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79 Cards in this Set
- Front
- Back
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What causes a paretic movement?
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Paretic movement means a weak movement.
This happens when you lose a nerve that supplies muscles, but you still have OTHER muscles that produce the movement that are innervated by a nerve that was not lost. |
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What causes upper brachial plexus injury?
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Falling on your head/shoulder.
Pullin a baby by their head. |
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What will you see in someone that has upper brachial plexus injury? What 4 things are lost?
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WAITER'S TIP POSITION
1. Lose flexion (musculocutaneous nerve) 2. Lose abduction (suprascapular nerve to supraspinatus) 3. Lose medial oration (infraspinatus) 4. Lose extension of the wrist (C5 innervates wrist extension) |
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What is upper brachial plexus also called?
What is the final position of the arm and hand? |
erg's palsy or Erb-Duchenne palsy.
Limb |
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What is the lower brachial plexus injury (Klumpke's palsy) caused by? What roots are affected?
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Caused by pulling the arm, or by holding onto something when falling.
C8 and T1 are affected |
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What will happen if you have a lower plexus injury?
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Main injury is to ulnar nerve = CLAW HAND, AND sensory loss among the anterior medial side of the forearm!!!! SENSORY LOSS IS IMPORTANT TO DIFFERENTIATE FROM ULNAR NERVE INJURY!!!!!
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Ulnar nerve injury causes claw hand, how exactly does this happen (what muscles are affected)?
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You will lose medial 2 lumbricals (pinky and finger next to it) so those fingers' MP joins will be extended and the IP joints will be flexed.
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If you have an upper plexus injury will your arm be pronated or supinaterd?
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It will be pronated.
Supinators are the supinator muscle and the biceps brachii. LOSE SUPINATION SO YOU ARE PRONATED. |
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What causes injury to long thoracic nerve? What roots are involved in the nerve?
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Injury to long thoracic nerve if you undergo a mastectomy or thoracic surgery.
Nerves involved: C5, C6, C7 |
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What causes injury to thoracodorsal nerve? What roots are involved?
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Same things that cause injury to long thoracic nerve: mastectomy, thoracic surgery
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If you have a mastectomy and your long thoracic nerve and your thoracodrsal nerves are injured what will happen?
What will the sensory loss be? |
-Long thoracic nerve: lose serratus anterior, lose protraction of scapula and lose upward rotation of the scapula -> WINGING OF THE SCAPULA
-Thoracodorsal nerve: lose latissimus dorsi, inability to use crutches -No sensory loss |
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If you injure your axillary nerve (C5,6) what will happen?
sensory loss? |
-Lose your deltoid: lose abduction
-Lose your teres minor: lose lateral rotation -Sensory loss: Lateral surface of the shoulder |
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What would cause loss of the musculocutaneous nerve?
What muscles will be weakened? Sensory loss? |
Penetrating wounds to the axilla.
Lose flexion of forearm, lose supination (biceps), weakness of arm flexion -Lose sensolry innervation of the lateral surface of the forearm |
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Injury to what nerve causes honeymoon palsy?
Effects of injury? Sensory loss? |
Injury to radial nerve which travels along the radial groove of the humerus.
Lose extension, WRIST DROP Sensory loss: small part on dorsal aspect of the hand |
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HOw will injuring the radial nerve affect elbow extension?
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Normally it is not affected because when the radial nerve normally branches off to innervate the triceps before entering the radial groove.
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If your pronator teres is inflamed what nerve is likely to be injured?
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The median nerve - it lies between the 2 heads of the pronator teres
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If you get median nerve injury what do you get?
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ape hand or hand of benediction
sensory loss in hand where expected |
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Is the median nerve anterior or posterior to the brachial artery?
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The median nerve is ANTERIOR to the brachial artery
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The subclavian artery is divided into 3 segments based on the anterior scalene.
what are the 3 main divisions? |
1. vertebral, internal thoracic, thyrocervical trunk
2. costocervical trunk 3. dorsal scapular artery |
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What does the thyrocervical trunk divide into?
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Inferior thyroid artery
trans-crevical suprascapular |
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What does the costoccervical trunk (which arises posteriorly) supply?
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It supplies the first 2 intercostals and the deep cervical muscles
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What does the dorsal scapular artery supply? (same as the dorsal scapular nerve)
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The dorsal scapular artery supplies the rhomboids and the levitator scapulae
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What is the relationship you find in the thoracic outlet amongst the vein, the anterior scalene and the artery?
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The subclavian vein is most anterior, then the anterior scalene, and the most posterior thing will be the subclavian artery.
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What are the 4 branches of the thoracoacromial trunk?
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Cadavers are dead people
-clavicular -acromial -deltoid -pectoral |
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What are the branches off the axillary artery
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1. superior thoracic
2. lateral thoracic and thoracoacromial 3. anterior and posterior circumflex humeral arteries, and the subscapular artery |
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What does the superior thoracic artery innervate?
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fist 2 intercostal spaces and part of the serratus anterior
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What does the lateral thoracic artery supply
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-lateral aspect of breast
-serratus anterior -pectoralis |
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The cubital fossa is bounded to the sides by brachioradialis and pronator teres. What is the floor?
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The floor of the cubital fossa is the supinator and the brachialis
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What is the relationship between the brachioradialis and the radial artery?
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The radial artery runs medially to the brachioradialis
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How does the ulnar artery enter the hand (via what?)
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Via the Guyon canal
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If you have hammer syndrome caused by vibration, what artery is damaged?
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The ulnar artery
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If you see a splinter hemorrhage what will you suspect?
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Proximal arterial occlusion
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In the THIGH
What innervates the anterior compartment? The posterior compartment? The medial compartmetn? |
Anterior compartment: femoral nerve
Posterior compartment: tibial nerve Medial compartment: obturator nerve |
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What is the main role of the iliofemoral ligament?
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To support the head of the femur when standing to minimize the muscle activation
Ischiofemoral also helps |
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What are the 4 hip flexors?
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1. rectus femoris
2. sartorius: laterally rotates, abducts the thigh 3. iliopsoas 4. pectineus: also adducts, internally rotates thigh |
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What are the hip extensors?
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-Hamstrings (Semitendinosus, semimembranosus, biceps femoris)
-Gluteus maximus |
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What are the hip abductors?
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-Tensor fascia latta, gluteus medius, gluteus minimus
ALL INNERVATED BY SUPERIOR GLUTEAL NERVE |
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Hip adductors:
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Adductors, gracilis, pectineus
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Lateral rotators:
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Obturator internus, gemelli, quadratus femoris, piriformis
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Medial rotators?
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No specific muscles, but adductors do a lot of the motions
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What are the 2 muscles in the anterior compartment of the thigh?
What do they do? What are they innervated by? |
-Sartorius: from ASIS will flex and laterally rotate the thigh (also flexes the knee
-Rectus Femoris: from AIIS will extend the knee -Innervated by the femoral nerve |
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What are the muscles in the medial compartment of the thigh?
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-adductors
-gracilis (obtrurator nerve) |
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What are the muscles in the posterior compartment of the thigh?
What are they innervated by |
-semimembranosus
-semitendinosus -biceps femoris -All innervated by the tibial nerve except the short head of the biceps femoris which is innervated by the common fibular nerve |
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What is congenital dysplasia?
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Dislocation of the hip joint
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A patient presents with a shortened externally rotated leg, what part of the bone did they break?
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They have a femoral neck fracture
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When doing a hip replacement surgery you start out laterally to avoid which vessels?
Then you go between the rectus femoris and the gluteus medius, what nerve is in danger? |
Step 1: avoid the femoral nerve, artery and vein
Step 2: Lateral cutaneous femoral nerve is in danger, circumflex artery is also in danger |
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What compartment do knee flexors come from?
What are they? |
-Come from ALL compartments
-Hastrings: posterior compartment -Sartorius: anterior compartment -Gastronemius |
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Osgood Shlatter disease iis pain over thetibial tuberosity often in childer 10-15. What muscle tendon inserts at the tibial tuberosity and is implicated in the syndrome?
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Vastus lateralis, vastus medialis, vastus intermedius
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During the gait cycle the hip flexes and extends once. When does it flex? When does it extend?
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Flexes during initial swing
Extends during loading |
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What bones is the upper ankle joint formed by?
What shape is it? What movement is allowed? |
Upper ankle joint formed by the tibia and the fibula on the talus.
Shape: SELLAR ONLY FLEXION AND EXTENSION IS ALLOWED |
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What joints allow the inversion and eversion of the foot?
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-subtalar joint
-transverse tarsal joint |
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What bones is the subtalar joint formed by?
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The talus and the calcareous
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What bones is the transverse tarsal joint formed by?
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-Horizontal line dividing the Talus and the Calcaneous from the navicular and the cuboid
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The subtalar joint is between what bones? What movement does it allow?
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Subtalar joint: between talus and calcaneus.
Allows inversion and eversion |
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What 2 joints allow inversion and eversion of the foot?
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Subtalar joint and transverse tarsal join.
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What 3 muscles are in the anterior compartment of the leg? What are they innervated by?
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Tibialis anterior, EHL, EDL.
Dep fibular nerve. |
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What muscles do dorsiflexion of the leg?
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Extensor hallucis longus
Extensor digitorum longus |
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If you have excess inversion what fraction is expected?
If you have excess eversion what fraction is expected? |
Excess inversion, fibular fraction.
Excess eversion, fibular and tibial fraction. |
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In terminal swing will you use:
foot dorsiflexors, foot plantar flexors, invertors of evertors? |
Foot dorsiflexors to clear the ground in preparation for heel strike: Extensor digitorum longus, extensor hallucis longus
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In push off will you use:
foot dorsiflexors, foot plantar flexors, invertors of evertors? |
Plantar flexion: Flexor hallucis longus, flexor digitrom lung us, triceps surae
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What is considered the "spring" ligament in the foot?
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The plantar calcaneonavicular ligament
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What does the medial plantar nerve in the foot innervate (branch of the tibial nerve)?
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MED LAFF
Medial plantar nerve innervates -most medial lumbrical -abductor hallucis -flexor hallucis brevis -flexor digitorum brevis . The lateral plantar nerve will innervate the rest |
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Walking:
Initial contact |
-Quadriceps femoris contracts concentrically to extend the knee
-Hamstrings contracts eccentrically to prevent over flexion -Dorsiflexion of foot to prevent foot drag |
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Loading response (3)
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-knee flexes passively
-quadriceps femoris contracts to prevents over flexion -Gluteus maximus contracts to extend the hip |
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Mid stance (3) (What is happening with the foot)?
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--quadriceps femoris contracts to extend the knee
-hamstrings flex to prevent over extension -Glutes medius and minimus and tensor fascia latta contract to stabilize the leg -Ankle and plantar flexion contracting ECCENTRICALLY to control forward motion of the tibia relative to the planted foot. (In late stage contract CONCENTRICALLY to provide power for push off) |
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Initial swing (3)
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-Rectus femoris and iliopsoas flexes the hip
-Knee flexes for clearance |
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What are the borders of the femoral triange?
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Inguinal ligament
Adductor longus sartorial |
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From medial to lateral what is found in the 3 compartments of the femoral sheath?
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Femoral vein, femoral artery, femoral nerve
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The femoral artery divides into what? What do the divisions do?
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The common femoral artery divides into deep and superficial.
The superficial continues to become poplitieal. The deep femoral artery becomes the deep artery of the tight, the medial circumflex femoral and the lateral circumflex femoral arteries |
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What is the deep femoral artery and the superficial femoral artery divided by?
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Divided by the adductor longus
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What do the medial and circumflex femoral arteries supply blood to?
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Medial circumflex femoral artery: neck of femur
Lateral circumflex femoral artery: lateral aspect of thigh |
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If you were looking at a cross section of the thigh, what is more lateral the Semitendinosus or the Semimembranosus
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Semitendinosus is more lateral.
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What are the contents of the popliteal fossa? (5)
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-tibial nerve
-common fibular nerve -popliteal artery -popliteal vein -lesser saphenous vein |
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What does the anterior tibial artery travel with (n)?
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Travels with the deep fibular nerve
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The anterior tibial artery continues to the foot where it become what? What is the other artery?
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Anterior tibial artery becomes dorsal is pedis, there is also a lateral tarsal artery.
Together they form the arcuate artery |
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What nerve travels with the fibular artery?
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NONE
NO NERVE TRAVELS WITH THE FIBULAR ARTERY |
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What nerve is responsible for dorsiflexion?
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Deef fibular nerve (or peroneal)`
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What arteries for the plantar arch?
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The deep plantar artery (coming from dorsal is pedis) and the lateral plantar artery (coming from posterios ttibial artery)
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What happens if you get a clot in the superficial femoral vein?
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You get a deep vein thrombosis because the superficial femoral vein is NOT superficial but deep.l
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