Flashcards
(24 cards)
Injury to the neck,
Deviation of tongue towards paralysed side
Hypoglossal nerve injury
Loss of gag reflex,
Loss of taste in post 1/3 of tongue
Glossopharyngeal nerve lesion
Facial weakness+ loss of taste in ant 2/3 of tongue
Facial nerve injury
Lymph nodes drainage
Ant 2/3 of tongue?
Post 1/3 of tongue?
Tip of tongue
Skin ( scrotum, valva, perineum)
Gonads
Lateral foot
Posterior oropharynx
Glans clitoris
Submandibular LN
Jugulo-omohyoid LN
Sub mental LN
Superficial Inguinal LN (all below umbilicus) except:-
Gonads (testis and ovaries): Para Aortic LN
Lateral foot: Popliteal LN
Jugular LN ( deep cervical LN)
External iliac LN
Vocal cord paralysis, weak cough, dysphonia and parasympathetic problems such as constipation, tachycardia, afib, arrythmias, sexual dysfunction and gastrparesis.
Vasgus nerve lesion
Jaw deviation to side of weak pterygoid muscle, mastication muscle weakness and loss of sensation of face
Trigeminal nerve lesion
Double vision on climbing up and down
Trochlear nerve SO4
Double vision on looking sideways
Abduscens nerve LR6
Mydriasis, ptosis, exophthalmos
Enophthalmos and ptosis
Diplopia on downward gaze
Diplopia on looking right or left
Occulomotor nerve lesion
Horner syndrome
Trochlear
Abducens right or left ipsilateral
Memory loss and superior homonymous quadrantanopia
Temporal lobe stroke
Inferior homonymous quadrantanopia
Parietal lobe stroke
Bitemporal homonymous hemianopia
Pituitary tumor
Deep tendon Reflexes:
Ankle
Knee
Biceps
Triceps
Anal wink refelx
Cremasteric reflex
Brachioradialis
S1,S2 Sciatic nerve
L3,L4 Femoral nerve
C5,C6 Musculocutaneous nerve
C7,C8 Radial nerve
S2-S4
L1,L2
C6,C7 Radial nerve
Causes wrist extension with radial deviation
Dorsiflexion of foot ( tight fitting shoes, pain in dorsum of foot, fibular neck fracture)
Deep peroneal nerve supplies small area between first and second toe, superficial peroneal nerve supplies dorsum of foot. Common peroneal nerve is injured in fibular neck fracture.
Motor functions of cervical roots
C5
C6
C7
C8
T1
Flex elbow
Extend wrist
Extend elbow
Flex fingers
Adduct and abduct fingers
Structures at important vertebral levels
C6
C7
T4
T8
T10
T12
L1
L3
L4
C6- Trachea and esophagus begins
Larynx and pharynx end
C7- isthmus of thyroid gland
Stellate ganglion
T4- Arch of aorta
Carina
Azygos vein drain into svc
T8- Inferior vena cava hiatus
T10- Esophageal hiatus
T12- Aorta hiatus
L1- Transpyloric plane, 9th costal cartilage, pylorus of stomach, fundus of gall bladder, neck of pancreas, Conus medularis (end of spinal cord), hilum of kidneys, superior mesenteric artery, celiac trunk
L3- Umbilicus, umbilical dermatome T10
L4- Iliac Crest
Bifurcation of abdominal aorta
Duputyeren contracture
It is a progressive disorder of thickened fibrous tissue within the palmar fascia usually in line with the fifth or ring finger results ultimately in flexion position of affected fingers.
Risk factors: Diabetes, laborer, smoking, phenytoin use, alcohol excess
Management is fascisctomy to release contracture
Lower limb nerve injuries
Femoral nerve
Obtruator nerve
Sciatic nerve
Tibial nerve
- L2 to S3. Loss of knee extension and some loss of hip flexion. Paraesthesia of medial aspect of thigh.
- Hip adduction. Skin of middle part of medial thigh
- Foot drop, loss of sensation below the knee laterally. Give rise to common peroneal nerve (spn- foot eversion, dpn-foot dorsiflexion) and tibial nerve.
- Foot plantar flexion and inversion. Sensory supply to sole of foot
- Paraesthesia of thumb, index and middle finger
- Paresthesia of little+ring finger
- Paraesthesia of dorsal aspect of thumb and btween index and middle finger area
- Median N
- Ulnar nerve
Proximal injury to elbow causes loss of sensation over little+ ring finger while distal injuries at wrist cause clawing of hand.
“ the closer to the the paw, the worse the claw” - Radial N
- Housemaids knee
- Retroperitoneal organs
- Perforated duodenal/pyloric ulcer
- Perforated posterior gastric ulcer
- Pancreas
- Prepatellar bursitis, swelling and pain over anterior inferior patella. Symptoms include redness, inability to flex the knee and pain+ swelling is localized over the bursa ( below patella)
- Suprarenal (adrenal) glands, IVC & aorta, duodenum (sec and third part), pancreas, ureters, colon (ascending and descending), kidneys, inferior part of rectum and esophagus.
- Greater sac
- Lesser sac
- Lesser sac
Blood supply of lower limb
External iliac A –> Femoral A –> Popliteal A –> Anterior Tibial A –>Dorsalis pedis A
Site of obstruction is always one level proximal to that of affected muscle group.
Doing push up against wall scapula winging is exaggerated?
Winging exaggerated by slowly lowering arm?
Winging exaggerated by arm abduction at shoulder level?
Long thoracic nerve
Dorsal scapular nerve
Accessory nerve
Doing push ups is Long Tiring Work
Arm needs to be abducted to wear accessories
DorSLOW scapular nerve, slow lowering of arm
Lumbosacral nerve root entrapments
L4
L5
S1
Motor weakness of knee extension
Motor weakness of big toe dorsiflexion
Motor weakness of plantar flexion
PED
TIP
Peroneal Eversion Dorsiflexion
Tibial Inversion Plantarflexion
