OS 202B: Introduction to Clinical Neuroscience
Neuro OSCE
Neuro OSCE Trans 1
May 10, 2017
Francis Laudemir Libre
MUSCLE NERVE ROOTS
UPPER EXTREMITY
Muscle Group Muscles Nerve Roots Nerves
Shoulder Abductors Deltoid C5, C6 Axillary nerve
Shoulder Adductors Pectoralis Major C5, C6 Lateral pectoral nerve
Elbow Flexors Brachialis and biceps C5, C6 Musculocutaneus
Elbow Flexors of the Semi-pronated arm Brachoradialis C5, C6 Radial nerve
Elbow Extensors Triceps C6, C7, C8 Radial nerve
Wrist Extensors Flexor digitorum superficialis C7, C8 Radial and ulnar nerve (Remember Dr. Leslies
Flexor digitorum profundus story)
Flexor Carpi Radialis
Flexor Carpi Ulnaris
Palmaris Longus
Flexor Pollicis Longus
Wrist Flexors Extensor digitorum C7, C8 Radial and ulnar nerve (Remember Dr. Leslies
Extensor carpi radialis longus story)
Extensor carpi radialis brevis
Extensor carpi ulnaris
Extensor indicis
Extensor digiti minimi
Extensor pollicis longus
Extensor pollicis brevis
Finger Abductors Dorsal interossei C8, T1
Finger Adductors Palmar Interossei C8, T1
Finger Extensors Similar to wrist extensors C7, C8, T1
Finger Flexors Similar to wrist flexors C7, C8, T1
How did you memorize in case you forgot:
Sing the rhythmic upper ex song:
C5! C6 (Abduct shoulder), C5! C6 (Adduct shoulder), C5!, C6 (Flex elbow). C5, C6 (semipronate elbow)! C6, C7!, C8 (Extend elbow), C7, C8 (extend wrist), C7 C8(extend wrist), C8, T1! (abduct fingers),
C8 T1 (adduct fingers)!, C7, C8, T1 (flex and extend fingers)
Clinical pearls
Proximal weakness suggestive of myopathy
Distal weakness suggestive of peripheral neuropathy
Pyramidal weaknesss UMN dysfunction. Think like a pyramid basta finger extension, elbow extension and shoulder abduction with preservation of the elbow flexion and grip.
-also characterized by upper limb extensor < flexor, reverse in lower limb
LOWER EXTREMITY
Muscle Group Muscles Nerve Roots Nerves
Hip Flexors Iliopsoas L1, L2, L3 Femoral nerve
Hip Abductors Gluteus medius L4, L5, S1
Gluteus minimus
Sartorius
TLF
Hip Adductors Adductor brevis L2, L3, L4
Adductor Longus
Adductor magnus
Obturator externus
LIBRE 1 of 2
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Pectineus
Gracilis
Hip Extensors Gluteus maximus L5, S1, S2 Inferior gluteal nerve
Knee Extensors Quads femoris L2, L3, L4 Femoral nerve
Knee Flexors Hamstrings L5, S1, S2 Sciatic nerve
Foot Dorsiflexors Several L4, L5 Deep peroneal nerve
Foot Plantarflexors Gastrocnemus S1, S2 Sciatic nerve
Soleus
Foot Inverters L4, L5 Posteriro Tibial
Foot Everters L5, S1 Common peroneal
Toe extensor Extensor halluces longus S1 Deep fibular nerve
Clinical pearls:
Foot drop damage to peroneal nerve (loss of ankle dorsiflexion)
REFLEXES
Reflex Reflex Arc Roots
Biceps C5, C6
Brachoradialis C5, C6
Triceps C6, C7
Patellar (Quadriceps femoris) L2, L3, L4
Ankle (triceps surae) L5, S1, S2
If UMN hypereflexic since no inhibition
If LMN hyporeflexic
SURNAME 1, SURNAME 2, SURNAME 3, [EDITORS SURNAME] 2 of 2