Gross Anatomy Clinical Correlations

Front 1

during surgery in the inferior part of the axilla, what nerve is in danger?

Back 1

thoracodorsal nerve (C6-C8), supplying latissimus dorsi

(also in mastectomies when removing tail of spence)

Front 2

if a patient cannot raise their bodies with the upper limbs (climb) or use an axillary crutch, what have they injured?

Back 2

thoracodorsal nerve (C6-C8), which causes paralysis of latissimus dorsi

Front 3

what happens if one injures the dorsal scapular nerve?

Back 3

paralysis of rhomboids on same side, so the scapula on affected side will be farther from midline than the one on the normal side

Front 4

when is the axillary nerve usually injured?

Back 4

during fracture of the surgical neck of the humerus
during dislocation of the glenohumeral joint
by compression from improper use of crutches

Front 5

what are the symptoms of an axillary nerve injury?

Back 5

deltoid atrophy (flattening of shoulder and slight hollow inferior to acromion)

anasthesia on lateral side of proximal portion of arm

Front 6

what are the symptoms of an aneurysm of the axillary artery?

Back 6

compression of trunks of brachial plexus, causing pain and anesthesia in the areas supplied by the affected nerves

Front 7

what is a prefixed brachial plexus?

Back 7

when the superior most root (anterior ramus) of the brachial plexus is C4 and the inferior root is C8

Front 8

what is a postfixed brachial plexus?

Back 8

when the superior-most root of the brachial plexus is C6 and the inferior-most root is T2

inferior trunk could be compressed by 1st rib

Front 9

for what spinal nerves does a bicipital myotatic reflex test integrity? how is it performed?

Back 9

C5 and C6

performed by tapping finger as it is placed on the biceps tendon in the cubital fossa (+ve is involuntary contraction of biceps)

Front 10

what is biceps tendinitis?

Back 10

inflammation of the tendon of the long head of the biceps

(usually the result of throwing sports and racquet sports)

Front 11

what is crepitus?

Back 11

grating, crackling or popping sounds and sensations experienced under the skin and joints

Front 12

what are the symptoms of a ruptured tendon of the long head of the biceps?

Back 12

snap or pop when it ruptures
detached muscle belly forms a ball near the center of the distal part of the arm

Front 13

what is hemostasis?

Back 13

stopping bleeding through manual or surgical control of blood flow

Front 14

where is the best place to clamp the brachial artery for surgery?

Back 14

distal to the profunda brachii

Front 15

what is ischemic compartment syndrome?

Back 15

a muscle flexion deformity, caused because after 6 hours of ischemia, muscles die and are replaces with fibrous scar tissue, causing the involved muscles to shorten permanently

Front 16

what is the most common cause of injury to the musculocutaneous nerve?

Back 16

inflicted wound by weapon like a knife

(injuries are uncommon because it is protected in its position)

Front 17

what are the symptoms of injury to the radial nerve?

Back 17

paralysis of triceps, brachioradialis, supinator, extensor muscles of wrist and fingers

(if in radial groove, only weakness of triceps since only medial head affected)

Front 18

what is the characteristic clinical sign of radial nerve injury?

Back 18

wrist-drop
(inabilty to extend the wrist and fingers at the metacarpophalangeal joints)

Front 19

what is elbow tendinitis?

Back 19

aka tennis elbow and lateral epicondylitis

repeated forceful flexion and extension of the wrist straining the attachment of the common extensor tendon producing inflammation of lateral epicondylar periosteum

Front 20

what are the symptoms of elbow tendinitis?

Back 20

pain over lateral epicondyle, radiating down posterior surface of forearm

follows activities with lots of forceful extension of the wrist

Front 21

what is mallet (baseball) finger?

Back 21

avulsion of attachment of a long extensor tendon

-finger is forced into hyperflexion because patient cannot extend it

Front 22

what causes the "hand of benediction"? what is it?

Back 22

injury to the median nerve in the elbow region (or before)

digits 2-3 remain extended while trying to make a fist, and thenar muscles cannot contract

Front 23

what is anterior interosseous syndrome? how does it present?

Back 23

injury to anterior interosseous nerve, which paralyzes the flexor digitorum profundus and flexor pollicis longus, but not the thenar muscles

"pinch" posture when attempting to make an "ok" sign

Front 24

why can injuries to the median nerve sometimes be undiagnosed?

Back 24

communications between the ulnar and median nerves, only occasional in patients, allow some muscles not to be paralyzed even with complete lesion of the median nerve

Front 25

what are the four most common locations of injury to the ulnar nerve?

Back 25

posterior to medial epicondyle
cubital tunnel
at the wrist
in the hand

Front 26

what forms the cubital tunnel?

Back 26

tendinous arch connecting the humeral and ulnar heads of flexor carpi ulnaris

Front 27

what is "claw hand"?
what causes "claw hand"?

Back 27

inability to flex medial 1.5 digits when others are flexed

caused by injury at the elbow or forearm of the ulnar nerve

Front 28

what is dupuytren contracture of palmar fascia?

Back 28

idiopathic disease in which palmar fascia and aponeurosis are shortened, thickened, and become fibrotic

(treated with surgical removal of fibrotic parts of palmar fascia)

Front 29

what is tenosynovitis?

Back 29

inflammation of the tendon and synovial sheath of a digit, caused by infection of digital synovial sheath

Front 30

what is quervain tenovaginitis stenosans?

Back 30

excessive friction between tendons of adductor pollicis longus and extensor pollicis brevis, caused by repetitive forceful use of hands during gripping and wringing

Front 31

why must one compress the brachial artery to work on hand injuries?

Back 31

extensive anastomoses between palmar arches cause profuse bleeding which is not controllable by compressing one or the other

Front 32

what muscles are affected by carpal tunnel syndrome?

Back 32

thenar muscles (abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis)

Front 33

what is "simian hand"?

Back 33

emaciation of thenar eminence caused by atrophy of muscles due to a lesion in the median nerve

thumb is adducted and extended

Front 34

why does simian hand commonly occur in a patient who has attempted to commit suicide?

Back 34

the median nerve is relatively superficial, so it is cut when attempting to cut the arteries

Front 35

how is the clawing in ulnar canal syndrome different from that in proximal ulnar nerve injuries?

Back 35

ability to flex is unaffected in ulnar canal syndrome
no radial deviation of the hand

Front 36

what is handlebar neuropathy?

Back 36

nerve compression resulting from putting pressure on the hooks of the hamates (as in riding a bike) and compressing ulnar nerves

results in sensory loss on medial side of hand and weakness of intrinsic hand muscles

Front 37

what is a simian crease?

Back 37

single transverse palmar crease, often found in patients with down syndrome (trisomy 21)