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The upper trunk lesions are d/t:
trauma (MVA, birth trauma)
Another name for upper trunk lesion
Erb Duchanne Palsy
Erb Duchenne Palsy is d/t _________ of the neck which leads to paralysis of which cervical roots?
hyperextension

C5, C6
C7 root can be compressed by:
cervical disk lesion
fracture of surgical neck can cause what nerve lesions?
Axillary n
dislocation of the humerus can cause which nerve lesions?
Axillary nerve lesion (decreased abduction & sensory over deltoid)
intramuscular injections can cause which nerve lesions?
Axillary nerve lesion (decreased abduction & sensory over deltoid)
Midshaft fracture of humerus can cause lesion of what nerve?
radial nerve in the spiral groove
Lower trunk lesions can be d/t what?
cervical rib
pancoast tumor of lung
Another name for lower trunk lesion
Klumpke's palsy
Which nerve roots are damaged in Klumpke's palsy?
C8, T1
A pt presents with clawing of all digits.
Name of claw?
Which nerves damaged?
Which muscles damaged?
Klumpke's total claw
C8, T1
Loss of all lumbricals = finger extensors & finger flexors are unopposed = clawing
Which nerve is compressed by incorrect use of a crutch?
Radial n
What nerve is damaged d/t supracondylar fracture of the humerus?
Median n.
What nerve causes pronator teres syndrome?
Median n.
Which nerve is stretched by the subluxation of the radius?
Redial n (deep branch)
Which nerve is damaged d/t fxt of medial epicondyle of humerus?
Ulnar n
Superficial laceration at the thenar eminence can damage which nerve?
Recurrent branch of the medial nerve to thenar muscles
Fracture of the hook of hamate leads to lesion of what nerve?
Ulnar n
Dislocation of the lunate can lead to which nerve lesions?
Median n
Saturday Night Palsy
Radial N lesion d/t compression against the spiral groove of the humerus = weak wrist and finger extension, weak brachioradialis reflex C6) BUT normal triceps
Hand of Benediction
Median n lesion = digits 2 and 3 remain partially extended when pt makes a fist
Ape hand
PROXIMAL Median n lesion - THUMB movement is limited only to flexion/extension (NO apposing of thumb)
Can carpal tunnel radiate to the elbow?
YES
Which nerve is the main one for flexors?
musculocutaneous nerve
Which nerve is the main one for thumb + pronators?
Median n
1) pt has this problem when they try to extend fingers

2) pt has this problem when they try to flex fingers
1) can't extend 4th/5th fingers = DISTAL ulnar nerve lesion

2) can't flex 2nd/3rd fingers = proximal median nerve lesion = "Pope's blessing"
1) if pt has this after trying to extend fingers

2) if pt has this after trying to flex fingers
1) can't extend 2nd/3rd fingers = DISTAL median nerve lesion

2) can't flex 4th/5th fingers = PROXIMAL ulnar nerve lesion
TOTAL claw of all of the fingers in the hand is d/t damage to what?
the LOWER trunk (C8, T1)
What is the mnemonic and the muscles in the THENAR eminence?

What is the mnemonic and the muscles in the HYPOTHENAR eminence?
THENAR = "OAF" = Median nerve
- Opponens pollicis
- Abductor pollicis brevis
- Flexor pollicis brevis

HYPOTHENAR = "OAF Minimi" = Ulnar n.
- Opponens digiti minimi
- Abductor digiti minimi
- Flexor digiti minimi
What do the DORSAL interosseus muscles do?

What do the PALMAR interosseus muscles do?
"DAB PAD"

ABduct fingers = "DAB = Dorsals ABduct"

ADduct fingers = "PAD = Palmars ADduct"
Which nerve innervates the interosseus muscles?
Ulnar n. = which innervates all the wimpy muscles
Which nerves innervate the lumbricals?

What is the action of the lumbrical muscles?
Two medial lumbricals = innervated by the ulnar nerve

Two lateral lumbricals = innervated by the median nerve

Lumbrical muscles FLEX the MCP joint & extend the PIP & DIP
What muscle & nerve are required to initiate abduction of the arm?
Supraspinatus muscle = innervated by the supraspinatus nerve
What muscle & nerve are required to abduct arm beyond 10*?
Deltoid muscle = axillary nerve
What muscle & nerve are required to raise the arm above horizontal (>90*)?
Serratus anterior muscle = long thoracic n

Trapezius muscle = spinal accessory nerve
Name the college/protein defect in:

Osteogenesis imperfecta
Ehlers Danlos syndrome
Marfan's
Osteogenesis imperfecta - Type I collagen
Ehlers Danlos syndrome - Type III collagen
Marfan's - fibrillin
What is the landmark used for the pudendal nerve block?
ischial spine
What is the landmark used for the lumbar puncture?
iliac crest (which is at L4)
Name the dz:

Pathologic fxt and anemia in a pt
osteopetrosis (can't break down bone, so thickened, dense bone that are prone to fxt. Because there is building of bone, it's decreasing free space for the marrow = pancytopenia)
What is the triad of McCune-Albright syndrome?
multiple unilateral bone lesions (short stature)

endocrine abnormalities (precocious puberty)

Unilateral pigmented skin lesions (cafe au lait) spots
Which finger joints are affected in osteoarthritis?

Which finger joints are affected in rheumatoid arthritis?
osteoarthritis - DIP (Haberden's nodes) & PIP (Bouchard's nodes)

rheumatoid arthritis - MCP & PIP (panus formation)...but NO DIP involvement!!
Rheumatoid arthritis is a type ____ hypersensitivity
Type III - IgM (Rheumatoid factor) binds to the Fc region of IgG, forming a complex
1) Can't see, can't pee, can't climb a tree

2) Can't see, can't pee, can't hear

3) can't see, can't spit, can't climb shit
1) Reiter's syndrome (mc d/t chlamydia)

2) Alport syndrome (hereditary nephritis)

3) Sjogren's syndrome
What is the tx for acute gout?

chronic gout?
acute gout = nsaids (DOC; ie..indomethacin), steroids, colchicine

chronic gout = allopurinol, probenecid, colchicine (prophylaxis), nsaids
Tx for pseudogout
colchicine (decrease inflammation!)
Nsaids
What are the 4 serongeative spondyloarthropathies?

Which HLA are they associated with?
HLA-B27

Mnemonic is "PAIR"

Psoriatic arthritis
Ankylosing spondylitis
Inflammatory bowel disease
Reiter's syndrome (Reactive syndrome)
What two problems can cause Reiter's syndrome?
Post-GI infection (Shigella flexneri)

Chlamydia infection
What things are associated with Ankylosing spondylitis?
Dz of spine and SI JOINTS!
Uveitis
Aortic regurgitation
HLA-B27
Anti-Jo-1 Ab is associated with what
polymyositis/dermatomyositis
What does increase CK and aldolase mean?
increased muscle breakdown and damage.

Seem in polymyositis/dermatomyositis

(polymyalgia rheumatica does NOT have increased CK since it's not a muscle problem!!)
This neuromuscular junction dz is associated with thymus hyperplasia (thymoma)
Myasthenia gravis
This neuromuscular junction dz is associated with paraneoplastic diseases
Lambert-Eaton syndrome
- small cell lung cancer!
What is Legg-Calve-Perthes dz?
avascular necrosis of head of femur
- seen in boys > girls
- ~3-10 yo
- pt presents with a limp and decreased ROM in one of the hips & compains of ipsilateral knee pain

It is the MC cause of limp in the 4-10yo age group (painless limp)
"pruritic, purple, polygonal papules" described what?
Lichen planus
- sawtooth infiltrate of lymphocytes at the dermal-epidermal junction
- associated with Hep. C
Actinic keratosis
premalignant lesions caused by sun exposure
-small, rough, erythematous or brownish papules = "cutaneous horn"
- Can peel the lesions off but will grow back!!
- precursor to Squamous cell carcinoma
Tx = 5-FU!
A pt has painful petechial rash mainly on the anterior shins. Dx?
Erythema nodosum
- ifnlammaotyr lesions of SubQ fat
- Associated with sarcoidosis, coccidioidomycosis, histoplasmosis, TB, leprosy, & strep infections
A pt had a patch on his back, which then developed into a "Christmas tree" distribution
Pityriasis rosea ("piTREEriasis")
What are the ABCD's of Melanoma?
Skin ABCD Mnemonic of Melanoma
Melanoma is characterized by:

- Asymmetric lesion
- Border is irregular
- Colors
- Diameter of more than 0.5 cm