studentquest

QUIZ QUESTIONS
What muscles are innervated by the PIN? AIN? (radial nerve is only sensory after the wrist)
supinator, ECRB, ECU, ED, EPL/B, APL, EI, EDM
FPL, lateral 1/2 of FDP, pronator quadratus
What structures are located in the carpal tunnel?
Median nerve, FDS, FDP, FPL
What muscles are attached to the lateral epicondyle?
ECRB/L, ED, supinator, anconeus
What muscles are attached to the medial epicondyle?
FCU, FCR, FDS, FPL, pronator teres, palmaris longus
What 3 thumb muscles are innervated by 3 different nerves? And what are the muscles?
Adductor pollicis (ulnar n)
EPB (radial)
Oppenens pollicis (median)
What muscles of the shoulder are ER? IR?
ER: PIT
IR: SPLAT
How do you palpate the capitate?
Extend the wrist and find the divot
What makes up the femoral triangle? What structures are located in the triangle?
Sartorius,
gracilis,
inguinal
ligament
Femoral
nerve, artery,
vein, inguinal
lymph node
(from lateral
to medial)
QUIZ QUESTIONS
What muscle is used for as a "push up" pressure relief in those with SCI? (scapular depression and pelvic elevation (lifting the
buttocks)
Latissmus dorsi
What structures make up the Quadrangular space?
teres minor/major, humerus, triceps LH; axillary n. and posterior circumflex humeral a
What are the deep 6 external rotators (excluding glute max)?
SUP/INF GEMELLUS, PIRIFORMIS, OBTURATOR INT & EXT, QUADRATUS FEMORIS
Draw the circle of willis…
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Basilar artery lesion: locked-in
syndromecomplete paralysis of
voluntary muscles, except for those
that control the eyes. People with
Locked-in syndrome are conscious
and can think and reason but are
unable to speak or move. Vertical
eye movements and blinking can be
used to communicate
Lateral pontine syndrome  MarieFoix syndrome): Affects the nuclei of
CN VII, & VIII, corticospinal tract,
spinothalamic tract, and cerebellar
tracts. It results in contralateral
hemiparesis, contralateral loss of
proprioception & vibration,
ipsilateral limb ataxia, ipsilateral
facial palsy, lateral hearing loss,
vertigo, and nystagmus. The blood
supply affected is the perforating
branches of the basilar artery and
the anterior inferior cerebellar
artery.
Lateral medullary (Wallenberg)
syndrome The usual sx of lateral medullary infarction
include vertigo, dizziness, nystagmus, ataxia, nausea and
vomiting, dysphagia, and hiccups. Dysphagia is more
profound in lateral medullary syndrome patients
Medial medullary (dejerine) syndrome Affects the fibers
of CN XII, corticospinal tract, and medial lemniscus spinal.
Results in ipsilateral tongue weakness, ipsilateral loss of
proprioception & vibration, contralateral hemiparesis, and
contralateral face sparing hemi hypesthesia. The blood
supply affected is the branches from the vertebral
artery and the anterior spinal artery
What structures make up the snuffbox? And what is located
inside?
Medial: EPL; lateral: APL, EPB
CARTs (cephalic vein/artery, radial nerve, tendons of
EPL/B)
QUIZ QUESTIONS
What is scapular winging and what motions are most likely affected?
LTN palsy or damage/weakness to the serratus anterior muscle, flexion/abduction of the UE
Patients compensate with the trapezius
Annie, a 5 year old, was playing with her brothers when one
pulled her arm hard. She cried but stopped when Ronnie
attempted to find the injury by pronating and supinating her
hand. What condition did she have?
Nursemaid’s elbow (radial head dislocation)
Headache from the back of the neck, up over the back of the
head, is due to “strangulation” of the greater occipital nerve by
what muscle?
The trapezius (via origin from greater occipital
protuberance)
What is cyclist’s palsy? What would treatment is indicated?
ulnar nerve becomes irritated and compressed in the
wrist within or distal to Guyon's canal, due to the
pressure exerted on the hands on the handlebars, people
often have a hyperextended position of the wrist resting
on the handlebars or hoods
Splinting at night, minimizing repetitive wrist extension, pt education on positioning, change handlebars, etc.
What is cyclist syndrome?
Sx pain, numbness, and dysfunction in the distribution of the pudendal nerve. (This includes the genitalia, perineum,
rectum, and lower urinary tract.)
Excessive cyclingThe condition is presumably because of chronic perineal microtrauma, which causes fibrosis in the
pudendal canal as well as the sacrospinous and sacrotuberous ligaments
perineal pain exacerbated by sitting, which is relieved by standing or lying
How many muscles attach to the scapula and what are they?
18
RTC (4), teres major, deltoid, trapezius, levator scapulae, rhomboids (2), latissimus dorsi, biceps (LH), coracobrachialis,
triceps (LH), pectoralis major, pectoralis minor, serratus anterior, omohyoid
What passes through the heads of the FCU?
Ulnar nerve
What passes through the heads of pronator teres?
Median nerve
If median nerve is cut/damaged after is passes
through PT, would you experience weakness in
pronation?
o Yes, pronator quadratus (innervated by
the AIN)
What is the ‘unhook the brassier’ muscle?
Pec minor
What is Saturday night / honeymoon palsy?
compressive neuropathy of the radial nerve that
occurs from prolonged, direct pressure onto the upper medial arm or axilla by an object or surface
What is Erb’s palsy? Klumpke’s palsy?
paralysis of the arm caused by the injury to the upper group of the main nerves supplying it, specifically the upper trunk C5C6 of the brachial plexus; loss of sensation in the arm and paralysis and atrophy of the deltoid, biceps, and brachialis
QUIZ QUESTIONS
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muscles. The muscular damage results in the classical
sign of Erb’s palsy called the ‘waiter’s tip hand.’ The
neonate presents with the arm hanging limply from the
shoulder with adduction at the shoulder, internal
rotation of the upper arm, pronation of the forearm, an
outward direction of the palm, giving the appearance of
"waiter's tip posture.".
Klumpke injury, there is paralysis of the forearm and
hand muscle due to injury in C7, C8, and T1. The
neonate presents with a "claw hand" due to injury to
the flexor muscles of the wrist, fingers, and forearm
pronator. It also affects the intrinsic muscles
What is the amphibian/diving reflex?
Immersion in cold water stimulates this
physiologic response which will exhibit a
decreased HR, increases peripheral
vasoconstriction (BP increases), and decrease
cardiac output; this is done in order to reduce
the O2 demand and preserve the vital organs
Conversely, immersion in hot temperature
water, BP will decrease secondary to rapid
peripheral vasodilation
Melanoma
Asymmetry (unmatching halves)
Borders (uneven)
Color (shades of brown, black, tan)
Diameter (>5 mm, width of pencil eraser)
Evolving (change; size, shape, color,
elevation)
Aphasia
Broca’sMCA stroke (premotor area of the
left frontal lobe); slowed and hesitant speech
pattern, where the patient’s vocab is limited;
pt presents with difficulty properly arranging
words into well-formed sentences
o BEN (Broca’s, expressive, non-fluent)
Wernicke’sMCA stroke (auditory
association cortex in the left lateral temporal
lobe); speech that flows smoothly with a
preserved melody, however the speech is often incoherent; the patient’s auditory comprehension is impaired thus the pt
demonstrates difficulty with comprehending spoken language and following commands; pt may also be unable to
comprehend written words
o Receptive, sensory, or fluent aphasia
Global MCA stroke (1/3 frontal convolution and the posterior aspect of the superior temporal gyrus); combo of both
Broca’s and Wernicke’s aphasia and is characterized as a non-fluent speech with poor comprehension
o Patient’s with global aphasia have a significantly poorer prognosis compared to the other forms of aphasia
Treatment: promoting aphasics’ communication effectiveness (PACE); visual action therapy (VAT)
QUIZ QUESTIONS
Draw the brachial plexus…
Ottawa foot/ankle rules:
foot/ankle x-ray is indicated ifthere is pain present in the midfoot zone AND ANY ONE of the following are present:
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an inability to bear weight both immediately and in the emergency department for 4 steps
QUIZ QUESTIONS
What is the screw home mechanism?
OKC: Tibia on femur: tibia externally rotates
CKC: Femur on tibia: femur internally rotates
Loss of full knee extension ROM is a frequent finding in the population with knee OA
o Such loss of normal terminal knee ext may have important effects on knee mechanics during walking and standing
o A primary goal of physical therapy is to have a positive effect on the patient's ability to achieve terminal (endrange) knee extension during ADLs
The "screw-home" mechanism is considered to be a key element to knee stability for standing upright. The tibia rotates
internally during the swing phase and externally during the stance phase
o ER occurs during the terminal degrees of knee ext and results in tightening of both cruciate ligs, locks the knee
o The tibia is then in the position of maximal stability with respect to the femur.
o Last 30º of Extension causes a
Medial rotation of Femur on Tibia
will keep joint in closed packed
position. The Knee is Unlocked
by Lateral rotation of Femur.
o In open Kinematic chain Tibia
laterally rotates on Femur during
last 5º of Extension to produce
LOCKING. Unlocking by Medial
rotation
In most of the knee problems generally
there is an insufficiency on terminal
extension and VMO function.
What is the Listers’ tubercle?
Used as a pulley for the EPL
What does the lower subscapular nerve innervate? Nerve roots?
Subscapularis and teres major
What are the 3 signs of a Colles’ fx? Smiths fx?
Radial bone becomes shorter (more proximal), wrist drifts to the radial side, “dinner fork” deformity; displaced dorsally DC
Palmar displacement; SP
A patient’s recent MRI
confirms an acute L4 - L5
posterolateral disc herniation.
Upon
examination, which of the
following findings is the MOST
likely present?
A. Diminished knee jerk reflex
B. Impaired sensation along
the lateral thigh, anterior
knee, extending down the
medial tibia and
into the medial malleolar
region
C. Delayed heel off
D. Impaired sensation in the
web space between the first
and second digits
QUIZ QUESTIONS
What are the muscles of mastication?
Temporalis, masseter, medial pterygoid
What is DeQuervain’s syndrome?
EPB and APL; caused by repetitive gripping; chronic overuse
What is Gamekeeper’s thumb/ skier’s thumb?
UCL tear