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Nick Georgelos Random Trivia
100
One would expect to find this type of sensory loss in PIN neuropathy.
What is no sensory loss. The PIN has no cutaneous branches.
100
The deep radial motor nerve becomes the Posterior Interosseus nerve as it pierces this forearm muscle.
What is Supinator.
100
A patient with true PIN neuropathy is able to weakly extend their wrist, why?
What is the ECRB and ECRL is PROXIMAL to the common site of PIN compression, therefore the wrist is able to extend (albeit radially).
100
This three-headed muscle is innervated by the radial nerve.
What is the Triceps...you're welcome :)
100
Dr. Annaswamy has been Faculty at UT Southwestern Medical Center since this year.
What is 1999.
200
Physical exam findings in someone with Radial Neuropathy at the spiral groove will have these key findings. (Name what would be spared and what would be, classically, affected).
Spared = elbow extension, sensation to posterior upper arm. Affected = Finger Extensors, Wrist Extensors, Supination, slightly weak elbow flexion, and sensory deficits over the dorsum hand/thumb/IF/MF/RF.
200
These are the muscles that are spared in "Saturday Night Palsy" (Radial Nerve injury at the spiral groove), and these are the cutaneous innervations spared.
What is Triceps and Anconeus. What is the Posterior Cutaneous Nerve and Lower Lateral Cutaneous Nerve.
200
This is the muscle that you study when doing a radial motor NCS and describe the setup. Additionally, describe the setup for Radial Sensory NCS.
What is the EIP. Active 2 cm proximal to ulnar styloid on dorsum of arm. Reference over ulnar styloid. Stimulate radial nerve at forearm, at elbow between biceps and BR, below the spiral groove, and above the spiral groove. For Sensory, Active is at snuffbox, reference distal over tendon, and stimulate 10cm proximally along radius.
200
These nerve roots contribute to the Radial Nerve
What is C5-6-7-C8-T1.
200
This biblical disease is the most common cause of neuropathy WORLDWIDE.
What is Leprosy (Hansen's Disease).
300
Improper use of crutches can result in Radial Neuropathy at the Axilla which causes weakness in these muscles.
What is all radially innervated muscles including Triceps and Anconeus.
300
There are many possible causes of true PIN Neuropathy; this is the most common cause and these are two other causes (brownie points for the specific name of the fracture (hint: one of the causes is a fracture)
What is Entrapment at the Arcade of Frohse (tendinous proximal border of the supinator mm.). Additionally, Lipoma, Ganglion Cyst, Synovitis, and Monteggia Fracture.
300
A demyelinating PIN lesion will show these findings for Sensory NCS and motor NCS.
What is normal sensory NCS, normal CMAP amplitude, and conduction block between forearm and elbow.
300
The superficial radial nerve is a total sensory nerve. Point to where you can palpate it on your hand and describe the distribution that it innervates.
Overlying the extensor tendon of thumb. Innervates the dorsum of hand over Thumb, Index Finger, Middle Finger, and 1/2 of Ring Finger...but SPARES the distal phalanx.
300
A positive "Flick Test" can be positive in this syndrome. Also, demonstrate the "Flick Test".
What is Carpal Tunnel Syndrome.
400
Welcome to your USMLE Step 2 refresher course. The patient is a 46yo M that presents to your office with chief complaint of vague abdominal pain symptoms and a right wrist drop. Physical exam is positive for wrist extensor weakness as well blue lines along his gums. He also is pale. He reports he likes to eat paint chips. What is his diagnosis and what is the treatment?
Lead Poisoning. Treat with Succimer or Penicillamine. Congratulations, you passed your Step 2 Exam!
400
Injury to the radial nerve/PIN as it passes between the brachialis and brachioradialis is called Radial Tunnel Syndrome. This type of injury has this NCS/EMG findings. It presents with these neurologic signs. And differs from Lateral Epicondylitis in this way.
It has no NCS/EMG abnormalities. No neurologic deficits. And is different from LE in that resisted supination causes more pain RTS than LE. Of note - the PIN has C Fibers (nociception) and IIA Afferent Fibers (temperature) in which pressure causes pain but are unable to be picked up on EMG/NCS.
400
A patient comes to you with weakness in extensors including triceps after using crutches. These are two muscles that you could needle to rule out a more proximal posterior cord lesion.
What is latissimus dorsi and/or deltoid.
400
The radial nerve is an extension of this cord in the brachial plexus. Bonus Question - what are the other FOUR branches that come off this cord proximal to the radial nerve. Must name in order from distal to proximal.
What is the Posterior Cord. Axillary, Lower Subscapular, Thoracodorsal, Upper Subscapular
400
In suspected Neurogenic Thoracic Outlet syndrome, this is a provocative test that can be done in the office. Also, describe the test.
What is Adson's Test. Abduct/Extend/Externally rotate arm, monitor the radial pulse and have the patient rotate head TOWARDs that arm (ipsilateral side). A positive test is decrease/loss of pulse.
500
Superficial Radial Sensory Neuropathy is also called this Eponym and associated with this other eponym named diagnosis ~30-50% of the time.
What is Wartenberg's Syndrome. A/w De Quervains Tenosynovitis.
500
This is the Greek name given for injury to this portion of the radial nerve that results in sensation deficits over the dorsum of hand and no motor weakness. Also, name a cause of this injury.
What is "Cheiralgia Paresthetica". Due to compression of Superficial Radial Sensory nerve from crossing arms, tight watches/hand cuffs, etc.
500
Explain the EMG findings that would differentiate from a Superficial Radial Sensory Neuropathy, PIN neuropathy, Radial Neuropathy at Spiral Groove, Radial Neuropathy at Axilla, Posterior Cord Lesion, and C7 lesion.
SRSN = no abnormalities, purely sensory. PIN = spares BR, Triceps, Anconeus, supinator, and ECRL. RN@SG = Triceps/Anconeus spared. RN@A = triceps and anconeus involved. Posterior Cord = deltoid, lats involved. C7 = pronator teres, FCR.
500
These are the muscles supplied by the radial nerve. (Must name 10 of 12)
What is... Triceps, Anconeus, Brachioradialis, ECRL, ECRB, Supinator, EDC, EDM, ECU, APL, EPL, EPB, EIP.
500
Dr. Nicholas Georgelos was on a path to greatness in this sport while in high school until his career was curtailed by a devastating 3 month ear infection.
What is Swimming.
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