Term
NERVE LESION:
surgical neck of humerus |
|
Definition
|
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Term
NERVE LESION:
Dislocation of shoulder |
|
Definition
|
|
Term
problem of adduction from 10-90 degrees
(what other muscle is lost? what sensory loss?) |
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Definition
axillary nerve lesion
- Teres minor (lateral rotation is weakened)
- lateral side of upper arm |
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Term
NERVE LESION:
Removal of lymph nodes during mastectomy |
|
Definition
Long thoracic
(may also be lesioned by a stab wound) |
|
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Term
NERVE LESION:
Humerus fracture @ midshaft |
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Definition
|
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Term
NERVE LESION:
improper use of crutches |
|
Definition
|
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Term
loss in radial nerve injury?
motor & sensory |
|
Definition
MOTOR:
- extensor compartments (triceps are usually weak, but still functional; forarm muscles are useless)
- supinator
SENSORY:
- posterior forearm
- lateral aspect of dorsum of hand |
|
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Term
NERVE LESION:
Supracondylar fracture of humerus |
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Definition
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Term
| Proximal median nerve lacerations Sx? |
|
Definition
(i.e. in a suprcondylar fracture)
Motor:
- all forearm flexors except flexar carpi ulnaris & medial 1/2 flexor digitorum profundus (ulnar deviation on wrist flexion & no DIP flexion of digits 2&3)
- loss of pronation
- 1st & 2nd lumbricles
- thumb muscles except adductor (ulnar N)
Sensory:
- median nerve distribution of hand
Thenar muscle wasting --> ape hand |
|
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Term
|
Definition
Median nerve damage (proximal or distal)
(this means flattening of thenar eminence & inability to oppose) |
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Term
NERVE LESION:
Suicide attempt |
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Definition
| Median nerve (slashing wrist) |
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Term
NERVE LESION:
carpal tunnel/lunate dislocation |
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Definition
|
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Term
| distal median nerve lesion Sx? |
|
Definition
Motor: only hand manifestations
- thenar muscles (abductor, opponens, flexor)
Sensory:
- median nerve distribution of hand
- nebulous wrist pain & decreased grip strength in carpal tunnel; loss of sensation in fingers, but not palm |
|
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Term
NERVE LESION:
Medial epicondyle of humerus |
|
Definition
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Term
NERVE LESION:
ulnar subluxation |
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Definition
|
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Term
| Proximal ulnar nerve lesion effects |
|
Definition
Motor:
- flexor carpi ulnaris & ulnar portion of FDP (radial deviation on wrist flexion & DIP flexion of last 2 fingers lost)
- 4th&5th lumbricles
- interosseus muscles (can't ab/adduct fingers)
- adductor pollicis
- all the little finger muscles (digiti minimi)
Sensory:
- ulnar distribution of hand
2 possible manifestations:
- Popes blessing: loss of lumbricles --> hyperextension of MP & flexion of PIP/DIP of 4th&5th digits
- Claw hand: paralysis of ulnar 1/2 of FDP --> clawing when making fist |
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Term
NERVE LESION:
Slashing of wrist, hook of hamate fracture |
|
Definition
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Term
| Distal ulnar nerve lesion |
|
Definition
Motor:
- no forearm deficits
- lumbricles of 4th & 5th digit --> pope's blessing
- interosseus mucles --> can't ab/adduct fingers
- adductor pollicis
- digiti minimi muscles
Sensory:
- ulnar hand distribution |
|
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Term
NERVE LESION:
Violent stretch btw head & shoulder |
|
Definition
upper trunk of brachial plexus (C5&6)
Erb's palsy --> arm medially rotated & pronated (waiter's tip)
(From paralysis of C5&C6 --> biceps (musculocutaneous) & subscapular muscle (lower&upper subscapular nerves in posterior cord, but they derive from C5& C6) |
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Term
NERVE LESION:
sudden pull upward of arm |
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Definition
Lower trunk of brachial plexus (C8 & T1)
Klumpke's palsy
Loss of function of hand and wrist (claw hand) |
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Term
| What goes through flexor retinaculum? |
|
Definition
| FDS, FDP, Flexor pollicis longus, & median nerve |
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Term
| Contents of cubital fossa |
|
Definition
From lateral to medial:
-Radial nerve
- Biceps tendon
- Brachial artery
- Median nerve
- medial cubital vein is a superficial boundary
Boundaries of cubtial fossa:
Superior: medial/lateral epicondyle of humerus
Medial: pronator teres
Lateral: brachioradialis |
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Term
|
Definition
most common wrist fracture:
- Fracture of distal radius pulls it posterior & shortens it (dinner-fork deformity)
- often accompanied by fracture of styloid process of ulna |
|
|
Term
| avascular necrosis w/ this wrist fracture |
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Definition
| scaphoid (distal-to-proximal blood flow) |
|
|
Term
| where can you palpate anterior tibial artery? |
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Definition
| dorsalis pedis pulse (courses w/ deep peroneal nerve) |
|
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Term
| Where can you palpate posterior tibial artery? |
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Definition
behind medial malleolus (courses w/ tibial nerve)
Posterior tibial also gives off peroneal artery, which passes behind lateral malleolus |
|
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Term
| major blood supply to head & neck of femur |
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Definition
| medial femoral circumflex artery |
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Term
NERVE LESIONS:
surgery above piriformis in greater sciatic foramen; polio |
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Definition
| Superior gluteal (Trendelenburg's sign) |
|
|
Term
| Things you can get Trendelenburg's sign w/? |
|
Definition
- superior gluteal nerve lesion (above piriformis in greater sciatic foramen)
- Gluteus medius/minimus paralysis
- Polio
- Congenital/acquired hip dislocations
- Femur fractures
- Coxa vara |
|
|
Term
| which hip falls if you have a lesion of the right superior glueteal nerve? |
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Definition
| left hip (the right glut medius/maximus holds up the left hip) |
|
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Term
NERVE LESIONS:
inferior greater sciatic foramen (2) |
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Definition
| sciatic nerve & inferior gluteal |
|
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Term
can't get out of chair, climb stairs, or jump
Will lean backwards before heal strike when walking |
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Definition
| inferior gluteal nerve injury (glut max) |
|
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Term
| can't adduct thigh & sensation is lost on medial aspect |
|
Definition
obturator (rarely injured)
(courses in/around psoas --> follows internal iliac to obturator vessels --> exits through obturator foramen) |
|
|
Term
NERVE LESIONS:
Trauma to femoral triangle |
|
Definition
|
|
Term
|
Definition
Motor:
- Iliacus & sartorius --> weakened flexion of thigh
- quadriceps femors --> loss of leg extension
Sensory:
- anterior thigh
- medial leg & foot |
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|
Term
NERVE LESIONS:
Popliteal fossa trauma |
|
Definition
|
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Term
| Tibial nerve paralysis Sx? |
|
Definition
Motor:
- Gastroc, soleus, plantaris --> can't plantar flex foot
- can't flex toes (FDL & flexor ballucis longus)
- Tibialis posterior --> weakened inversion
Sensory:
- sole of foot |
|
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Term
NERVE LESIONS:
Calcaneovalgocavus (i.e. dorsiflexion & eversion of foot) |
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Definition
| Tibial (popliteal fossa injury) |
|
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Term
NERVE LESIONS:
fracture of neck of fibula/blow to lateral leg |
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Definition
| common fibular (peroneal) nerve |
|
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Term
NERVE LESIONS:
footdrop & inversion of foot --> high stepping gate |
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Definition
| common fibular (peroneal) |
|
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Term
| Common fibular (peroneal) nerve lesion |
|
Definition
Motor:
- eversion lost (peroneus longus&brevis)
- foot drop (peroneus longus)
- loss of toe extention (extensor digitorum & ballucis longus)
Sensory:
- anterolateral leg
- Dorsum of foot (between 1st & 2nd phalanges is deep peroneal, everything else is superficial peroneal) |
|
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Term
| Lower limb flexed at hip joint, adducted, medially rotated, & shorter than opposite limb |
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Definition
| posterior dislocation of hip; sciatic nerve may be damaged |
|
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Term
| where does the great saphenous join femoral vein? |
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Definition
|
|
Term
| where does the ACL attach? |
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Definition
| anterior tibia, posterior femur (prevents anterior displacement |
|
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Term
|
Definition
unhappy triad:
-MCL
-ACL
- medial meniscus or lateral meniscus, can't figure out who's right w/ this |
|
|
Term
|
Definition
| ankle forcibly everted --> medial ligament torn, which avulses medial malleolus --> ankle moves laterally --> fibula fractured |
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Term
| what is anterior to medial maleolus of ankle? |
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Definition
- saphenous nerve (sensation of medial leg)
- great saphenous vein (drainage of medial leg & thigh) |
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Term
| What is posterior to medial maleolus in order of most anterior to most posteior |
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Definition
- Tibialis anterior
- Flexor Digitorum longus
- tibial nerve & posterior tibial artery
- Flexor Hallucis longus |
|
|
Term
| Name branches of internal carotid |
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Definition
No branches in neck, 3 branches in cranium:
- Ophthalmic (goes through superior orbital fissure)
- Anterior cerebral
- Middle cerebral |
|
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Term
| Name branches of external carotid (8, all in neck) |
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Definition
- superior thyroid
- Lingual
- Facial
- Ascending pharyngeal
- Occipital
- Posterior auricular
- Superficial temporal
- Maxillary (middle meningeal is a branch) |
|
|
Term
| what gives rise to the middle meningeal artery & what foramen does it come through? |
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Definition
External carotid --> maxillary artery --> middle meningeal
foramen spinosum --> epidural hematoma |
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Term
What provides most venous drainage of face?
How can this vein cause a meningitis? |
|
Definition
facial vein (drains into internal jugular)
Facial vein collects blood from the cavernous sinus through the superior ophtalmic vein (danger zone of face) |
|
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Term
| connects facial vein w/ cavernous sinus |
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Definition
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|
Term
Describe cervical triangles by answering these questions:
- What divides anterior/posterior triangles?
- What is the carotid triangle
- What is the occipital triangle |
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Definition
- Sternocleidomastoid
- Anterioinferior: anterior omohyoid ; Anterosuperior: posterior digastric ; Posterior: SCM
CT has (CA, Internal JV, CN X)*, ansa cervicalis, sympathetic trunk, CN XI, CN XII)
- Anterior: SCM; Inferior: posterior digastric; Posterior: trapezius
OT has:
Arteries: transverse cervical, suprascapular, subclavian, -external jugular vein
Nerves: Brachial plexus, phrenic, lesser occipital, greater auricular, transverse cervical, supraclavicular, XI |
|
|
Term
| knife wound to posterior triangle --> can't abduct arm past 90 degrees |
|
Definition
| CN XI --> Trapezius muscle paralyzation |
|
|
Term
| where is the brachia plexus (in terms of neck anatomy) |
|
Definition
| posterior triangle (occipital triangle) between anterior & medial scalenes |
|
|
Term
| how does the internal jugular/carotid/vagus neurovascular bundle run |
|
Definition
| medial to lateral: carotid, vagus, internal jugular |
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Term
| only muscle that abducts vocal cords |
|
Definition
|
|
Term
| only muscle not innervated by recurrent laryngeal |
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Definition
| cricothyroid (external branch of superior laryngeal, from vagus) |
|
|
Term
| what does bilateral damage to recurrent laryngeal nerves cause? |
|
Definition
| dyspnea (b.c. vocal folds move down & close off air passage |
|
|
Term
| fracture of temporal/parietal bones |
|
Definition
|
|
Term
| Name 11 cranial foramen & the structures that pass through each. |
|
Definition
1) Cribriform plate: CN 1
2) Optic canal: CN2, retinal artery
3) Superior orbital fissure: CN3,4,6,&V1; superior ophthalmic vessels
4) Foramen rotundum: V2
5) Foramen ovale: V3, lesser petrosal nerve
6) Foramen spinosum: middle meningeal
7) Foramen lacerum: internal carotid
8) Internal auditory meatus: VII & VIII
9) Jugular foramen: IX, X, XI, sigmoid sinus (fracture causes uvula paralysis & inability to shrug shoulders)
10) Hypoglossal canal: XII
11) Foramen Magnum: medulla, XI, Vertebral arteries
1 is in anterior fossa (ethmoid)
2-8 are in middle fossa (sphenoid)
9-11 are in posterior fossa (temporal & occipital) |
|
|
Term
| herniation w/ epidural hematoma? |
|
Definition
uncal --> compress CNIII
(middle meningeal artery) |
|
|
Term
| headache --> blood seen on csf tap |
|
Definition
| subarachnoid hemorrhage (don't see blood in CSF for other brain hemorrhages) |
|
|
Term
| what ligament limits excess neck movement (shaking head no) |
|
Definition
alar ligaments (atlantoaxial joint); left ligament limis turning head to right
(aside: nodding head yes is the atlanto-occipital joint) |
|
|
Term
| cruciform (transverse) ligament rupture |
|
Definition
| dens goes into brain --> quadriplegia or death |
|
|
Term
| whiplash stretches which tendon |
|
Definition
|
|
Term
| breast lung & prostate cancer spread to brain via? |
|
Definition
| vertebral venus plexus (communicate w/ dural sinuses) |
|
|
Term
|
Definition
| sickle cell (central depressions in vertebral body from avascular necrosis due to sickling in vertebral arteries) |
|
|
Term
| A herniated disc will always impinge on which nerve route (e.g. herniation btw T4&T5) |
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Definition
|
|
Term
| pedicles don't develop properly --> anterior vertebral displacement |
|
Definition
|
|
Term
| Fracture of lamina between articular processes --> vertebral body dislocation |
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Definition
|
|
Term
| Ossification of annulus fibrosis (bamboo spine); inflammatory infiltrate; HLA-B27 |
|
Definition
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|
Term
Vertebral level of:
- Carotid bifurcation
- Thyroid cartilage
- Cricoid cartilage (& start of trachea/esophagus)
- Sternal notch
- Sternal angle/carina
- Hilum (covers 3)
- IVC hiatus
- Esophageal Hiatus
- Aortic Hiatus
- Kidneys
- Celiac
- SMA
- Renal arteries
- Gonadal arteries
- IMA/end of spinal cord/ umbilicus
- Iliac crest/aortic bifurcation
- end of dural sac
- end of sigmoid colon |
|
Definition
- Carotid bifurcation: C4
- Thyroid cartilage: C5
- Cricoid cartilage (& start of trachea/esophagus): C6
- Sternal notch: T2
- Sternal angle/carina: T4
- Hilum (covers 3): T5-7
- IVC hiatus: T8
- Esophageal Hiatus: T10
- Aortic Hiatus: T12
- Kidneys: T12-L3 (12th rib is immediately deep to left kidney)
- Celiac: T12
- SMA: L1
- Renal arteries: L1
- Gonadal arteries/end of spinal cord: L2
- IMA/ umbilicus: L3
- Iliac crest/aortic bifurcation: L4
- end of dural sac: S2
- end of sigmoid colon: S3 |
|
|
Term
| anterior spinal artery supplies how much spinal cord? |
|
Definition
|
|
Term
| Important blood supply to lower part of spinal cord |
|
Definition
great radicular artery of adamkiewicz
comes directly off aorta: can be damaged during repair of AAA --> person becomes paraplegic & has bladder/bowel incontinence |
|
|
Term
| name layers when doing epidural |
|
Definition
skin
superficial fascia
supraspinous ligament
infraspinous ligament
ligamentum flavum
epidural space (has internal vertebral venous plexus)
dura mater
arachnoid |
|
|
Term
Name dermatome for specific landmark:
- Clavicle:
- Thumb:
- Middle & index fingers:
- Ring & little fingers:
- Nipples:
- Umbilicus:
- Inguinal region:
- Anterior & medial surface of lower limb
- Big toe:
- Dorsum of foot:
- Lateral surface of foot & little toe:
- Perineum |
|
Definition
- Clavicle: C5
- Thumb: C6
- Middle & index fingers: C7
- Ring & little fingers: C8
- Nipples: T4
- Umbilicus: T10
- Inguinal region: T12
- Anterior & medial surface of lower limb: L1-4
- Big toe: L4
- Dorsum of foot: L5 (Tibial nerve)
- Lateral surface of foot & little toe: S1
- Perineum: S2,3,4 (pudendal) |
|
|
Term
Scottie dog appearance of lumbar vertebra, what is the:
- Eye:
- Head:
- Collar:
- Front leg:
- Back leg & Body: |
|
Definition
- Eye: Pedicle
- Head: transverse process
- Collar: Pars intarticularis (thing fractured in spondylolysis)
- Front leg: inferior articular process
- Back leg/Body: spinous process & lamina |
|
|
Term
| where do you insert a subclavian venous catheter |
|
Definition
midclavicular line, below the clavicle; must go through skin, superficial fascia, subclavius muscle, & clavipectoral fascia
(the anterior scalene & R subclavian artery are located posterior to the vein, improper insertion = hemothorax) |
|
|
Term
| the central tendon of the diaphragm lies directly posterior to... |
|
Definition
| the xyphoid-sternal notch |
|
|
Term
| person w/ bronchogenic carcinoma has a displaced carina |
|
Definition
| - mets to tracheobronchial lymph nodes |
|
|
Term
| single enlarged node at the head of the clavicle |
|
Definition
| Virchow's node: primary cancer of upper abdomen (usually gastric adenocarcinoma) |
|
|
Term
| pt px w/ right sided diaphragm paralysis, hoarseness, pain in shoulder & axilla, & horners on right side |
|
Definition
tumor @ apex of lung
- phrenic nerve
- recurrent laryngeal nerve
- superior thoracic nerve
- sympathetic chain |
|
|
Term
cancer of the scrotum mets ___
cancer of the testes mets ____ |
|
Definition
- superficial inguinal nodes
- deep lumbar nodes (para-aortic) |
|
|
Term
| Name layers of flank abdomen & the corresponding layers int he scrotal sac |
|
Definition
- Skin --> skin
- Campers/scarpas fascia --> Colles/Dartos fascia
- External oblique --> External spermatic fascia
- Internal oblique --> Cremasteric muscle
- Transverse abdominus --> DOES NOT PASS THROUGH IC
- Transversalis fascia --> Internal spermatic fascia
- Parietal peritoneum --> Tunica vaginalis |
|
|
Term
| tumors of lower 1/3 of esophagus spread to which lymph nodes? |
|
Definition
|
|
Term
| 3 sites of gallstone obstruction |
|
Definition
- cystic duct: painful epigastric colic; possibility for cholecystitis
- common bild duct: obstructive jaundice possible
- ampulla: obstructive jaundice & pancreatitis possible |
|
|
Term
| long vasa recta & large plica circularis |
|
Definition
jejunum
(ileum has short vasa recta & small plica) |
|
|
Term
| define false & true pelvis |
|
Definition
true pelvis is below linea terminalis (pelvic inlet
false pelvis is between iliac crests & the pelvic inlet |
|
|
Term
| boarders of greater & lesser sciatic foramen |
|
Definition
(PICTURE IS NECESSARY)
Greater:
superomedial: sacrum
Inferomedial: sacrotuberous&spinous ligaments
Lateral: greater sciatic notch
-----------------
Lesser:
superior: iscial spine/sacrospinous ligament
Lateral: lesser sciatic notch
Inferiomedial: sacrotuberous ligament
(pudendal nerve must pass around sacrospinous ligament in order to get to the perineum) |
|
|
Term
name structures coming out:
- Greater Sciatic Foramen:
- Lesser Sciatic Foramen: |
|
Definition
- Greater Sciatic Foramen: Piriformis, Sciatic N, Sup Gluteal N/A/V, Inf Gluteal N/A/V
(also: posterior femoral cutaneous N & nerve to quadratus femoris)
- Both: Internal pudendal V/A, Pudendal N, (also: nerve to obturator internis)
-Lesser: Pudendal V/A/N & N to obturator internis |
|
|
Term
| Ureter passes inferior to ___ in males/females |
|
Definition
Males: ductus deference/testicular artery
Females: transverse cerivcal (i.e. cardinal) ligament housing uterine artery (from internal iliac) |
|
|
Term
Median ligament
Medial ligaments
Lateral ligaments |
|
Definition
- urachus (allantois)
- umbilical arteries
- inferior epigastric vessels |
|
|
Term
Cancer of the rectum may met to the liver b.c. of the IMV, alternatively, direct spread in the following directions would cause what?:
- Posterior:
- Lateral:
- Anterior (for males & females): |
|
Definition
- Posterior: sciatica
- Lateral: invade ureter
- Anterior males: prostate, seminal vesicle, bladder
- Anterior females: uterus/vagina |
|
|
Term
| finish the path: inferior rectal vein --> |
|
Definition
| inferior rectal vein --> internal pudendal vein --> internal iliac vein --> IVC |
|
|
Term
| prostate drains in which 2 places (explain location of mets) |
|
Definition
1) internal iliac veins (mets to lung & heart)
2) Vetebral venous plexus (mets to vertebral column & brain) |
|
|
Term
| Corpus spongiosum or cavernosum transmit the urethra |
|
Definition
| spongiosum (cavernosum has 2 columns) |
|
|
Term
| which muscle provides protection of subclavian vessels when there is a fracture of the clavicle? |
|
Definition
|
|
Term
| Pt px w/ spinal TB; months later, he has a red bulge on flank & groin. What happened? |
|
Definition
| psoas abscess: infection gets into psoas sheath and spreads (classically w/ TB) |
|
|
Term
| the sternoclavicular joint overlies the bifurcation of what artery? |
|
Definition
braciocephalic vein into subclavian & internal jugular
disolocation of this joint could compress: trachea, carotids/jugular, subclavian A/V, brachiocephalic trucks |
|
|
Term
Where is the most common location of a rib fracture?
Which intercostal nerve innervates rib 7? |
|
Definition
- Just anterior to the angle
- The nerve that lies just inferior to that rib (i.e. give anesthetic in the 7th intercostal space, between 7th & 8th ribs) |
|
|
Term
| interosseous artery in the forarm ends where |
|
Definition
| proximal to the wrist (sort of like the profunda brachii in the arm) |
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|
