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Change in Direction
Reconstruction if Severe
Bending knee at 90° angle, increases posterior gliding of tibia due to PCL injury
Medial Knee Injury
Valgus Stress Test
Abnormal passive adduction
Knee either extended or at ~ 30° angle, medial (varus) force leads to lateral space widening of tibia, causing LCL injury.
Fibrocartilage Semicircular Band
Clicking and Locking
Pain on External Rotation
Common injury in contact sports due to lateral force applied to a planted leg.
Classically, consists of damage to the ACL, MCL, and medial meniscus (attached to MCL); however, lateral meniscus injury is more common.
Presents with acute knee pain and signs of joint injury/ instability.
Prepatellar bursitis vs Baker cyst
Inflammation of the prepatellar bursa in front of the kneecap
Can be caused by repeated trauma or pressure from excessive kneeling (also called “housemaid’s knee”)
Popliteal fluid collection in gastrocnemius-semimembranosus bursa commonly communicating with synovial space and related to chronic joint disease
Overuse injuries of the elbow
Medial epicondylitis (golfer’s elbow): Repetitive flexion (forehand shots) or idiopathic leads to pain near medial epicondyle
Lateral epicondylitis (tennis elbow) Repetitive extension (backhand shots) or idiopathic leads to pain near lateral epicondyle.
"Some Lovers Try Positions That They Can't Handle"
Carpal Tunnel Syndrome
Median Nerve Entrapment
Compression at Carpal Tunnel
Numbness, Tingling and Pain in Hand
Guyon canal syndrome
Compression of ulnar nerve at wrist or hand.
Classically seen in cyclists due to pressure from handlebars.
Dermatomes - Cervical
C2 - Posterior Cap Distribution
C3 - High Turtleneck
C4 - Low Collar Shirt
C5 - Anterolateral Shoulder
C6 - Thumb
C7 - Middle Finger
C8 - Pinky Finger
Dermatomes - Thoracic
T1 - Medial Arm
T4 - Nipple
T7 - Xiphoid
T10 - Belly Button
T12 - Pubis
Dermatomes - Lumbosacral
L2 - Medial Thigh
L3 - Medial Knee
L4 - Kneecap, Medial Ankle and Big Toe
L5 - Dorsum of Foot
S1 - Lateral Foot, Posteriolateral Thigh
S 2, 3, 4, 5 - Perianal and Genitals
419 Upper Extremity Nerves: Axillary, Musculocutaneous, Radial, Recurrent branch of median nerve
Cuase: fractured surgical neck of humerus; anterior dislocation of humerus
Flattened deltoid; Loss of arm abduction at shoulder (> 15 degrees); Loss of sensation over deltoid muscle and lateral arm
Deltoid is responsible for abduction of the arm from 15-100 degrees
Posterior circumflex often damaged concurrently
U. Paralysis of teres minor (and therefore arm abduction weakness
Cause: upper trunk compression
Loss of forearm flexion (biceops brachii, brachialis and coracobrachialis (coraco also adducts)) and supination
Loss of sensation over lateral forearm
Cause: midshaft fracture of humerus; compression of axilla, eg, due to crutches or sleeping with arm over chair (“Saturday night palsy”)
Wrist drop: loss of elbow, wrist, and finger extension
Decreased grip strength (wrist extension necessary for maximal action of flexors)
Loss of sensation over posterior arm/forearm and dorsal hand
Often associated with deep brachial artery injury
U. Absent triceps reflex
U. Dorsal thumb sensory loss
U. Distal dmg at supinator canal (repeat pronation/supination, screwdriver; trauma, radius dislocation ), only loss of finger/thumb extension
U. Innervates the brachioradialis and supinator muscle; loss of sensation of the dorsal hand, forearm and upper arm
Recurrent branch of median nerve
Superficial laceration of palm
“Ape hand”; Loss of thenar muscle group: opposition, abduction, and flexion of thumb; No loss of sensation
Nerve Palsies - Erb's Palsy (Waiter's tip)
Superior (Upper) Trunk
Lateral Traction on Neck during Delivery
Trauma in Adults
Waiter's Tip Deformity
Nerve Palsies - Klumpke's Palsy
C8 to T1 Roots
Upward Arm Force during Delivery
Grabbing Tree Branch to Break a Fall
Intrinsic Hand Muscles
Nerve Palsies - Thoracic Outlet Syndrome
Compression of Brachial Plexus
Compression of Subclavian Vessels
Cervical Rib Abnormality
Nerve Palsies - Winged Scapula
Long Thoracic Nerve
Axillary Node Dissection in Mastectomy
Scapula Cannot Anchor to Thorax
Inability to Raise Arm Above Head
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