x) of the suprascapular nerve

Answer 14

innervate the supraspinatus muscle, which is responsible for abduction from 0-15 degrres

Question 15

F(x) of the deltoid muscle

Answer 15

abduction from 15-90 degrees

Question 16

Injury to the superior trunk of the brachial plexus affects nerves going to:

Answer 16

suprascapular
axillary
musculocutaneous

Question 17

What happens if the suprascapular and axillary nerves are damaged?

Answer 17

impaired abduction & lateral rotation of the forearm

Question 18

Significance of Intertubercular Sulcus

Answer 18

origin for the pectoralis major and the latissimus dorsi

Question 19

Latissimus Dorsi innervation

Answer 19

thoracodorsal nerve (C6-C8_=)

Question 20

Describe the cause and effect of Tennis elbow

Answer 20

cause: flexors and extensors in the forearm have long, tendinous origins.

relevance to tennis elbow: extensor muscles originate from the lateral epicondyle, and overuse/strain of the common tendon leads to inflammation around the area of the affected epicondyle (in this case, the lateral epicondyle)

Question 21

Describe the cause and effect of Golfer’s elbow

Answer 21

cause: flexors and extensors in the forearm have long, tendinous origins.

relevance to golfers elbow: extensor muscles originate from the medial epicondyle, and overuse/strain of the common tendon leads to inflammation around the area of the affected epicondyle (in this case, the medial epicondyle)

Question 22

What is the symptomology of a superior brachial plexus trunk injury?

Answer 22

“waiters position/tip”

limb hangs by the side in medial rotation

Question 23

Lower trunk injury of the brachial plexus is called

Classic sign

Answer 23

Klempke’s palsy

claw hand