Anatomy Of Upper And Lower Limb

Front 1

Shoulder Abduction

Back 1

Deltoid C5 Axillary

Front 2

Elbow Flexion

Back 2

Biceps C5,6 Musculocutaneous
Brachioradialis C6 Radial
(+ reflex)

Front 3

Elbow Extension

Back 3

Triceps C7 Radial (+ reflex)

Front 4

Radial wrist extension

Back 4

Extensor carpi radialis longus and profundus C6 Radial (+reflex)

Front 5

Finger extensors

Back 5

Extensor digitorum C7 Radial (post. interosseus)

Front 6

Finger flexors

Back 6

Flexor digitorum longus and profundus C8 Median (ant. interossesus) (+reflex);
Flexor digitorum profundus C8 Ulnar

Front 7

Finger abduction

Back 7

dorsal interossei T1 Ulnar; abductor pollicus brevis T1 Median

Front 8

Hip flexion

Back 8

Iliopsosas L1/L2, Femoral

Front 9

Hip adduction

Back 9

adductors, L2/3, Obturator

Front 10

Hip extension

Back 10

gluteus maximus, L5/S1, inferior gluteal

Front 11

Knee flexion

Back 11

Hamstrings, S1, sciatic

Front 12

Knee extension

Back 12

quads, L3/4, (++reflex), femoral

Front 13

Ankle dorsiflexion

Back 13

tibialis anterior, L4, deep peroneal

Front 14

Ankle eversion

Back 14

peronei, L5/S1, superficial peroneal

Front 15

Ankle inversion

Back 15

tibialis posterior, L4/5, tibial

Front 16

Ankle plantar flexion

Back 16

gastrocnemius, soleus, S1/2, tibial (++reflex)

Front 17

Big toe extension

Back 17

Extensor hallucis longus, L5, deep peroneal (babinski)

Front 18

Hip abduction

Back 18

gluteus medius, L4/5, superior gluteal

Front 19

Foregut

Back 19

Abdominal esophagus, stomach, superior part of duodenum, liver, pancreas, spleen
Celiac, Greater Splanchnic T5-9

Front 20

Greater Splanchnic

Back 20

T5-9

Front 21

Midgut

Back 21

descending duodenum-proximal 2/3 of transverse colon
Sup. Mesenteric, Lesser Splanchnic, T10-11

Front 22

Lesser Splanchnic

Back 22

T10-11

Front 23

Hindgut

Back 23

distal 1/3 transverse colon-midway through anal canal
Inf. Mesenteric, Lumbar Splanchnic, L1-2

Front 24

Lumbar Splanchnic

Back 24

L1-L2

Front 25

Renal

Back 25

Renal Artery/Ganglion, Least Splanchnic, T11-T12

Front 26

Least Splanchnic

Back 26

T11-T12

Front 27

Referred pain of appendicitis

Back 27

via lesser splanchnic and sup. mesenteric ganglion to T10 (umbilicus)

Front 28

Referred pain of angina

Back 28

via sympathetics arising from T1-T5, and leaving symp chain from C1-T4. ischemia = pain at C1-T5 levels

Front 29

Causalgia = pain from hyperstimulate nerves that travel w/blood vessels and follow sympathetics

Sympathetic Effects of anesthesia?

Back 29

knock out sensory neurons in ganglion, but also knock out some of symp chain = 1)dilation (flushed skin), 2)sweat glands (dry skin), 3)erector pili muscles (no goosebumps); (sometimes constricted pupil and sunken eyeball = Horner's syndrome)

Front 30

Innerv and fn of Serratus Anterior?

Back 30

Long thoracic nerve (directly from C5,6,7 roots); scapular protraction, elevate glenoid; suscptible to injury--> winged scapula

Front 31

Suprascapular nerve, roots, fn, injury?

Back 31

C5,6 from upper trunk; infra- and supraspinatus (rotator cuff, abduction and lat rotation); compression = lat shoulder pain (C5,6 cutaneous territory), musc atrophy

Front 32

Thoracodorsal nerve, roots, fn?

Back 32

Lat. dorsi, from post cord C6,7,8 (susceptible in breast surgery), extension, medial rotation, adduction

Front 33

Axillary nerve, roots, fn?

Back 33

Deltoid, from post cord, C5,6, suscept to compression w/shoulder dislocation (abduction), sensory loss in patch of skin in upper lat arm

Front 34

Snuff box tendons?

Back 34

Abductor pollicus longus, extensor pollicus brevis, extensor pollicus longus; radial artery traverses it; point tenderness from scaphoid fracture or tenosynovitis of ext. poll. long. tend.

Front 35

Wrist abduction

Back 35

extensor (radial) and flexor (median) carpi radialis

Front 36

Wrist extension

Back 36

extensor carpi radialis and ulnaris, extensor digitorum

Front 37

Wrist adduction

Back 37

extensor (radial) and flexor (ulnar) qcarpi ulnaris

Front 38

Radial nerve injury

Back 38

suscept in radial groove and axilla (crutch paralysis); weak elbow extensors, paralysis of supinatory, wrist and thumb extensors = WRIST DROP; loss of triceps jerk, brachiorad tend reflex; sensory loss in post forearm and lat dorsum of hand

Front 39

Musculocutaneous nerve injury

Back 39

usu. in fractures of upper humerus; motor loss-elbow flexion weakness (esp when supinated), loss of biceps tend. reflex, sensory loss on anterolat. forearm

Front 40

Median nerve in forearm

Back 40

C6,7,8;
-pronation (pronator teres and quadratus),
-wrist flexion (flexor carpi radialis, palmaris longus, digital flexors)
-wrist abduction (flexor carpi radialis)
-digit flexion (flexor digitorum superficialis and profundus)

Front 41

Median nerve, intrinsic hand muscles

Back 41

C8,T1
-Thumb flexion, medial rotation, opposition (flexor pollicus brevis, opponens pollicus
-Thumb abduction (abductor pollicus brevis---abd.poll.longus is radial n.)
-Abduction of index/midd fingers (lumbricals 1,2)
-Flexion MP + Extension PIP/DIP (lumbricals 1,2)

Front 42

Median nerve paralysis-above elbow (forearm effects)

Back 42

motor paralysis of pronator teres = supinated forearm

Front 43

Median nerve paralysis-wrist effects

Back 43

weak flexion and abduction, causes hand extension and ulnar deviation (adduction)

Front 44

Median nerve paralysis-MP,PIP,DIP joints

Back 44

weak flexion, thus mid/index fingers extended

Front 45

Median nerve paralysis-hand

Back 45

thenar muscle paralysis (recurrent median nerve) = ape thumb (external rotation and adduction)

Front 46

Carpel Tunnel Syndrome

Back 46

paralysis of thenar muscles-ape thumb
sensory loss on 3.5 fingers, palmar surface, and dorsal surface from tips of finger to PIP joing

Front 47

Ulnar nerve at forearm

Back 47

C8,T1
Wrist flexion and adduction, and some finger flexion (flexor carpi ulnaris, flexor digitorm profundus)

Front 48

Ulnar nerve at hand

Back 48

C8,T1
Thumb adduction (adductor pollicus,
finger adduction (palmar interossei and 3,4 lumbricals)
finger abduction (dorsal interossei and 3,4 lumbricals)
MP flexion and PIP/DIP extension (same)

Front 49

Ulnar nerve injury

Back 49

susceptible to injury in medial epicondyle groove (funny bone) and olecronon
partial claw hand--paralysis of intrinsic hand muscles (except thenar), abducted and externally rotated thumb
sensory loss of medial 1.5 fingers and ulnar border of hand

Front 50

Upper trunk lesion

Back 50

C5,6 (separation of shoulder and neck, seen in breech delivery)
axillary, suprascapular, musculocutaneous, radial nerve(to supinator and brachiorad.)

=Erb's paralysis --> waiter's tip position, sensory loss along lat arm and forearm (C5/6 dermatomes)

Front 51

Lower trunk lesion

Back 51

C8,T1
trauma due to tug by outstretched arm
paralysis of intrinsic hand muscles--> claw hand (b/c long digital flexors (med) and long wrist extensors (rad) unopposed)
sensory loss of medial forearm and hand

Front 52

Costoclavicular syndrome or Thoracic Outlet Syndrome (TOS)

Back 52

where subclav v./a. and lower trunk enter axilla, between scalene anterior and medius, and 1st rib and clavicle
-compression = lower trunk palsy and vascular insufficiency
also can be compressed by pancoast tumor