MS Block Gross anatomy

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Most energy efficient way to counter counteract flexion-extension movements.
Ligaments
Iliofemoral ligament
Prevents hyperextension of the hip.
Type I muscle fibers
The most energy efficient muscle fiber type
Popliteus action
Unlocks the knee by rotating the femur laterally and slight knee flexion
Stride
Initial contact with one leg to initial contact with opposite leg
Step
Touchdown, Midstance, Liftoff
Pelvis during step
Forward rotation of pelvis with a swing limb
Heel strike
Gluteus maximus and anterior tibialis
Loading response
Quads and gastrocs
Midstance
Triceps surae
Jack-knife gait
If gluteus maximus or hamstring is weak. (inferior gluteal/tibial nerve)
Trendelenberg gait
Lean away from affected side.
Quadriceps gait
If femoral nerve is hurt. Knee collapse into flexion at initial contact and early loading response.
Quadriceps past midstance
No activity
Action of interossei and lumbricles
Help flex the MCP and extend the IP joint.
Precision grip
Partial felxion, Lower levels of FDP contraction, Passive tension in lumbricals (ulnar and median nerve), Active force via interossei (ulnar)
Avulsion
Spinal nerve torn from spinal cord.
Rupture
Spinal nerve torn beyond CNS
Neuroma
Spinal nerve torn and partially healed.
Neuropaxia
Spinal nerve stretched and damaged
C5
abduction of arm
C5 and 6
Flexion of elbow
C6, 7, 8
Extension of elbow
C8
Flexion of digits
T1
Adduction and abduction of digits
Erb-duchenne palsy (upper brachial plexus injury)
Roots of C5 and C6.
Lateral neck bending (fall on shoulder/childbirth).
Suprascapular, axillary, musculocutaneous, radial.
Deltoid and supraspinatus (arm adducted, cannot abduct).
Infraspinatus (Arm medially rotated by pec major and latissimus cannot rotate laterally).
Biceps, brachialis (Elbow extended, cannot flex, forearm pronate, WAITER's TIP)
Lower brachial plexus injury (Klumpke's)
C8-T1 damaged roots.
Hyperabduction of arm (grabbing object while falling).
Paralysis or weakness of short muscles of hand.
Claw hand.
Thoracic outlet syndrome.
Axillary nerve
Fracture of surgical neck of humerus. Dislocation of glenohumeral joint. Improper use of crutches. Regimental badge. Weakness in deltoid.
Musculocutaneous nerve
Biceps, coracobrachialis, and brachialis (weakness in elbow flexion and forearm supination).
Lateral cutaneous nerve of the forearm (loss of sensation on the lateral surface of forearm.
Ligament of struthers syndrome
Weakness of all median nerve nerve muscles (pronator teres, most finger flexors).
Thenar wasting (Ape hand).
Benediction hand, sensory loss over thenar eminence.
Pronator teres syndrome
Compression due to pronator teres. Pain on pronation but no muscle loss.
Anterior interosseous nerve
Cannot make OK sign. Weak flexion on 1st IP joint.
Carpal tunnel
Thenar wasting. No sensory loss.
Path of ulnar nerve
Guyon's canal
Proximal median nerve damage (cubital fossa and above)
Motor=finger and wrist flexors, thenar muscles, 1st and 2nd lumbricals. Can't flex distal IP joints on digits 2 and 3. Benediction hand when attempting to make a fist.
Above elbow=loss of pronation and medial deviation during wrist flexion.
Loss of sensation in lateral palm and tips of digits 1-3. Flexor of thumb IP joint only.
Ulnar nerve forearm neuropathies
Elbow-loss of dexterity, decreased grip and pinch strength.
Weakness in adduction at wrist.
Ulnar claw hand, froment sign. Digit 4-5 numbness.
Manerfelt's sing
index finger at PIP joint is hyperextended on pinching. Ulnar nerve injury.
Froment's sign
Adductor pollicis is weak
Upper humerus radial (Saturday night palsy)
Weakness in elbow and wrist extensors, weak wrist abduction and extension. Numbness on dorsum of hand.
Lower humerus radial nerve
Triceps spared. Lose brachioradialis, ECRL, ECRB, and wrist extensors, Numbness on dorsum of hand.
Posterior interosseous nerve
Brachioradialis and triceps functioning. Wrist drop.
Saturday night palsy
Happens via fracture of humerus
Long thoracic nerve (serratus anterior)
Winged scapula
Accessory nerve
Trapezius. Surgery in posterior triangle ofneck. Weak elevation of scapula.
Suprascapular
Overhead motion. Cannot abduct the first 15 degrees.
Herpes zoster (shingles)
Affects dermatomes and is dormant in the cell bodies of infected sensory nerves
Sclerotome
Vertebrae and ribs
Lateral plate mesoderm
Appendicular skeleton
Block vertebrae
improper segmentation
Spina bifida
Failure of the neural arches to fuse or adequately form. Occulta=mild "hair tuft"
Meninges herniates
Meningocele
Meninges and spinal cord herniate
Myeloeningocele
Nucleus pulposus
Type II collagen
Annulus fibrosis
Type I (fibrocartilage)
Sharpey's fibers
attach to the bone
Bertolotti's syndrome
5th lumbar fused with sacral = sacralizaiton
Primary curves
thoracic and sacral (kyphosis)
Swayback
Excessive lordosis
Hunchback
Exessive kyphosis
Herniations
tend to be posterior and lateral (lower cervical or lower lumbar)
Whiplash
Injury to anterior longitudinal ligament. Head and neck hyperextended then slammed forward.
Lumbar puncture
Done below L2 (most commonly L4-L5) to avoid spinal cord.
L4
Supracristal plane
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