Peripheral Nerves

1. True or False. The peripheral nervous system includes		G7 p.786:35 mm
a. spinal nerves	true
b. all cranial nerves	false
c. cranial nerves III-XII	true
d. cervical, brachial, lumbosacral plexus	true
2. True or False. Upper motor neuron paralysis includes		G7 p.786:135mm
a. clonus	true
b. hyperactive reflexes	true
c. muscle spasms	true
d. atrophy	false
e. fasciculations	false (Choices d and e are characteristic of lower motor neuron paralysis.)
3. List the 11 muscles of the shoulder and their nerves and roots.		G7 p.787:40mm
Hint: pqrst (tssrppldbb)
a. muscle, t_____	trapezius
i. nerve, s_____ a_____	CN X1 spinal accessory
ii. roots,_____	C3,4
b. muscle, s_____ a_____	serratus anterior
i. nerve, l_____ t_____	long thoracic
ii. roots,_____	C5,6,7
c. muscle, s_____	supraspinatus
i. nerve, s_____	suprascapular
ii. roots,_____	C4,5,6
d. muscle, i_____	infraspinatus
i. nerve, s_____	suprascapular
ii. roots,_____	C5,6
e. muscle, r_____	rhomboids
i. nerve, d_____ s_____	dorsal scapular
ii. roots,_____	C4,5
f. muscle, p_____ m_____	pectoralis minor
i. nerve, a_____ t_____	anterior thoracic (med) aka pectoral nerve
ii. roots,_____	C7,8
g. muscle, p_____ m_____	pectoralis major (lat.
i. nerve, a_____ t_____	anterior thoracic anterior thoracic med) aka pectoral nerve
ii. roots, _____	C4,5,6,7,8
h. muscle, l_____ d_____	latissimus dorsi
i. nerve, t_____	thoracodorsal
ii. roots, _____	C5,6,7,8
i. muscle, d_____	deltoid
i. nerve, a_____	axillary
ii. roots, _____	C5,6
j. muscle, b_____	brachialis
i. nerve, m_____	musculocutaneous
ii. roots,_____	C5,6
k. muscle, b_____	biceps
i. nerve, m_____	musculocutaneous
ii. roots,_____	C5,6
4. List 11 muscles of the shoulder and arm, their nerve, and their action.		G7 p.787:40mm
a. muscle, t_____	trapezius
i. nerve,_____	CNX1
ii. action,_____ _____	shrug shoulders
b. muscle, s_____ _____	serratus anterior
i. nerve,_____ _____	long thoracic
ii. action,_____ _____ _____	forward shoulder thrust
c. muscle, s_____	supraspinatus
i. nerve,_____	suprascapsular
ii. action,_____ _____ _____	abduct arm 90 degrees
d. muscle,_____	infraspinatus
i. nerve,_____	suprascapsular
ii. action,_____ _____ _____	backhand tennis shot
e. muscle, r_____	rhomboids
i. nerve,_____ _____	dorsal scapular
ii. action,_____ _____	abduct scapulae
f. muscle, p_____ m_____	pectoralis minor
i. nerve,_____ _____ _____	pectoral nerve medial
ii. action,_____ _____	adduction arm
g. muscle, p_____ m_____	pectoralis major
i. nerve,_____ _____ _____ _____ _____ _____	pectoral nerve lateral and medial
ii. action,_____ _____ _____ _____ _____	adduction arm and push arm forward
h. muscle, l_____ d_____	latissimus dorsi
i. nerve,_____	thoracodorsal
ii. action,_____ _____, _____ _____, _____	adduct arm, ladder climb, cough
i. muscle, d_____	deltoid
i. nerve,_____	axillary
ii. action,_____ _____ _____	abduct arm > 90 degrees
j. muscle, b_____	brachialis
i. nerve,_____	musculocutaneous
ii. action,_____ _____	flex forearm
k. muscle, b_____	biceps
i. nerve,_____	musculocutaneous
ii. action,_____and_____ _____	flex and supinate forearm
5. True or False. The suprascapular nerve innervates which of the following?		G7 p.787:75mm
a. teres major	false—subscapular nerve (C5-C7)
b. teres minor	false—axillary nerve (C4-C5)
c. infraspinatus	true
d. supraspinatus	true
6. The suprascapular nerve contains roots from_____, _____, and_____	C4, C5, C6	G7 p.787:75mm
7. Describe the latissimus dorsi muscle.		G7 p.787:82mm
a. function
i. l_____ _____	ladder climbing
ii. c_____	cough
iii. a_____	adductor—together with pectoralis
b. nerve	thoracodorsal nerve
c. cord	posterior cord
d. roots	C6,7,8
8. True or False. The deltoid muscle		G7 p.787:90mm
a. abducts arm 0 to 90 degrees	false (The arm is abducted 0 to 90 degrees by the supraspinatous muscle.)
b. abduct arm > 90 degrees	true
c. is innervated by the axillary nerve	true
d. rotates the arm out	false (Arm is rotated out by the infraspinatus muscle.)
9. True or False. The abductor pollicis longus		G7 p.788:60mm
a. is innervated by the median nerve	false
b. is innervated by the radial nerve	true
c. is innervated by the ulnar nerve	false
d. is innervated by the posterior interosseous nerve	true (The posterior interosseus nerve is a continuation of the radial nerve in the forearm.)
10. True or False. The median nerve is responsible for the following movements of the thumb:		G7 p.788:110mm
a. adduction	false (served by ulnar nerve)
b. abduction	true
c. extension	false (served by radial nerve)
d. flexion	true
e. opposition	true
11. Complete the following about the movements of the thumb:		G7 p.788:110mm
a. Actions of nerves to the thumb
i. median nerve, Hint: FAO
F—action, f_____ muscle, f_____ p_____ b_____and l_____ root,_____	flexion flexor pollicis brevis and longus C8, T1, median
A—action, a_____ muscle, a_____ p_____ b_____ root,_____	abduction abductor pollicis brevis C8, T1, median
O—action, o_____ muscle, o_____ p_____ root,_____	opposition opponens pollicis C8, T1
ii. ulnar nerve
action, a_____ muscle, a_____ p_____ root,_____ _____	adduction adductor pollicis C8, T1
iii. radial nerve
action, e_____ muscle, e_____ p_____ b_____and l_____ root, C_____ and C_____	extension extensor pollicis brevis and longu C7, C8
b. Plane of movement for the thumb
i. extension is _____	plane of palm
ii. flexion is _____	plane of palm
iii. adduction is _____	perpendicular to palm
iv. abduction is _____	perpendicular from palm
v. opposition is _____	across the palm
12. Complete the following about peripheral nerves of the leg:		G7 p.788:145mm
Hint: fosis pdstp (follow our sign. it says “please don’t spoil the plants”)
a. f_____	femoral
b. o_____	obturator
c. s_____	superior gluteal
d. i_____	inferior gluteal
e. s_____	sciatic (trunk)
f. p_____	peroneal (trunk)
g. d_____	deep peroneal
h. s_____	superficial peroneal
i. t_____	tibial
j. p_____	pudendal
13. Name the nerves of the lower extremities and the roots that form them.		G7 p.788:145mm
a. f_____	femoral, 1,2,3
b. o_____	obturator, 2,3
c. s_____	superior gluteal, 4, 5, S1
d. i_____	inferior gluteal, 5, S1, S2
e. s_____	sciatic, 5, S1, S2
f. p_____	peroneal, 4, 5, S1
g. d_____	deep peroneal, 4, 5
h. s_____	superficial peroneal, 5, S1
i. t_____	tibial, 4, 5, S1, S2, S3
j. p_____	pudendal, S2, S3, S4
14. Name the nerves of the lower extremities and the muscles and function of the muscles they serve.		G7 p.788:155mm
a. nerve, f_____	femoral
i. muscle, i_____, q_____ f_____, s_____	iliopsoas, quadriceps femoris, sartorius
ii. function, f_____ h_____	flex hip
b. nerve, o_____	obturator
i. muscle, a_____	adductor
ii. function, a_____ t_____	adduct thigh
c. nerve, s_____ g_____	superior gluteal
i. muscle, g_____ m_____	gluteus medius
ii. function, a_____ t_____	abduct thigh
d. nerve, i_____ g_____	inferior gluteal
i. muscle, g_____ m_____	gluteus maximus
ii. function, f_____ l_____	flex leg
e. nerve, s_____ t_____	sciatic trunk
i. muscle, b_____s_____ s_____	biceps femoris, semi tendenosis, semi membranosis
ii. function, e_____ t_____	extend thigh
f. nerve, d_____ p_____	deep peroneal
i. muscle, t_____ a_____,e _____ h_____ l_____	tibialis anterior, extensor hallucis longus (EHL)
ii. function, g_____ t_____ e_____, f_____ d_____	great toe extension, foot dorsiflexion
g. nerve, s_____ p_____	superficial peroneal
i. muscle, p_____ l_____	peroneus longus
ii. function, p_____ f_____ f_____ and t_____	plantar flexion foot and toes
h. nerve, t_____ tibial
i. muscle, p_____ t_____, g_____, s_____, f_____ h_____ l_____	posterior tibial, gastrocnemius, soleus, flexor hallucis longus (FHL)
ii. function, p_____ f_____ f_____ and t_____	plantar flex foot and toes
i. nerve, p_____	pudendal
i. muscle, p_____, s_____	perineal, sphincters
ii. function, v_____ c_____ of p_____ f_____	voluntary contraction of pelvic floor
15. True or False. The gluteus maximus muscle		G7 p.789:37mm
a. abducts thigh	true (The gluteus maximus abducts thigh in a prone position.)
b. adducts thigh	false (thigh—adduction — the obturator externus muscle and pectineus muscle)
c. medially rotates thigh	false (thigh—medial rotation— the gluteus medius and minimus muscle)
d. externally rotates thigh	false (thigh—external rotation —the obturator externus muscle)
e. is innervated by superior gluteal nerve	false (The gluteus maximus is innervated by the inferior gluteal nerve.)
16. True or False. The tibialis anterior muscle is responsible for foot		G7 p.789:60mm
a. dorsiflexion	true
b. plantar flexion	false (plantar flexion—soleus muscle, gastrocnemius muscle)
c. eversion	false (eversion—peroneus longus and brevis muscles)
d. inversion	false (inversion—posterior tibialis muscle)
17. Complete the following about the function of peripheral nerves:		G7 p.789:65mm
a. The function of extension of the great toe is served by
i. muscle, _____ _____ _____	extensor hallucis longus
ii. root, _____	L5
b. The function of foot dorsiflexion is served by
i. muscle,_____ _____	tibialis anterior
ii. root, _____	L4
c. Which is the best L5 muscle? (Hint: The letter E is the fifth letter in the alphabet.)	extensor hallucis longus	G7 p.789:140mm
18. True or False. The extensor hallucis longus muscle		G7 p.789:65mm
a. is the best L5 muscle	true
b. extends great toe	true
c. dorsiflexes foot	true
d. is innervated by the deep peroneal nerve	true
19. Complete the following regarding timing of surgical repair of nerves:		G7 p.790:55mm
a. If the nerve must regenerate a long distance, repair should be done____.	early
b. After _____ months most muscles cannot recover.	24

Brachial Plexus

20. True or False. The brachial plexus is formed by the dorsal rami of C5-T1.	false (It is formed by the ventral rami of C5-T1. The dorsal rami innervate the paraspinal muscles.)	G7 p.790:90mm
21. Draw a diagram of the brachial plexus.		G7 p.790:90mm

Fig. 24.1
22. On your diagram of the brachial plexus, label the following:		G7 p.790:90 mm
roots C4-T1; organization RTDCN (roots, trunks, divisions, chords, nerves); names of trunks—SMI (superior, middle, inferior); add names of cords— LMP (lateral, medial, posterior)

Fig. 24.2
23. Add the nerves to the basic outline of the brachial plexus nerves: 16. (Hint: Donald says somewhat loudly, “Mickey Mouse, you are right to so sincerely love Minnie Mouse madly.”)		G7 p.790:92mm

Fig. 24.3
24. Draw the complete brachial plexus.		G7 p.790:93mm

Fig. 24.4
25. Draw the left brachial plexus—outline.		G7 p.790:94 mm

Fig. 24.5
26. Draw the left brachial plexus and add details requested in questions 21 through 23.		G7 p.790:95mm

Fig. 24.6
27. Complete the following about the brachial plexus:		G7 p.790:100mm
a. Name the roots (6).	C4, C5, C6, C7, C8, T1
b. Name the segments (5). (Hint: Run to do Cindy’s needs.)	roots. trunks, divisions, chords, nerves
c. Name the nerves (16). (Hint: Donald says somewhat loudly, “Mickey Mouse, you are right to so sincerely love Minnie Mouse madly.”)	dorsal scapular suprascapular subclavius lateral pectoral musculocutaneous median ulnar axillary radial thoracodorsal subscapular upper subscapular lower long thoracic medial pectoral medial brachial cutaneous medial antebrachial cutaneous
d. Name the trunks (3).	superior, middle, inferior,
e. Name the cords (3).	lateral, medial, posterior
28. Trace, using the brachial plexus diagram, the theoretically possible root contribution to each nerve and then compare with the actual root contribution in each nerve.		G7 p.790:100mm Fig. 24-1
a. nerve, d_____ s_____	dorsal scapular
i. theoretical,_____	C4,5
ii. actual,_____	C4,5
b. nerve, s_____	suprascapular
i. theoretical,_____	C4,5,6
ii. actual,_____	C4,5,6
c. nerve, s_____	subclavius
i. theoretical,_____	C6
ii. actual,_____	C6
d. nerve, l_____ p_____	lateral pectoral
i. theoretical,_____	C4,5,6,7
ii. actual,_____	C4,5,6,7
e. nerve, m_____	musculocutaneous
i. theoretical,_____	C5,6,7
ii. actual,_____	C5,6,7
f. nerve, m_____	median
i. theoretical,_____	C5,6,7, T1
ii. actual,_____	C5,6,7, T1
g. nerve, u_____	ulnar
i. theoretical,_____	C8, T1
ii. actual,_____	C7,8, T1
h. nerve, a_____	axillary
i. theoretical,_____	C4,5,6,7,8, T1
ii. actual,_____	C4,5,6,7,8, T1
i. nerve, r_____	radial
i. theoretical,_____	C4,5,6,7,8, T1
ii. actual,_____	C4,5,6
j. nerve, t_____	thoracodorsal
i. theoretical,_____	C5,6,7,8, T1
ii. actual,_____	C6,7,8
k. nerve, s_____ u_____	subscapular upper
i. theoretical,_____	C5,6,7,8, T1
ii. actual,_____	C5,6,7
l. nerve, s_____ l_____	subscapular lower
i. theoretical,_____	C5,6,7,8, T1
ii. actual,_____	C5,6,7
m. nerve, l_____ t_____	long thoracic
i. theoretical,_____	C5,6,7
ii. actual,_____	C5,6,7
n. nerve, m_____ t_____	medial thoracic (pectoral)
i. theoretical,_____	C8,T1
ii. actual,_____	not listed
o. nerve, m_____ b_____	medial brachial
i. theoretical,	C8,T1
ii. actual,_____	not listed
p. nerve, m_____ a_____	medial antebrachial
i. theoretical,_____	C8,T1
ii. actual,_____	not listed
29. List the brachial plexus nerves (except for median ulnar and radial), the muscles they serve, the roots that are in that nerve, and the action of the muscles.		G7 p.790:100mm Table 24-4
a. nerve, d_____ s_____	dorsal scapular
i. muscle,_____	levator scapulae
ii. root,	C3,4,5
iii. action,	elevate scapulae
b. nerve, d_____ s,_____	dorsal scapular
i. muscle,_____	rhomboids
ii. root,_____	C4,5
iii. action,_____ _____ _____ _____	adduct and elevate scapula
c. nerve, s_____	suprascapular
i. muscle,_____	supraspinatus
ii. root,_____	C4,5,6
iii. action,_____ _____ _____ _____ _____	adduct arm 0 to 90 degrees
d. nerve, s_____	supraspinatus
i. muscle,_____	infraspinatus
ii. root,_____	C5,6
iii. action,_____ _____ _____	rotate arm out
e. nerve, m_____	musculocutaneous
i. muscle,_____ _____	biceps brachii
ii. root,_____	C5,6
iii. action,_____ _____ _____ _____	flex and supinate forearm
f. nerve, m_____	musculocutaneous
i. muscle,_____	coracobrachialis
ii. root,_____	C5,6,7
iii. action,_____ _____ _____ _____	flex and adduct forearm
g. nerve, m_____	musculocutaneous
i. muscle,_____	brachialis
ii. root,_____	C5,6
iii. action,_____	flex forearm
h. nerve, a_____	axillary
i. muscle,_____	deltoid
ii. root,_____	C5,6
iii. action,_____ _____ _____	abduct arm > 90 degrees
i. nerve, s_____	subscapularis
i. muscle,_____ _____	teres major
ii. root,_____	C5,6,7
iii. action,_____ _____	adduct arm
j. nerve, t_____	thoracodorsal
i. muscle,_____ _____	latissimus dorsi
ii. root,_____	C5,6,7,8
iii. action,_____ _____, _____, _____	adduct arm, ladder, cough
k. nerve, a_____	axillary
i. muscle,_____ _____	teres minor
ii. root,_____	C4,5
iii. action,_____ _____	rotation lateral
l. nerve, l_____ t_____	long thoracic
i. muscle,_____ _____	serratus anterior
ii. root,_____	C5,6,7
iii. action,_____ _____ _____	forward shoulder thrust
30. Considering the brachial plexus and radial nerve, list the branches of the radial nerve cascade in proper sequence and the function of the muscles.		G7 p.791:30mm
Hint: rest in peace, retbes in peeeeeae
a. r_____	radial
b. e_____	extensor
c. t_____	triceps
d. b_____	brachioradialis
e. e_____	extensor carpi radialis
f. s_____	supinator
g. i_____	i
h. n_____	n posterior interosseus nerve
i. p_____	p
j. e_____	extensor carpi ulnaris
k. e_____	extensor digitorum communis
l. e_____	extensor digiti minimi
m. e_____	extensor pollicis brevis
n. e_____	extensor pollicis longus
o. a_____	abductor pollicis longus
p. e_____	extensor indicis
31. True or False. The radial nerve is formed by		G7 p.791:29mm
a. C5-T1	false
b. C5-C8	true
c. C6-T1	false
d. C5-C7	false
32. True or False. Regarding the radial nerve, it		G7 p.791:29mm
a. is formed by C5-C8	true
b. innervates triceps	true
c. innervates supinator	true
d. innervates brachioradialis	true
e. continues into forearm as posterior interosseus nerve	true
33. What is innervated by the axillary nerve?		G7 p.791:105mm
a. t_____ m_____	teres minor
b. d_____	deltoid
34. Regarding the brachial plexus and median nerve, list the 11 branches of the median nerve cascade in proper sequence.		G7 p.791:120mm
a. p_____	pronator teres
b. f_____	flexor carpi radialis
c. p_____	palmaris longus
d. f_____	flexor digitorum superficialis
e.f_____	flexor digitorum profundus
f. f_____	flexor pollicis longus
g. p_____	pronator quadratus
h. f_____	flexor pollicis brevis
i. a_____	abductor pollicis brevis
j. o_____	opponens pollicis
k. l_____	lumbricales 1 and 2
35. Regarding the brachial plexus and median nerve, list the 11 branches of the median nerve cascade and the function of the muscles.		G7 p.791:120mm
a.
i. p_____ t_____	pronator teres
ii. function: f_____ p_____	forearm pronator
b.
i. f_____ _____ _____	flexor carpi radialis
ii. function: r_____ f_____ of h_____	radial flexion of hand
c.
i. p_____ _____	palmaris longus
ii. function: h_____ f_____	hand flexion
d.
i. f_____ _____ _____	flexor digitorum superficialis
ii. function: f_____ m_____ p_____, fingers_____ to _____	flex middle phalanx, fingers 2 to 5
e.
i. f_____ _____ _____	flexor digitorum profundus
ii. function: f_____ d_____ p_____, fingers _____ to _____	flex distal phalanx, fingers 2 to 3
f.
i. f_____ p_____ l_____	flexor pollicis longus
ii. function: f_____ d_____ p_____ of t_____	flex distal phalanx of thumb
g.
i. p_____ _____	pronator quadratus
ii. function: p_____ f_____	pronates forearm
h.
i. f_____ p_____ b_____	flexor pollicis brevis
ii. function: f_____ p_____ p_____ of t_____	flexes procimal phalanx of thumb
i.
i. a_____ _____ _____	abductor pollicis brevis
ii. function: a_____ t_____ m_____	abducts thumb metacarpal
j.
i. o_____ _____	opponens pollicis
ii. function: op_____ t_____ m_____	opposes thumb metacarpal
k.
i. l_____ 1 and 2	lumbricales
ii. function: e_____ 2 d_____ p_____ of _____ 2 and 3	extend 2 distal phalanges of fingers 4 and 5
36. Which muscles in the hand are innervated by the median nerve?		G7 p.791:150mm
Hint: loaf
a. l_____	lumbricals 1 and 2
b. o_____	opponens pollicis
c. a_____	abductor pollicis brevis
d. f_____	flexor pollicis brevis
37. Which muscles are served by the anterior interosseous nerve?		G7 p.791:170mm
a. f_____ d_____ p_____	flexor digitorum profundus
b. f_____ p_____ l_____	flexor pollicis longus
c. p_____ q_____	pronator quadratus
38. Regarding the brachial plexus and ulnar nerve, list the muscles served by the ulnar nerve cascade in proper order and the function of the muscles.		G7 p.792:25mm
Hint: “Ffafner I Love Him”
a.
i. f_____ c_____ u_____	flexor carpis ulnaris
ii. function: u_____ f_____ of h_____	ulnar flexion of hand
b.
i. f_____ _____ _____	flexor digitorum profundus
ii.f_____ d_____ p_____ of f_____ _____ and _____	flex distal phalanx of fingers 4 and 5
c.
i. a_____ p_____	adductor pollicis
ii. function: t_____ a_____	thumb adductor
d.
i. f_____ _____ _____	flexor pollicis brevis
ii. function: f_____ p_____ p_____ of t_____	flex proximal phalanx of thumb
e.
i. i_____	interossei
ii. function: dorsal a_____	abducts
iii. function: palmar a_____ f_____ p_____ p_____ at m_____ joints	abducts flex proximal phalanges at metacarpo phalangeal joints
f.
i. l_____	lumbricales
ii. function: e_____ t_____ d_____ p_____ of _____ _____ and _____ at i_____ j_____	extends two distal phalanges of 3 and 4 at interphalangeal joints
g. h_____	hypothenar abductor digiti minimi, flexor digiti minimi opponens
i. function: a_____ l_____ f_____	abduction little finger
ii. function: f_____ l_____ f_____	flex little finger
39. Study Chart.		G7 p.791:20mm

40. Which muscles in the arm are innervated by the ulnar nerve?	none	G7 p.792:30mm
41. Regarding the following additional (2) nerves of the brachial plexus, number the roots and name the muscles and their actions:		G7 p.792:60mm also G7 p.792:110mm
a. nerve, musculocutaneous
i. roots,_____	C5,6,7
ii. muscles, b_____, c_____, b_____	biceps, coracobrachialis, brachialis
iii. action, f_____ f_____ and s_____	flex forearm and supinates
iv. f_____ f_____ and a_____	flex forearm and adducts
v. f_____ f_____	flex forearm
b. nerve, axillary
i. roots,_____	C4,5,6
ii. muscles, d_____, t_____ m_____	deltoid, teres minor
iii. action, a_____ a_____ _____ to _____ degrees	abduct arm 30 to 90 degrees
iv. l_____ a_____ r_____	lateral arm rotation
42. Complete the following about anatomic variants with Martin-Gruber anastomosis:		G7 p.792:135mm
a. Connections between the_____ and _____ nerves	median; ulnar
b. In the_____	forearm
c. Found in _____% of cadavers	23%

Peripheral Neuropathies

43. List the etiology.		G7 p.793:65mm
Hint: dang the rapist
a. d_____	diabetes
b. a_____	alcohol
c. n_____	nutritional, B₁₂
d. g_____	Guillain-Barré
e. t_____	traumatic
f. h_____	hereditary
g. e_____	entrapment
h. r_____	renal, radiation
i. a_____	amyloid
j. p_____	porphyria, paraneoplastic
k. i_____	infectious, Hanson
l. s_____	sarcoidosis
m. t_____	toxins, heavy metals
44. Complete the following regarding peripheral neuropathy:		G7 p.793:130mm
a. The most common peripheral neuropathy that is an inherited disorder is C_____ -M_____ -T_____ s_____.	Charcot-Marie-Tooth syndrome
b. The percent of patients with diabetes mellitus who develop diabetic neuropathy is _____%.	50%
45. Which syndrome is associated with pure sensory neuropathy?	paraneoplastic syndrome (also seen with pyridoxine therapy)	G7 p.794:75mm
46. True or False. Alcohol neuropathy includes		G7 p.794:100mm
a. motor neuropathy	false
b. sensory neuropathy	true
c. absent Achilles reflex	true
d. intense pain	false
47. Brachial neuritis		G7 p.794:78mm
a. aka P_____ t _____syndrome	Parsonage tumor
b. aka i_____ brachial plexus neuropathy	idiopathic
c. Etiology:_____	unclear
d. Prognosis:_____	good
e. Predominant symptom:_____	pain
f. Followed by:_____ in _____%	weakness, 96%
g. Confined to shoulder girdle in _____%	50%
48. True or False. The most important study in the diagnosis of lumbosacral plexus neuropathy is		G7 p.796:45mm
a. magnetic resonance imaging (MRI)	false
b. computed tomography (CT)	false
c. electromyography (EMG)	true (EMG in lumbosacral neuropathy—rule out diabetic neuropathy!)
d. erythrocyte sedimentation rate (ESR)	false
49. EMG in lumbosacral neuropathy shows what in regards to:		G7 p.796:45mm
a. fibrillation potentials_____	increased
b. motor unit potentials in number_____	decreased
c. motor unit potentials in amplitude_____	increased
d. motor unit potentials in duration_____	increased
e. motor unit potentials that are_____	polyphasic
f. have changes involving at least_____ segments	2
g._____ the paraspinal muscles is highly_____	sparing diagnostic
50. Complete the following about diabetic neuropathy:		G7 p.796:65mm
a. Diabetic patients show neuropathy or EMG changes_____%.	50
b. The first symptom of diabetes may be_____.	neuropathy
c. Neuropathy might be reduced by control of blood_____.	sugar
51. Complete the following about drug induced neuropathy:		G7 p.797:145mm
Hint: CDEF
a. C_____	Chemotherapy drugs
b. D_____	Dilantin
c. E_____	Elavil
d. F_____	Flagyl
52. True or False. Femoral neuropathy includes		G7 p.798:25mm
a. weakness of quadriceps and iliopsoas	true
b. patellar reflex—reduced	true
c. femoral stretch—positive	true
d. sensation over lateral calf reduced	false (Femoral neuropathy includes ↓ sensation over anterior thigh and medial calf.)
53. Answer the following regarding femoral neuropathy:		G7 p.798:35mm
a. Name the muscle responsible for
i. knee extension	quadriceps femoris
ii. hip flexion	iliopsoas
b. To distinguish L4 radiculopathy from femoral neuropathy, L4 radiculopathy would not involve the_____.	iliopsoas
c. Femoral neuropathy is caused by
i. d_____	diabetes
ii. c_____	compression
54. True or False. The most frequent cause of femoral neuropathy is		G7 p.798:75mm
a. intraabdominal tumor	false
b. retroperitoneal hematoma	false
c. diabetes	true (Diabetes is the most frequent cause. All options can cause femoral neuropathy.)
d. entrapment due to inguinal hernia	false
e. trauma	false
55. True or False. Regarding AIDS neuropathy:		G7 p.798:110mm
a. It usually presents as proximal symmetric polyneuropathy.	false (It is a distal symmetric polyneuropathy.)
b. Only HIV+ patients do not develop it.	true
c. It never includes sensory elements.	false (usually includes numbness and tingling)
d. It has infectious etiology.	true
e. It may be caused by lymphomatous invasion of the meninges or nerves.	true
56. Complete the following about monoclonal gammopathy:		G7 p.799:28mm
a. Include entities such as
i. m_____	myeloma
ii. Waldenström_____	macroglobulinemia
b. Responsible for _____% of neuropathies	10%
57. Complete the following about perioperative neuropathies ulnar:		G7 p.799:126mm
a. Avoid elbow flexion of greater than _____ degrees.	110
b. It tightens the_____ _____ retinaculum.	cubital tunnel
58. Complete the following about lower extremity neuropathy:		G7 p.799:172mm
a.
i. Common peroneal in _____%	81%
ii. risk is_____ position	lithotomy
b. femoral neuropathy where there is hemorrhage in the_____ muscle	psoas	G7 p.800:27mm
c. meralgia paresthetica		G7 p.800:40mm
i. tends to occur_____	bilaterally
ii. in young slender_____	males
iii. positioned_____	prone
iv. in operations lasting_____ hours	6 to 10
v. recovers in approximately_____ _____	6 months
59. What is the management of lower extremity neuropathy?		G7 p.800:53mm
a. Call neurologist if not better in_____ days.	5
b. Do EMG not earlier than_____ weeks.	3
60. Complete the following about amyloid neuropathy:		G7 p.800:82mm
a. Amyloid can be deposited in_____ _____.	peripheral nerves
b. It produces a _____neuropathy.	Sensory
c. It can produce pressure on nerves, i.e.,_____ _____.	carpal tunnel
61. Complete the following about post-cardiac catheterization neuropathy:		G7 p.800:145mm
a. It involves the_____ nerve.	femoral
b. It usually involves_____.	hematomas
62. Describe the anatomy of the peripheral nerve.		G7 p.801:53mm
a. Which connective tissue membrane surrounds individual axons?	endoneurium surrounds individual axons
b. Which surrounds groups of axons (i.e., fascicles)?	perineurium bundles axons (covered by endoneurium) into fascicles
c. Which surrounds groups of fascicles (i.e., nerves)?	epineurium groups fascicles (covered by perineurium) into nerve trunk
63. Complete the following regarding injury and regeneration of nerve:		G7 p.801:75mm
a. The regeneration rate =_____	1 mm/day (i.e., 1 inch per month)
b. Sunderland system
i. first-degree anatomy_____	preserved; conduction block, compression, or ischemia
ii. second-degree axon_____ connective tissue is_____	injured; endo-, peri-, epineurium intact (endoneurium provided tube for regeneration)
iii. third-degree axon and endoneurium d_____	axon and endoneurium disrupted (grossly normal appearance, recovery related to extent of intrafascicular fibrosis)
64. Complete the following about the peripheral neuropathies:		G7 p.801:75mm
a. fourth-degree axon endoperi_____	interruption of all elements but epineurium is intact, nerve is indurated and enlarged	G7 p. 802:82mm
b. fifth-degree axon endoperi and epineurium is completely t_____	completely transected
c. sixth-degree mixed_____ through_____ degree injuries	mixed first through fourth	G7 p.802:105mm
65. Complete the following about the peripheral neuropathies:		G7 p.801:110mm
a. Nerve regeneration occurs at the rate of_____ mm/day.	1 mm/day	G7 p.802:62mm
b. Nerve regeneration occurs at the rate of inch(es)/month.	1 inch/month
c. Describe injury classification of peripheral nerves and regeneration prognosis.	two classifications: Seddon and Sunderland
i. axon compressed	first-degree = Seddon neuropraxia; conduction block from compression or ischemia; anatomy preserved
ii. axon injured	second-degree = Seddon axonotmesis; injury to axon with Wallerian degeneration; endoneurium/perineurium/ep ineurium intact; endoneurium provides “tube” to optimize successful reinnervation of target muscle
iii. axon and endoneurium disrupted	third-degree = axon and endoneurium disrupted; recovery inversely related to interfascicular fibrosis; gross normal appearance
iv. axon, endoneurium and perineurium disrupted	fourth-degree = interruption axon, endoneurium, perineurium; gross reveals indurated enlarged nerve
v. axon endo-, peri-, and epineurium disrupted	fifth-degree = Seddon neurotmesis; complete transection of axon, endo-, peri-, epineurium
66. What are etiologies of brachial plexus injuries?		G7 p.801:130mm
Hint: cpt
a. c_____	compression
b. p_____	penetration
c. t_____	traction
67. Complete the following about traction (stretch) injuries of the brachial plexus selectively:		G7 p.801:138mm
a. spare the
i. _____ _____	medial cord
ii. _____ _____	median nerve
b. injure the
i. _____ _____	posterior cord
ii. _____ _____	lateral cord
68. Complete the following about the peripheral neuropathies:		G7 p.801:150 mm
a. What nerve injury cannot be repaired?	proximal to dorsal root ganglion (i.e., preganglionic)
b. What is the evidence for such an injury?
Hint: prEHms	pain
	rhomboids
	EMG
	Horner
	meningocele
	scapula
69. List the characteristics of Erb and Klumpke brachial plexus injury.		G7 p.802:130mm
a. e_____	extended
b. r_____	rotated
c. p(b)_____	pronated
d. k(cl)	claw
e. l_____	lower roots C8 T1
f. u_____	ulnar type claw plus
g. m_____	median type claw
h. p_____	palsy
70. Describe upper and lower brachial plexus injury.		G7 p.802:135mm
a. upper brachial plexus injury
i. D_____ -E_____ palsy	Duchenne-Erb palsy
ii. u_____ p_____ C_____ C_____	upper plexus C5, C6
iii. f_____ s_____ h_____ h_____ from s_____	forceful separation humeral head from shoulder
iv. d_____ or m_____ c _____	commonly dystocia or motorcycle crash
v. i_____ r_____ a_____ with e_____ e_____	internally rotated arm with extended elbow
vi. b_____ t_____	bellhop’s tip, hand not affected
b. lower brachial plexus injury
i. K_____ p_____	Klumpke palsy
ii. l_____ p_____ C_____, T_____	lower plexus C8, T1
iii. s_____ p_____ of a_____ sudden pull of abducted arm in
iv. f_____ or P_____ t_____ s_____	fall or Pancoast tumor syndrome
v. c_____ h_____ with w_____ /w_____ of s_____ h_____ m_____	claw hand with weakness/wasting of small hand muscles
vi. s_____ h_____	simian hand
71. Complete the following about brachial plexus birth injuries:		G7 p.802:135mm
a.
i. most common is_____	upper
ii. consisting of C5-C6_____ % and	50%
iii. C5,C6-C7_____%	25%
iv. lower C8-T1 _____%	2%
b. combined is_____%	20%
c. bilateral_____%	4%
d. spontaneous recovery is_____%	90%
72. Characterize upper brachial plexus injury—Erb palsy.		G7 p.802:140mm
a. roots involved_____	C5(ABCDE) fifth letter of alphabet, Erb palsy mainly C5 and also C6, C7
b. position of upper extremity (Hint: erp)
i. e_____	extended
ii. r_____	rotated
iii. p_____	pronated
iv. looks like_____ _____ _____	bellhop’s tip position
c. Weak muscles and their roots
i. d_____	deltoid
roots,_____	C5, C6
ii. b_____	biceps
roots_______,	C5, C6
iii. r_____	rhomboids
roots,_____	C4, C5
iv. b_____	brachioradialis
roots,_____	C5, C6
v. s_____	supraspinatus
roots,	C4, C5, C6
vi. i_____	infraspinatus
roots_______,	C5, C6
d. mechanism_____ _____	shoulder separation
e. from:
i. b_____ i_____	birth injuries
ii. m_____ a_____	motorcycle accidents
73. Characterize lower brachial plexus injury—Klumpke palsy.		G7 p.802:155mm
a. roots involved	C7, C8, T1
b. position of upper extremity (Hint: klump)
i. kl_____	claw hand (Simian hand)
ii. u_____	ulnar claw
iii. m_____	plus median claw
iv. p_____	paralysis
c. weak muscles
i. upper extremity_____	small muscles of hand
ii. face_____	Horner if T1 involved
d. mechanism: traction on_____ arm	abducted
e. from
i. f_____	falls
ii. b_____	birth
iii. P_____	Pancoast tumors
74. Complete the following regarding birth injury of brachial plexus:		G7 p.802:175mm
a. incidence is_____	0.3 to 2/1000 births
i. upper	50% C5, C6
ii. upper plus C7	25% C5, C6, C7
b. mixed	20%
c. lower	2% C7, T1
d. bilateral	4%
75. True or False. The following are indications for early surgical exploration of the brachial plexus:		G7 p.803:105mm
a. any injury needs repair	false (most injuries maximal deficit at onset then improve)
b. progressive deficit	true (progressive deficit likely vascular injury, explore immediately)
c. clean sharp injury	true (clean, sharp, fresh lacerating injuries → explore acutely and repair end-to-end tension-free within 72 hours)
d. gunshot wound (GSW) to brachial plexus	false (surgery is of little benefit)
76. List medical etiologies of entrapment neuropathies.		G7 p.804:85mm
a. a_____	arthritis rheumatoid
b. a_____	acromegaly
c. a_____	amyloidosis
d. p_____	polymyalgia rheumatica
e. c_____	carcinomatosis
f. d_____	diabetes
g. g_____	gout
h. h._____	hypothyroidism
77. Name the two most common syndromes of median nerve entrapment.		G7 p.806:60mm
a. c_____ t_____ s_____	carpal tunnel syndrome
b. p_____ t_____ s_____	pronator teres syndrome
78. Describe carpal tunnel syndrome (CTS) anatomy.		G7 p.806:72mm
a. The median nerve passes under the_____ _____ _____.	transverse carpal ligament
b. The motor branch either goes
i. _____ or	under
ii._____ the ligament	pierces
c. and serves the_____ muscles,	loaf
d. which are
i. l_____	limbricales 1 and 2
ii. o_____	opponens pollicis
iii. a_____	abductor pollicis
iv. f_____	flexor pollicis brevis
79. Answer the following about carpal tunnel syndrome:		G7 p.806:150mm
a. The transverse carpal ligament extends how far beyond the distal wrist crease?	3 cm
b. What is the name of the sensory nerve?	palmar cutaneous branch	G7 p.806:160mm
c. It arises_____ cm proximal to the wrist.	5.5 cm
d. It passes_____ the transverse carpal ligament	above	G7 p.806:172mm
e. and serves the_____ _____ sensation.	thenar eminence
80. Complete the following about the median nerve:		G7 p.806:177mm
a. Describe the sensory distribution of the median nerve.
i. thumb:_____ aspect	palmar
ii. fingers:_____, _____and half of_____	index, middle, and half of ring
iii._____ eminence and adjacent	thenar
iv. _____palm	radial
b. crosses_____ transverse carpal ligament	above
81. Describe main trunk median nerve compression.		G7 p.807:17mm
a. above elbow due to_____ _____	Struthers ligament → supracondylar to medial epicondyle, mostly asymptomatic
b. at elbow
i. b_____ a_____	bicipital aponeurosis
ii. p_____ t_____	pronator teres
iii. s_____ b_____	sublimis bridge
c. Honeymoon paralysis is due to_____ _____.	direct compression
d. Benediction hand is due to weakness of_____ _____ _____ I and II.	flexor digitorum profundus	G7 p.807:30mm
82. Characterize pronator teres syndrome (PTS).		G7 p.807:60mm
a. It compresses the_____ nerve	median
b. where it dives between the two heads of the_____ _____.	pronator teres
c. Symptoms are
i. pain in the_____	palm
ii. weakness in the_____	grip
iii. paresthesias in the_____ and_____.	thumb and index finger
iv. It differs from CTS in that there is no_____.	nocturnal pain in pronator teres syndrome
v. but there is_____ in PTS	pain in the palm
vi. because the_____ branch is compressed in PTS.	median palmar cutaneous
83. Describe pronator teres syndrome.		G7 p.807:60mm
a.
i. caused by repeated_____	pronation
ii. with a_____ _____	tight fist
b.
i. due to_____ _____ where it dives between	nerve entrapment
ii. two heads of the_____ _____	pronator teres
c. Symptoms are
i. a_____	ache
ii. p_____ in p_____	pain in palm
iii. w_____ g_____	weak grip
d. Distinguished from carpal tunnel syndrome by
i. non_____ e_____	nocturnal exacerbation
84. What are the key features of anterior interosseous neuropathy?		G7 p.807:95mm
a.
i. loss of f_____	flexion
ii. of the d_____ p______	distal phalanges
iii. of the t_____	thumb
iv. and i_____ f_____	index finger
b. due to
i. weakness of the f_____ d_____ p_____and the	flexor digitorum profundus
ii. f_____ p_____ l_____	flexor pollicis longus
c. no loss of_____	sensation (anterior interosseous is pure motor)
d. patient can’t_____	make “OK” sign
e. treatment
i. e_____	no identifiable cause— expectant; management 8 to 12 weeks
ii. e_____	if no improvement or if progression proceed with surgical exploration
85. Answer the following about the anterior interosseous nerve:		G7 p.807:100mm
a. If injured a person can’t do what with the thumb and index finger?	make an “O”
b. There is weakness of the
i. f_____ d_____ p_____and	flexor digitorum profundus
ii. f_____ p_____ l_____	flexor pollicis longus
c. Is part of what nerve?	median
d. Syndrome may be caused by_____ligament.	constricting
e. Is there any sensory loss?	no sensory loss
86. Describe the epidemiology of carpal tunnel syndrome.		G7 p.808:78mm
a. What is the most common median nerve entrapment neuropathy?	carpal tunnel syndrome
b. It is due to_____.	compression of the median nerve
c. Where?	distal to wrist crease
d. Age_____	middle-aged patient
e. Male/female ratio_____	4:1
f. Bilateral _____%	bilateral > 50%
g. Worse in_____	dominant hand
h. Phalen sign is performed by_____ of the wrist	forced flexion	G7 p.808:85mm
i. and is positive in_____%.	80%
87. What is double-crush syndrome?		G7 p.809:130mm
a. It involves two sites.
i_____	cervical radiculopathy
ii_____ median/ulnar neuropathy
b. It is exacerbated by_____.	neck movement
c. Pathophysiology
i. postulated that_____ compression	cervical
ii. compromises_____ _____	axoplasmic flow
iii. predisposing _____ _____ _____ injury	nerve to distal
88. Answer the following about carpal tunnel syndrome:		G7 p.810:25mm
a. What is the most sensitive electrodiagnostic test for carpal tunnel syndrome?	sensory latency nerve conduction velocity (NCV)
b. Which should be faster, median sensory conduction velocity or ulnar sensory conduction velocity?	median
c. By how much?	4 m/s faster
89. Complete the following about carpal tunnel syndrome:		G7 p.810:165mm
a. Describe treatment.
i. sp_____	splint
ii. st_____	steroids
iii. su_____	surgery
b. Incision should be slightly to the_____ side of the interthenar crease	ulnar
c. to avoid
i. p_____ c_____ b_____ and/or	palmar cutaneous branch	G7 p.812:43mm
ii. a_____ r_____ t_____ m_____ b_____.	anomalous recurrent thenar motor branch	G7 p.812:70mm
90. Complete the following about the ulnar nerve:		G7 p.812:155mm
a. Name the roots.	ulnar components C7, C8, T1
b. Motor findings of entrapment?		G7 p.813:17mm
(Hint: abcWF)
i. a_____	interossei wasting; atrophy,
ii. b_____	particularly thumb web space benediction hand
iii. c_____	claw deformity
iv. W_____	Wartenberg sign: abducted little finger	G7 p.813:22mm
v. F_____	Froment thumb sign	G7 p.813:27mm
c.
i. pain and tingling in_____ _____	little finger
ii. and _____ _____ _____ _____	ulnar half ring finger
91. Answer the following about ulnar nerve entrapment:		G7 p.813:17mm
a. What occurs to interossei?	atrophy
b. Little finger weak on
i. _____ is called	adduction
ii. W_____ s_____.	Wartenberg sign (little finger held in abduction)
c. Holding a piece of paper requires modification because of a weak
i. _____ _____ and is called	adductor pollicis
ii. _____ _____ _____ _____.	Froment prehensile thumb sign
d. Waving goodbye demonstrates a c_____ d_____	claw deformity of the hand
i. also known as m_____ en g_____	main en griffe	G7 p.813:40mm
ii. also known as b_____ h_____.	benediction hand
e. What other nerve injury can produce
i. benediction hand?	median
ii. upon what attempted action?	making a fist
92. Describe Wartenberg sign.		G7 p.813:22mm
a. It affects the_____.	little finger
b. What occurs to the_____?	little finger
c. It rests in_____	abduction
d. due to weakness of the t_____ p_____ i_____ m_____.	third palmar interosseous muscle
e. Which nerve is involved?	ulnar
93. Describe Froment sign.		G7 p.813:27mm
a. Test by having the patient g_____	grasp a piece of paper
b. using his t_____ and i_____ f_____.	thumb and index fingers
c. If the_____ nerve is weak what happens?	ulnar
d. Thumb b_____ b_____	bends backward (i.e., flexing the distal phalanx or extending proximal phalanx of the thumb)
e. Because ulnar innervated_____ is weak	adductor pollicis
f. Therefore the body substitutes for it the_____ _____ _____ _____,	stronger flexor pollicis longus
g. which is innervated by the_____ _____ _____ of the_____ nerve.	anterior interosseous nerve, median
94. Describe ulnar nerve entrapment.		G7 p.813:70mm
a. Injury above elbow due to
i. i_____ to m_____ c_____	injury to medial cord
ii. kinking at the a_____ of S_____	arcade of Struthers aponeurotic band
b. Entrapment at the e_____	elbow	G7 p.813:90mm
i. aka t_____ u_____ p_____	“tardy ulnar palsy” (delayed presentation—initial case 12 years > from injury to elbow—elbow dislocation/lateral condyle fracture; nerve is superficial, fixed and crosses joint)
ii. NCV is less than_____ m/s	48 m/s
iii. or a difference between the 2 slides of greater than_____ m/s	10 m/s
c. Entrapment in the f_____	forearm
d. Entrapment in the w _____ /h_____	wrist/hand
95. What are surgical treatment options for ulnar compression at the elbow?		G7 p.814:150mm
a. de_____ without_____	simple nerve decompression without transposition
b. de_____ with_____	nerve decompression with transposition
c. medial_____	epicondylectomy
d. Results in %		G7 p.815:125mm
i. excellent _____%	60%
ii. fair _____%	25%
iii. poor _____%	15%
e. True or False. What responds better?
i. pain and sensory loss	true
ii. weakness and atrophy	false
96. Answer the following about entrapement in the forearm—cubital tunnel syndrome:		G7 p.815:155mm
a. Involves which nerve?	ulnar
b. Due to which muscle?	flexor carpi ulnaris
c. The mechanism is compression between the	(Just distal to the elbow, the ulnar nerve passes from the groove between the)
i. m_____ e_____ and the	medial epicondyle and the
ii. o_____ p_____	olecranon process to enter the two heads of the flexor carpi ulnaris under the fascial band connecting the two heads (the cubital tunnel)
d. results in a_____ W_____, F _____, c_____	atrophy of the interrossei, Wartenberg sign, Froment prehensile thumb sign, claw deformity of the hand (main en griffe)
97. Characteristics of the cubital tunnel syndrome are		G7 p.815:155mm
a. c_____	claw deformity
b. c_____	(flexor) carpi ulnaris
c. u_____	ulnar nerve
d. b_____	band is tight
e. i_____	interossei atrophied
f. t_____	thumb sign Froment prehensile
g. t_____	two heads of flexor carpi ulnaris
h. a_____	atrophy of interossei
i. l(el)_____ e_____	elbow epicondyle
98. Describe the borders of the Guyon canal.		G7 p.816:25mm
a. roof
i. p_____ f_____	palmar fascia
ii. p_____ b_____ m_____	palmar brevis muscle
b. floor
i. f_____ r_____ of the p_____	flexor retinaculum of the palm
ii. p_____ l_____	pisohamate ligament
c. Below the floor is the t_____ c_____ l_____.	transverse carpal ligament
d. It contains only the_____ nerve and artery.	ulnar (At the middle of the canal the nerve divides into deep and superficial branches. Superficial branch is mostly sensory [except for the branch to palmar brevis] and supplies hypothenar eminence and ulnar half of ring finger. The deep [muscular] branch innervates hypothenar muscles, lumbricals 3, 4, and interossei.)
99. Describe the types of ulnar nerve lesions in Guyon canal type—location of compression—weakness-sensory deficit.		G7 p.816:70mm
a. type I
i. location of compression	just proximal to or within Guyon canal
ii. weakness	all intrinsic muscles innervated by ulnar nerve
iii. sensory deficit	palmar ulnar distribution (palmar ulnar distribution: the hypothenar eminence and ulnar half of ring finger both on the palmar surface only)
b. type, II
i. location of compression	along deep branch
ii. weakness	muscles innervated by deep branch (depending on location may spare hypothenar muscles)
iii. sensory deficit	none
c. type III
i. location of compression	distal end of Guyon canal
ii. weakness	none
iii. sensory deficit	palmar ulnar distribution (the hypothenar eminence and ulnar half of ring finger both on the palmar surface only)
100. Complete the following regarding radial nerve injuries:		G7 p.816:145mm
a. Sensation loss in the web space of the thumb indicates injury in the_____.	hand
b. Pain at the lateral epicondyle indicates compression of the_____ _____ _____ _____ _____.	supinator tunnel at the elbow
c.
i. Finger drop indicates injury to the_____	PIN
ii. resulting from entrapment at the a_____ of F_____.	arcade of Frohse
d.
i. Wrist drop indicates injury to_____-_____ _____	mid-upper arm
ii. where the nerve is in the_____ _____.	spiral groove
e. Triceps plus all distal muscle weakness indicates injury at the_____	axilla
f. above plus weakness of the deltoid and latissimus dorsi indicates injury to the_____	posterior cord
g. above plus winging of the scapula on the forward shoulder thrust indicates injury to the_____.	roots
101. Differentiate radial nerve injury from brachial plexus posterior cord injury.		G7 p.816:145mm
a. Check the function of the_____ and	deltoid
b._____ muscles.	latissimus dorsi radial nerve arises from posterior divisions of the three trunks of the brachial plexus to form the posterior cord. Sparing of deltoid (axillary) and latissimus dorsi (thoracodorsal) localizes injury to radial nerve and not the more proximal portion of the posterior cord.
102. Differentiate axilla and mid-upper arm radial nerve compression.		G7 p.816:175mm
a. Check the function of the_____ muscle.	triceps
b. Wrist drop plus weak triceps implicates injury at_____.	axilla; crutch misuse, weak triceps and distal, radial innervated muscles
c. Wrist drop but normal triceps implicates injury at_____.	mid-upper arm; sites: spiral groove, intermuscular septum; improper arm positioning with; intoxication “Saturday night palsy”; iatrogenic surgical positioning; callus old humeral fracture; wrist dropnormal triceps; DDX (lead poisoning)
103. Describe mid-upper or forearm radial nerve compression.		G7 p.817:38mm
a. Radial nerve compression mid-upper arm produces
i. w_____ (w_____ d_____)and	weakness (wrist drop)
ii. _____ _____	wrist numbness
iii. because it compresses_____ and_____ ____ _____.	PIN and superficial (sensory) radial nerve (finger drop)
b. Injury to the posterior interosseous nerve (PIN) produces		G7 p.817:75mm
i._____ of fingers	weakness
ii. but no weakness of_____	numbness
iii. because it compresses_____ and not the s_____ r_____ n_____.	PIN (motor) and not the superficial radial nerve (sensory)
c. Injury at the supinator tunnel produces		G7 p.817:105mm
i. _____ but no	pain
ii. _____ and no	weakness
iii. _____.	numbness
104. Complete the following about peripheral neuropathies:		G7 p.817:80mm
a. PIN refers to the_____ _____ _____	posterior interosseous nerve
b. a continuation of the_____ nerve,	radial
c. which serves the
i. e_____ of the f_____ and the	extensors of the fingers
ii. a_____ p_____ l_____	abductor pollicis longus
105. Complete the following about the radial nerve and wrist weakness:		G7 p.817:55mm
a. Failure of wrist extension (wrist drop) indicates_____ radial nerve injury.	proximal
b. Failure of finger extension (finger drop) indicates_____ injury.	PIN
106. Describe forearm/hand radial nerve compression management.		G7 p.817:95mm
a. posterior interosseous syndrome_____ _____ and_____ _____ _____	Surgical exploration if no improvement after 4 to 8 weeks expectant management. Lyse constrictions and arcade of Frohse.
b. supinator tunnel syndrome_____ _____ and_____ _____ _____	Responds to nerve decompression. Lyse constrictions and extensor carpi radialis brevis.
c. hand injury
i. Clinically you find_____ _____ _____ _____	small area of sensory loss dorsal
ii. at the_____ _____ of _____	web space of thumb
iii. often caused by_____.	handcuffs
iv. Symptoms are mild so_____ _____ _____ _____.	no surgery is needed
107. Describe the suprascapular nerve.		G7 p.818:35mm
a. Formed from roots_____	C5, C6
b. Entrapped at_____ _____ _____	transverse scapular ligament (TSL) (History: antecedent frozen shoulder or trauma)
c. Sensory symptoms_____ _____ _____ _____ _____	referred, poorly localized shoulder pain. Nerve innervates joint capsule, no cutaneous representation.
d. Motor symptoms
i. atrophy of_____ and_____	infraspinatus and supraspinatus
ii. weakness of a_____ _____ _____ _____ from 0 to_____ degrees	supraspinatus upper extremity abduction; 30
iii. weak_____ tennis shot	backhand
e. Is EMG helpful?	yes, to distinguish from rotation cuff injury
f. Treatment_____	surgery; if fails to improve cut TSL
g. Differentiate from C5 cervical radiculopathy and upper brachial plexus lesion by testing_____ and_____.	rhomboid and deltoid (will show weakness in C5 radiculopathy)
108. Define meralgia paresthetica.		G7 p.818:150 mm
a. hyperpathia located at the l_____u_____ t_____	lateral upper thigh (burning pain with hyperpathia)
b. entrapment of the l_____ f_____ c_____ nerve	lateral femoral cutaneous
c. True or False. It contains motor and sensory fibers.	false (pure sensory L2, L3)
109. Complete the following about peripheral neuropathies:		G7 p.820:95mm
a. Which is the most common nerve to develop acute compression palsy?	the common peroneal nerve
b. At what location?	fibular head
c. It results in impairment of
i. motor function:_____ _____	foot drop
ii. sensory loss:_____ of_____	dorsum of foot
110. Matching. Match the following:		G7 p.820:114mm
Nerve also known as:
musculocutaneous
medial popliteal
lateral popliteal
anterior tibial
a. tibial L4-5, S2-3
b. common peroneal L4-5, S1
c. deep peroneal L4-5, S1
d. superficial peroneal L5, S1
111. Matching. Match the nerve with the function it serves.		G7 p.820:114mm
Nerve functions:
plantar flexors and inversion
origin of deep and superficial peroneal
dorsiflexors superation toe extensors
plantar flexors and eversion
a. tibial
b. common peroneal
c. deep peroneal
d. superficial peroneal
112. Matching. Match the following nerve and its area of isolated sensory loss		G7 p.820:114 mm
Nerve area of isolated sensory loss:
lateral aspect of calf and dorsum of		foot
space between great and second top
a. deep peroneal
b. superficial peroneal
113. Matching. Match the nerve with its characteristics.		G7 p.820:119mm
Characteristic:
passes behind the fibular head; is the most common nerve to develop acute compression palsy; serves the foot extensors; serves the foot evertors; space between great toe and second toe; dorsum of foot Nerve:
a. common peroneal	,
b. deep peroneal	,
c. superficial peroneal	,
114. True or False. Loss of pinprick sensation to the web space between the great toe and first toe can occur with		G7 p.820:134mm
a. superficial peroneal nerve compression	false (sensory loss lateral leg and dorsum of foot)
b. deep peroneal compression	true
c. S1 nerve root compression	false (sensory loss to lateral foot and little toe)
d. none of the above	false
115. True or False. Entrapment of the common peroneal nerve at the fibular head may result in:		G7 p.785:107mm
a. weak soleus muscle	false (innervated by the tibial nerve)
b. foot drop	true
c. weak biceps femoris muscle	false (biceps femoris innervated by sciatic proximal to take off of common peroneal)	G7 p.1195:70mm
d. sensory impairment in the lateral calf and dorsum of foot	true (foot drop and sensory impairment in lateral calf and dorsum foot)
116. True or False. A foot drop may result from		G7 p.821:27mm
a. parasagittal meningioma	true	G7 p.1196:60mm
b. deep peroneal nerve palsy	true	G7 p.1195:180mm
c. L5 radiculopathy (occasionally L4)	true (L5 is more commonly the cause of foot drop.)	G7 p.1195:180mm
d. superficial peroneal nerve palsy	false (There is weakness of foot eversion but not foot drop.)	G7 p.820:140mm
e. common peroneal nerve palsy	true	G7 p.821:16mm
117. True or False. Peroneal nerve palsy may result from		G7 p.821:55mm
a. diabetes mellitus	true
b. clipping injury in a football player	true
c. venous thrombosis	true
d. leprosy (Hansen disease)	true
118. True or False. The posterior tibial nerve may be		G7 p.822:62mm
a. found in the tarsal tunnel	true
b. found posterior and inferior to the medial malleolus	true
c. trapped at the retinacular ligament	true
d. classically responsible for nocturnal pain and paresthesia at the heel	false (Heel is spared. Paresthesias are in the toes and sole of the foot.)
119. Matching. Match the following nerves with their functions and alternate names:		G7 p.820:114mm
Function and alternate name: also known as musculocutaneous; also known as medial popliteal; also known as lateral popliteal; also known as anterior tibial; serves plantar flexors of foot plus inversion; origin of deep plus sup P; foot dorsiflexors supination and toe extensors; foot plantar flex and eversion; space between great and second toe; lateral aspect of the calf and dorsum of foot Nerve:
a. tibial L4, 5, S2, S3	,
b. common peroneal	,
c. deep peroneal L4, 5, S1	, ,
d. superficial peroneal L5, S1	, ,

Thoracic Outlet Syndrome

120. True or False. Clinical presentation of the thoracic outlet syndrome may include		G7 p.822:155mm
a. pallor and ischemia of hand and fingers	true
b. arm swelling and edema	true
c. brachial plexus lower trunk dysfunction	true
d. brachial plexus medial cord dysfunction	true
121. True or False. Regarding the thoracic outlet syndrome, conservative treatment may be as effective as the surgical treatment.	true	G7 p.823:130mm