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Anatomy Review PDF
Anatomy Review PDF
Anatomy Review PDF
U world
Supplement to First Aid
MSS
Upper Extremity
Rotator cuff injury
Rotator cuff: (SITS)
Supraspinatus,
Infraspinatus,
Teres Minor and
Subscapularis
Most commonly injured: Supraspinatus
tendon
Presentation: Pain on Abduction of arm
Impingement Test: Supraspinatus
Jobes Test or Empty can test
GH joint is the most common dislocated joint in body
Anterior
dislocations are
more common
than posterior
Winged scapula
90-180 Abduction
Serratus
Anterior
Radial n. Injury Posterior Arm
Wrist Drop From
- Mid-shaft humerus Axillary n.
fractures
- Crutch palsy
- Supplies extensors
muscles (posterior) and
sensory to posterior
arm Radial n.
- Wrist drop b/c cant
extend
Radial n. course
Ulnar n.
Passes by Medial epicondyle in
arm (most common injury site)
and the guoyons canal over
Hook of hamate (another site of
injury)
Guoyons canal
Nerve passing by
hook of hamate
Median
n.
C6-T1 Antecubital
fossa
Median n. supply to muscles in hand
See loss of
Thenar
eminence w/
median n.
damage
ape hand
deformity
Median n. injury Injury
Suicide attempts
Carpal tunnel syndrome
Tx: release flexor retinaculum
Denervation atrophy
Loss of thenar eminence so ape
hand deformity
Benedict/Bishop/pope hand when
asked to make fist
Loss of sensation
Palmar surface
1st three and fingers
Procedures and Nerve Injuries
Radical Mastectomy Long thoracic n.
Thyroidectomy- Recurrent Laryngeal n.
Recurrent laryngeal during ligation Inferior thyroid a.
External branch of superior laryngeal nerve during ligation of superior thyroid a.
Delivery of child- (Shoulder Dystocia)
Musculocutaneous and Suprascapular n.
Head and shoulder violently stretched apart
Erb-Duchenne palsy (Waiters Tip)
Shoulder adducted, arm pronated, elbow extended
MSS
Lower Extremity
Common Peroneal (Fibular) n.
(FOOT DROP)
Prone to injury b/c
superficial location
especially lateral blow
to leg or during leg
cast
Common peroneal
superficial peroneal
and deep peroneal n.
Deep peroneal
innervates anterior
compartment which
dorsiflexes foot
Superficial peroneal
innervates lateral
compartment
(everts foot)
Sensory Innervation: Peroneal n.
Posterior
Leg
Tibial n
Posterior
thigh
(plantarflex
and invert).
Sensory to
sole of foot
Femoral n. injury
Can be due to big retroperitoneal hematoma, trauma, stretch injury,
etc
Innervates quadriceps muscles so:
Presentation: difficulty w/ climbing stairs and knee buckling
Sensory loss:
Anterior and medial thigh
Medial leg (saphneous n.)
Saphneous nerve is the largest purely sensory branch of femoral n.
Patellar reflex diminished
Superior Gluteal n. Injury
Gluteus medius and minimus muscles weaken
Result: Waddling gait
Cause: Supero-medial buttock injections
Positive Trendelenburgs sign
Injury is:
C/L side of dropped hip/pelvis
I/L side of standing leg
Pic: We see Right sided n. injury
Superior Gluteal n. injury
Superolateral
quadrant-
safest place
for buttock
injections
Superomedial
injection can injure
superior gluteal n.
Note: Lachmans
test for ACL tear
is MORE sensitive
PCL tear- Posterior Drawer test
Knee flexed
90 and
place
posterior
traction the
tibia
PCL tear
Terrible Unhappy Triad
Anserine bursitis
Overuse in athletes
Chronic trauma in OBESE pts
Pain at medial aspect of
knee
Psoas Muscle
Located Paravertebral B/L
Common Deformities
Presentation Nerve Injured
Brief
Jugular Foramen (Vernet)
Syndrome
Trachea
Azygous v.
Esophagus
Abdominal CT
A- 2nd part of
duodenum (lies by
the head of
pancreas)
B- Pancreas
E- jejunum loops
Duodenal ulcers are more common than gastric ulcers. Found in the
bulb.
Anterior bulb: Perforate
Posterior bulb: Hemorrhage through gastroduodenal a. ( common
hepatic a. )
Most gastric ulcers lesser curvature hemorrhage L. gastric a. ( from
celiac trunk)
Duodenum
1st part
- NOT
Retroperitoneal
2nd part
(Celiac a.)
Drain into
ampulla of
Vater (2nd part
duodenum)
SMA and
plexus
- Usually occurs
secondary to
rapid weight loss
(lose mesenteric
fat pad) or spinal,
scoliosis surgery
Lesser Omentum
- Inferior mesenteric a.
prevents it from ascending.
Hysterectomy:
Ureter lies
underneath
uterine a.
Ovarectomy
Ureter and
ovarian
vessels cross
pelvic inlet so
both at risk
11/12TH Rib Fracture- Kidney injury
- Iliac fossa
Transplanted kidney - Attach donor renal a
recipient ext/internal iliac
a.
- Transplant ureter or attach to
old ureters (recipients ureter)
Lymph node drainage
Para-aortic nodes: Testes b/c follows embryological origin
(retroperitoneal)
Also blood supply to testes is from aorta
Superficial Inguinal- All cutaneous drainage below umbilicus,
including external genitalia (scrotum and labia) and anus up to
pectinate line
Deep inguinal- glans penis and clitoris drain directly. Afferent
from superficial inguinal nodes
External iliac- drain superficial and deep inguinal nodes
Patent
Process
Vaginalis
(Communicating
hydrocele )
Varicocele
Left testes more
common
b/c Left testicular v.
drains Renal v.
IVC
L renal vein travels
b/w aorta and SMA
so can be
compressed easily
especially if SMA
engorges
Anterior urethra- Damaged during saddle injuries (fence or falling off bike
injuries) urine leaks beneath deep fascia of Buck
Posterior urethra- Membranous portion is the weakest part and is prone to
injury during pelvic fractures (MVA). Urine leak into retropubic space
Urethral injury-
S&S: full bladder sensation, inability to void, high riding boggy
prostate, blood at urethral meatus
Foley is C/I
Pudendal nerve
block Intravaginal pudendal block
in OB (palpate ischial spine)
Nerve runs behind Done when its too late for
ischial spine and epidural anesthesia
sacrospinous ligament