Orthopedics Rotation

Front 1

What innervates the deltoid muscle? What is deltoid muscle's function?

Back 1

C5 Axillary Nerve

Shoulder flexion, extension, and abduction

Front 2

What innervates the biceps? What is its function?

Back 2

C5-C6 musculocutaneous nerve

Forearm flexion at elbow, supinator of forearm

Front 3

What nerve is responsible for the biceps reflex?

Back 3

Primarily C5, some C6

(even a slightly diminished reflex indicates pathology)

Front 4

Describe dermatome of C5. What is C5?

Back 4

lateral arm

C5 = axillary nerve

Front 5

Muscle test for C6?

Name the muscles and the nerves

Back 5

Neither test is pure;
- wrist extensor group innervated by C6-C7, radial nerve
- three muscles: extensor carpi radialis longus and brevis (C6) and extensor carpi radialis (C7)

- biceps innervated by C5-C6 (musculocutaneous nerve)

Front 6

C6 reflex?

Back 6

Brachioradialis (only C6) - tested proximal to the wrist where the muscle becomes tendinous just before it inserts into the radius

Biceps reflex (C5 - C6) -

Front 7

Sensation testing for C6

Back 7

thumb and lateral arm

Front 8

Triceps muscle testing: nerve?

Back 8

C7, radial nerve

Front 9

Wrist flexor group: nerve?

Back 9

C7, median and ulnar nerves

wrist flexor group composed of two muscles: flexor carpi radialis (median nerve) and flexor carpi ulnaris (ulnar nerve)

Flexor carpi radialis (C7) is more important of these two muscles, since it actually powers most of wrist flexion)

Flexor carpi ulnaris, which is primarily innervated by C8, is less powerful

Front 10

Finger extensors: which nerve?

Back 10

C7, Radial nerve

Finger extension performed by three muscles
- extensor digitorum communis, extensor digiti indicis, and extensor digiti minimi

All above groups have some C8 innervation (though predominantly C7)

Front 11

Triceps reflex: which nerve?

Back 11

C7, tap its tendon where it crosses the olecranon fossa at the elbow

Front 12

Sensation distribution of C7

Back 12

Middle finger (occasionally, middle finger sensation also supplied by C6 and C8

Front 13

Muscle testing of C8

Back 13

Finger flexors
- two muscles which flex fingers are flexor digitorum superficialis (PIP joint) and flexor digitorum profundis (DIP joint)

Front 14

Sensation distribution of C8

Back 14

pinkie finger

Front 15

Finger Abductors: nerve?

Back 15

ulnar nerve, T1

1) dorsal interossei and 2) abductor digiti quinti

Front 16

Sensation of T1

Back 16

Medial arm: medial brachial cutaneous nerve

medial side of the upper half of the forearm

Front 17

Muscle group of L4

Back 17

Tibialis anterior: L4, deep peroneal nerve

test: offer resistance to dorsiflexion and inversion by pushing against the dorsal and medial aspects of the head and the first metatarsal bone.

Front 18

Patellar reflex: what nerve?

Back 18

L4

deep tendon reflex, mediated through nerves from L2-L4, but mostly through L4

Front 19

Sensation of L4

Back 19

covers medial side of the leg.

knee represents the division between the L3 dermatome (above) and the L4 dermatome (below)

Front 20

L5 muscle

Back 20

Extensor hallucis Longus: deep peroneal nerve

Gluteus medius: superior gluteal nerve --> abduct leg as patient is lying on side

Extensor digitorum Longus and Brevis: deep peroneal nerve --> flex toes

Front 21

Reflex of L5

Back 21

diffiicult to obtain tibialis posterior muscle L5 reflex

Front 22

Sensation of L5

Back 22

covers lateral leg and dorsum of foot

Front 23

Muscles of S1

Back 23

Peroneus longus and Brevis: S1, superficial peroneal nerve --> secure patient's ankle, have him plantarflex and evert his foot, and oppose his motion by pushing against the head of the fifth metatarsal with the palm of your hand.

Gastrocnemius-Soleus Muscles: S1, S2, Tibial nerve --> no legitimate manual test for it

Gluteus maximus: S1, inferior gluteal nerve --> have patient lie prone on the exam table with knees flexed and hip extended. Resist hip extension and palpate the gluteus maximus for tone.

Front 24

Reflex of S1

Back 24

Achilles tendon reflex: put achilles tendon into a slight stretch by gently dorsiflexing the foot. Then strike the tendon to induce a sudden, involuntary plantarflexion of the foot,.

Front 25

Sensation of S1

Back 25

covers lateral malleolus and lateral side and plantar surface of the foot.