AMC MCQ exam Prep by Dr Jayse
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کانال AMC MCQ exam Prep by Dr Jayse (@amcmcqprep) در بخش زبانی انگلیسی بازیگری فعال است. در حال حاضر جامعه شامل 10 374 مشترک است و جایگاه 2 628 را در دسته پزشکی و رتبه 314 را در منطقه سنغافورة دارد.
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از زمان ایجاد در невідомо، پروژه رشد سریعی داشته و 10 374 مشترک جذب کرده است.
بر اساس آخرین دادهها در تاریخ 15 سپتامبر, 2026، کانال فعالیت پایداری دارد. در ۳۰ روز گذشته تغییر اعضا برابر -56 و در ۲۴ ساعت گذشته برابر 3 بوده و همچنان دسترسی گستردهای حفظ شده است.
- وضعیت تأیید: تأیید نشده
- نرخ تعامل (ER): میانگین تعامل مخاطب 4.23% است و در ۲۴ ساعت نخست پس از انتشار، محتوا معمولاً 1.31% واکنش نسبت به کل مشترکان کسب میکند.
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پستهای کانال
| 2 |  بدون متن... | 320 |
| 3 | Purulent discharge from cervical os → Gonococcal/chlamydial cervicitis
Vulvar vesicles + painful ulcers → Genital herpes
Painless genital ulcer → Primary syphilis
Painful grouped vesicles → HSV
Painful genital ulcer + tender nodes → Chancroid
Painless beefy-red ulcer → Granuloma inguinale
Small painless ulcer + painful nodes → Lymphogranuloma venereum
Vulvar burning + recurrent vesicles → HSV infection
Genital ulcers + recurrent episodes → HSV
Vulvar pruritus + obesity/diabetes + yeast → Candida
Vaginal pH >4.5 + trichomonads → Trichomoniasis
Vaginal pH >4.5 + clue cells → BV
Vaginal pH normal + pseudohyphae → Candida
Lack of inflammation + fishy discharge → BV
Severe inflammation + frothy discharge → Trichomoniasis
Atrophic pale vagina + elevated pH → Genitourinary syndrome of menopause
Postmenopausal dryness + dyspareunia → Vulvovaginal atrophy
Persistent itching + white vulvar plaque → Lichen sclerosus
Thick leathery vulvar skin from scratching → Lichen simplex chronicus
Vulvar erythema + eczematous lesion in older woman → Extramammary Paget disease
Persistent vulvar lesion not responding to therapy → Biopsy
Vulvar carcinoma risk + lichen sclerosus → Squamous cell carcinoma
Heavy bleeding since menarche + easy bruising → von Willebrand disease
Menorrhagia + normal pelvic exam + adolescent → Consider bleeding disorder
Irregular heavy bleeding + anovulation → AUB-O
Intermenstrual bleeding + focal intracavitary lesion → Endometrial polyp
Saline infusion sonography + intracavitary mass → Endometrial polyp/submucosal fibroid
Submucosal fibroid → Heavy menstrual bleeding
Subserosal fibroid → Pressure/bulk symptoms
Intramural fibroid → Enlarged irregular uterus
Fibroid enlarging during pregnancy → Estrogen-responsive leiomyoma
Fibroid after menopause should shrink → Leiomyoma
Rapidly enlarging postmenopausal uterine mass → Leiomyosarcoma concern
Leiomyosarcoma → Usually arises de novo, not from fibroid
Endometrial biopsy needed in AUB age ≥45 → Rule out hyperplasia/cancer
Younger woman + AUB + unopposed estrogen risk → Endometrial biopsy
Endometrial thickness ≤4 mm in postmenopausal bleeding → Low cancer risk, if bleeding not persistent
Persistent postmenopausal bleeding despite thin stripe → Endometrial sampling
Obesity + PCOS + prolonged amenorrhea → Endometrial hyperplasia risk
Atypical hyperplasia/EIN → High risk of endometrial carcinoma
Type I endometrial cancer pattern → Estrogen-related endometrioid carcinoma
Type II endometrial cancer pattern → Serous carcinoma, older/thin patient
Psammoma bodies + papillary ovarian tumor → Serous ovarian carcinoma
BRCA mutation + adnexal mass → High-grade serous ovarian carcinoma risk
Adnexal mass + ascites + weight loss → Ovarian malignancy
Young woman + ovarian mass + tumor marker clue → Think germ-cell tumor first | 297 |
| 4 | Postpartum hemorrhage + uterus not palpable abdominally → Uterine inversion
Placenta previa + prior C-section → Placenta accreta spectrum
Postpartum hemorrhage + failure to lactate → Sheehan syndrome
Failure to lactate + amenorrhea after severe PPH → Sheehan syndrome
Leakage with cough/sneeze → Stress urinary incontinence
Urgency + leakage → Urge incontinence
Constant dribbling + high postvoid residual → Overflow incontinence
Continuous urine leakage through vagina → Vesicovaginal fistula
Stool or gas through vagina → Rectovaginal fistula
Anterior vaginal wall bulge → Cystocele
Posterior vaginal wall bulge → Rectocele
Uterus descending through introitus → Uterine prolapse
DES exposure in utero → Clear-cell adenocarcinoma of vagina/cervix
Genital warts → HPV 6,11
Cervical cancer → HPV 16,18
Bitemporal hemianopia + galactorrhea → Prolactinoma
Deep dyspareunia + infertility → Endometriosis
Dysmenorrhea + normal pelvic exam in young woman → Primary dysmenorrhea
Progressive dysmenorrhea in older reproductive-age woman → Secondary dysmenorrhea
Hot flashes + vaginal dryness → Menopause
Heavy bleeding + normal-sized uterus + irregular cycles → Ovulatory dysfunction
Infertility + prior PID → Tubal factor infertility
Infertility + dysmenorrhea + dyspareunia → Endometriosis
Amenorrhea + normal breasts + absent uterus → MRKH or AIS
Absent uterus + testes → AIS
Absent uterus + ovaries present → MRKH
Rapid-onset hirsutism + deep voice → Androgen-secreting tumor
Frothy discharge + strawberry cervix → Trichomoniasis
Fishy odor + clue cells → BV
Pruritus + cottage-cheese discharge → Candida
Pelvic pain + CMT + fever → PID
RUQ pain + violin-string adhesions → Fitz-Hugh–Curtis syndrome
Postcoital bleeding + friable cervix → Cervical cancer until evaluated
Postmenopausal bleeding + thickened endometrium → Endometrial pathology
Snowstorm + no fetus → Complete mole
Fetal tissue + triploidy → Partial mole
No chorionic villi + very high β-hCG → Choriocarcinoma
Ascites + pleural effusion + ovarian fibroma → Meigs syndrome
Signet-ring cells in both ovaries → Krukenberg tumor
Precocious puberty + Call-Exner bodies → Granulosa tumor
AFP + Schiller-Duval → Yolk sac tumor
LDH + fried-egg cells → Dysgerminoma
Testosterone + virilization → Sertoli-Leydig tumor
Hair + teeth + torsion risk → Mature teratoma
Secondary amenorrhea + positive pregnancy test → Pregnancy until proven otherwise
Amenorrhea + high prolactin + antipsychotic use → Drug-induced hyperprolactinemia
High prolactin + hypothyroidism → TRH-mediated hyperprolactinemia
Amenorrhea + low FSH + low estradiol → Hypothalamic/pituitary disorder
Amenorrhea + high FSH + low estradiol → Primary ovarian failure
Primary amenorrhea + uterus present + absent secondary sexual characteristics → Gonadal dysgenesis
Primary amenorrhea + uterus absent + normal breasts → MRKH or AIS
Primary amenorrhea + normal secondary sexual characteristics + obstruction → Imperforate hymen/transverse septum
Primary amenorrhea + cyclic abdominal mass → Hematocolpos
Hematocolpos → Imperforate hymen
Amenorrhea after postpartum curettage → Asherman syndrome
Infertility + recurrent miscarriage + intrauterine adhesions → Asherman syndrome
Recurrent pregnancy loss + uterine septum → Müllerian anomaly
Recurrent second-trimester loss + painless cervical dilation → Cervical insufficiency
Short cervix on ultrasound → Cervical insufficiency risk
Painless cervical dilation in 2nd trimester → Cervical insufficiency
Infertility + bicornuate/ septate uterus → Müllerian anomaly
Septate uterus → Highest miscarriage risk among common Müllerian anomalies
Two uterine horns + heart-shaped fundus → Bicornuate uterus
Two cervices + duplicated uterus → Uterus didelphys
Unicornuate uterus → Single Müllerian duct development
Pelvic pain + adnexal fullness + fever → Tubo-ovarian abscess
PID + complex adnexal mass → Tubo-ovarian abscess
PID + infertility → Tubal scarring
PID + ectopic risk → Tubal damage
Gonorrhea/chlamydia + ascending pelvic infection → PID
Dysuria + discharge + cervical friability → Cervicitis | 213 |
| 5 | 📝Gynecology 200 High-Yield Buzzwords & Signs 🔥🔥
Boggy uterus → Adenomyosis
Irregular firm uterus → Leiomyoma
Chocolate cyst → Endometriosis
Powder-burn lesions → Endometriosis
Fixed retroverted uterus → Endometriosis
Tender uterosacral nodules → Endometriosis
Strawberry cervix → Trichomoniasis
Frothy yellow-green discharge → Trichomoniasis
Clue cells → Bacterial vaginosis
Fishy odor → Bacterial vaginosis
Positive whiff test → Bacterial vaginosis
Cottage-cheese discharge → Candida
Pseudohyphae → Candida
Mucopurulent cervix → Cervicitis
Friable cervix → Cervicitis
Chandelier sign → PID
Cervical motion tenderness → PID
Violin-string adhesions → Fitz-Hugh–Curtis syndrome
RUQ pain + PID → Fitz-Hugh–Curtis syndrome
Postcoital bleeding → Cervical pathology / cervical cancer
Contact bleeding → Cervical cancer
Koilocytes → HPV infection
Cauliflower genital warts → Condyloma acuminatum
Flat moist genital lesions → Condyloma lata
Bluish bulging hymen → Imperforate hymen
Primary amenorrhea + cyclic pelvic pain → Outflow obstruction
D&C → amenorrhea → Asherman syndrome
Absent uterus + absent/scant pubic hair → AIS
Absent uterus + normal pubic hair → MRKH
Primary amenorrhea + short stature + webbed neck → Turner syndrome
Streak ovaries → Turner syndrome
Amenorrhea + galactorrhea → Hyperprolactinemia
Amenorrhea + weight loss/exercise/stress → Functional hypothalamic amenorrhea
Amenorrhea + hot flashes + high FSH → Primary ovarian insufficiency
Obesity + hirsutism + irregular menses → PCOS
String of pearls ovaries → PCOS
Rapid virilization → Androgen-secreting tumor
Sudden unilateral pain + vomiting → Ovarian torsion
Enlarged ovary + reduced Doppler flow → Ovarian torsion
Midcycle unilateral pelvic pain → Mittelschmerz
Positive β-hCG + unilateral pain → Ectopic pregnancy
Positive β-hCG + empty uterus above discriminatory zone → Ectopic pregnancy
Shoulder-tip pain + shock + pregnancy → Ruptured ectopic pregnancy
Snowstorm appearance → Molar pregnancy
Grape-like vesicles → Molar pregnancy
Very high β-hCG + hyperthyroidism → Molar pregnancy
Theca-lutein cysts → High β-hCG / molar pregnancy
Persistent β-hCG after molar evacuation → Gestational trophoblastic neoplasia
Very high β-hCG + lung metastases → Choriocarcinoma
Call-Exner bodies → Granulosa cell tumor
Coffee-bean nuclei → Granulosa cell tumor
Estrogen-producing ovarian tumor → Granulosa cell tumor
Precocious puberty + ovarian mass → Granulosa cell tumor
Postmenopausal bleeding + ovarian mass → Granulosa cell tumor
Schiller-Duval bodies → Yolk sac tumor
Elevated AFP + ovarian mass → Yolk sac tumor
Fried-egg cells → Dysgerminoma
Elevated LDH + ovarian mass → Dysgerminoma
Hair + teeth + sebum → Mature cystic teratoma
Dermoid cyst → Mature cystic teratoma
Virilization + ovarian mass → Sertoli-Leydig tumor
Ovarian fibroma + ascites + pleural effusion → Meigs syndrome
Bilateral ovarian masses + signet-ring cells → Krukenberg tumor
Early satiety + bloating + adnexal mass → Ovarian cancer
CA-125 elevation → Epithelial ovarian cancer marker
Postmenopausal bleeding → Endometrial cancer must be excluded
Unopposed estrogen → Endometrial hyperplasia/cancer
Obesity + chronic anovulation → Endometrial hyperplasia
Tamoxifen + bleeding → Endometrial pathology
Thin elderly woman + aggressive endometrial cancer → Serous endometrial carcinoma
Heavy menstrual bleeding + boggy uterus → Adenomyosis
Heavy menstrual bleeding + irregular firm uterus → Leiomyoma
Whorled uterine mass → Leiomyoma
Painful heavy menses + diffuse uterine enlargement → Adenomyosis
White parchment-like vulva → Lichen sclerosus
Severe vulvar pruritus + thin white skin → Lichen sclerosus
Persistent vulvar ulcer/mass → Vulvar cancer
Painful unilateral Bartholin mass → Bartholin abscess
New Bartholin mass in older woman → Consider malignancy
Postpartum fever + uterine tenderness + foul lochia → Endometritis
Cesarean delivery + postpartum fever → Endometritis
Persistent postpartum fever despite antibiotics → Septic pelvic thrombophlebitis
Postpartum hemorrhage + boggy uterus → Uterine atony | 262 |
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| 7 |  Thank you for the massive support and 8 more subscribers yo make it 1.1k!!! | 445 |
| 8 |  بدون متن... | 553 |
| 9 | MCQ ‼️
A 24-year-old patient with severe acute asthma has persistent bronchospasm despite repeated nebulized albuterol/ipratropium and IV corticosteroids. Which is the most appropriate next therapy?
A. Magnesium oxide 400 mg PO
B. Magnesium sulfate 2 g IV over 20 minutes
C. Magnesium sulfate 2 g IV push over 1 minute
D. Calcium gluconate 1 g IV over 10 minutes
E. Observe | 1 124 |
| 10 | Internal branch → sensory above vocal cords
Loss of laryngeal sensation → aspiration risk
⸻
Thyroid & ENT Surgical Anatomy
Superior thyroid artery → close to external branch of superior laryngeal nerve
Inferior thyroid artery → relationship with recurrent laryngeal nerve
Thyroidectomy complication + hoarseness → RLN injury
Thyroidectomy + inability to produce high-pitched sounds → external SLN injury
⸻
Ludwig Angina ⭐⭐⭐
Bilateral submandibular/sublingual infection → Ludwig angina
Dental infection → floor-of-mouth cellulitis → Ludwig angina
“Woody” induration of floor of mouth → Ludwig angina
Tongue elevation → Ludwig angina
Airway compromise → major danger
Usually odontogenic → mandibular molar infection
⸻
Parotitis
Painful parotid swelling + fever → parotitis
Purulent drainage from Stensen duct → bacterial parotitis
Stensen duct opens opposite upper second molar → parotid gland
Dehydrated hospitalized patient → bacterial parotitis risk
Mumps → bilateral parotitis + fever
⸻
Facial Nerve ⭐⭐⭐
CN VII → facial expression
Bell palsy → LMN facial nerve palsy
Entire ipsilateral face affected → Bell palsy
Cannot wrinkle forehead + cannot close eye + drooping mouth → LMN CN VII lesion
Forehead spared → UMN lesion/stroke
Bell palsy treatment → corticosteroids ± antivirals depending on presentation
Ramsay Hunt syndrome → vesicles in ear + ipsilateral facial paralysis
Ramsay Hunt → VZV reactivation
⸻
Bell Palsy vs Stroke ⭐⭐⭐
Bell palsy:
Forehead + eye closure + lower face all affected
UMN stroke:
Forehead relatively spared + contralateral lower facial weakness
⸻
Ramsay Hunt Syndrome
Facial paralysis + painful vesicles around ear → Ramsay Hunt
Varicella-zoster virus → Ramsay Hunt
Geniculate ganglion involvement → Ramsay Hunt
Can cause hearing loss/tinnitus/vertigo → Ramsay Hunt
⸻
Parotid Tumors
Most common benign salivary gland tumor → pleomorphic adenoma
Painless slow-growing parotid mass → pleomorphic adenoma
Facial nerve weakness + parotid mass → malignant salivary gland tumor
Facial nerve involvement in parotid mass → concerning for malignancy
🔥 20 Ultra-HY ENT Buzzwords
Bulging TM → Acute otitis media
Pain with tragal movement → Otitis externa
Foul-smelling otorrhea + white keratin → Cholesteatoma
4-kHz notch → Noise-induced hearing loss
Carhart notch → Otosclerosis
Weber → affected ear → Conductive hearing loss
Weber → unaffected ear → Sensorineural hearing loss
Vertigo + tinnitus + fluctuating hearing loss → Ménière disease
Positional vertigo + positive Dix-Hallpike → BPPV
Unilateral SNHL → Vestibular schwannoma
Bilateral vestibular schwannomas → NF2
Aspirin + asthma + nasal polyps → AERD
Hot potato voice + uvular deviation → Peritonsillar abscess
Drooling + tripod + thumbprint → Epiglottitis
Barking cough + steeple sign → Croup
Foul unilateral nasal discharge in child → Foreign body
Hoarseness after thyroidectomy → Recurrent laryngeal nerve injury
Cannot produce high-pitched sounds → External superior laryngeal nerve injury
Woody floor of mouth + dental infection → Ludwig angina
Facial paralysis + ear vesicles → Ramsay Hunt syndrome
#usmleprep #USMLEStep2CK #usmlestep1 #ent | 978 |
| 11 | Nasal obstruction + facial pressure + nasal discharge → chronic sinusitis
Nasal polyps → chronic rhinosinusitis association
⸻
Nasal Polyps ⭐
Pale, translucent, boggy nasal masses → nasal polyps
Usually painless → nasal polyps
Bilateral nasal obstruction → nasal polyps
Associated with asthma → nasal polyps
Aspirin sensitivity + asthma + nasal polyps → AERD/Samter triad
Nasal polyps + cystic fibrosis → classic association
Treatment → intranasal corticosteroids
⸻
AERD / Samter Triad ⭐⭐⭐
Asthma + nasal polyps + aspirin/NSAID sensitivity → AERD
NSAID ingestion → bronchospasm → AERD
COX-1 inhibition → ↓ prostaglandins + ↑ leukotrienes
Avoid nonselective NSAIDs → AERD
⸻
Adenoid Hypertrophy
Child + chronic nasal obstruction → adenoid hypertrophy
Mouth breathing → adenoid hypertrophy
“Adenoid facies” → chronic adenoid hypertrophy
Hyponasal speech → adenoid hypertrophy
Snoring/OSA in child → adenoid/tonsillar hypertrophy
Eustachian tube dysfunction/recurrent otitis media → enlarged adenoids
⸻
Tonsillitis / Peritonsillar Abscess ⭐⭐⭐
Fever + sore throat + tonsillar exudates → tonsillitis
Group A strep → Streptococcus pyogenes
Palatal petechiae → GAS pharyngitis
Tender anterior cervical lymphadenopathy → GAS
Cough + rhinorrhea → viral rather than GAS
Peritonsillar abscess
“Hot potato” muffled voice → peritonsillar abscess
Unilateral tonsillar swelling → peritonsillar abscess
Uvula deviates AWAY from affected side → peritonsillar abscess ⭐
Trismus → peritonsillar abscess
Drooling → peritonsillar abscess
Treatment → drainage + antibiotics
⸻
Retropharyngeal Abscess ⭐
Young child + fever + neck stiffness → retropharyngeal abscess
Drooling + dysphagia → retropharyngeal abscess
Neck swelling/stiffness → retropharyngeal abscess
Recent URI → possible precipitating infection
Posterior pharyngeal bulging → retropharyngeal abscess
Can cause airway obstruction → emergency
⸻
Epiglottitis ⭐⭐⭐
Child + high fever + drooling + respiratory distress → epiglottitis
Tripod position → epiglottitis
Muffled voice → epiglottitis
Stridor → epiglottitis
“Thumbprint sign” on lateral neck X-ray → epiglottitis
Do NOT aggressively examine the throat → risk of airway obstruction
Airway first → epiglottitis
Historically Hib → classic USMLE association
Unvaccinated child → think Hib
⸻
Croup ⭐⭐⭐
Barking cough → croup
Seal-like barking cough → croup
Inspiratory stridor → croup
Steeple sign → croup
Usually viral → parainfluenza
Usually age 6 months–3 years → croup
Treatment: dexamethasone → croup
Moderate/severe disease → nebulized epinephrine
Croup vs Epiglottitis
Barking cough → Croup Drooling + tripod + toxic appearance → Epiglottitis
⸻
Foreign Body
Sudden unilateral foul-smelling nasal discharge in child → nasal foreign body
Unilateral purulent rhinorrhea → nasal foreign body
Sudden coughing/choking episode → airway foreign body
Unilateral decreased breath sounds → bronchial foreign body
Most common site of aspiration → right main bronchus
⸻
Laryngeal Cancer ⭐
Persistent hoarseness >2–3 weeks → evaluate for laryngeal malignancy
Smoking + hoarseness → laryngeal squamous cell carcinoma
Alcohol + smoking → increased risk
Supraglottic tumor → dysphagia/odynophagia
Glottic tumor → early hoarseness
Persistent unilateral otalgia with normal ear exam → referred pain from head/neck malignancy
⸻
Vocal Cord Paralysis
Hoarseness after thyroid surgery → recurrent laryngeal nerve injury
Unilateral recurrent laryngeal nerve damage → hoarseness
Bilateral recurrent laryngeal nerve injury → airway obstruction/stridor
Left recurrent laryngeal nerve travels under aortic arch → thoracic lesions can cause hoarseness
Left vocal cord paralysis + mediastinal mass → recurrent laryngeal nerve compression
⸻
Recurrent Laryngeal Nerve
Motor innervation of most intrinsic laryngeal muscles → recurrent laryngeal nerve
Exception = cricothyroid → external branch of superior laryngeal nerve
RLN injury → hoarseness
Bilateral RLN injury → airway compromise
⸻
Superior Laryngeal Nerve
External branch → motor to cricothyroid
Cricothyroid → tenses vocal cords
External SLN injury → weak/high-pitched voice | 479 |
| 12 | Sensorineural hearing loss → presbycusis
Bilateral symmetric → presbycusis
⸻
Noise-Induced Hearing Loss
Chronic loud-noise exposure → SNHL
4-kHz notch on audiogram → noise-induced hearing loss ⭐
Concert worker / factory worker / firearm exposure → noise-induced SNHL
Usually bilateral → occupational noise exposure
⸻
Vestibular Schwannoma ⭐⭐⭐
Unilateral sensorineural hearing loss → vestibular schwannoma
Unilateral tinnitus → vestibular schwannoma
Balance problems + unilateral hearing loss → vestibular schwannoma
CN VIII tumor → vestibular schwannoma
Cerebellopontine angle mass → vestibular schwannoma
Bilateral vestibular schwannomas → NF2
NF2 + bilateral CN VIII tumors → classic association
MRI with gadolinium → diagnostic imaging
⸻
Ménière Disease ⭐⭐⭐
Episodic vertigo + hearing loss + tinnitus → Ménière disease
Fluctuating sensorineural hearing loss → Ménière
Aural fullness → Ménière
Endolymphatic hydrops → underlying mechanism
Low-frequency hearing loss initially → Ménière
Episodes last minutes to hours → Ménière
No focal neurologic deficits → supports peripheral vertigo
Buzzword triad:
Vertigo + tinnitus + fluctuating hearing loss
⸻
BPPV ⭐⭐⭐
Brief episodes of vertigo triggered by head movement → BPPV
Rolling over in bed → vertigo → BPPV
Looking up → vertigo → BPPV
Positive Dix-Hallpike → BPPV
Nystagmus with positional testing → BPPV
Most commonly posterior semicircular canal → BPPV
No hearing loss → BPPV
Treatment → Epley/canalith repositioning maneuver
Key distinction:
BPPV = positional + seconds + NO hearing loss
⸻
Vestibular Neuronitis
Acute prolonged vertigo after viral illness → vestibular neuritis
Vertigo lasting days → vestibular neuritis
No hearing loss → vestibular neuritis
No tinnitus → vestibular neuritis
Peripheral vestibular disorder → vestibular neuritis
Labyrinthitis
Vertigo + hearing loss after viral infection → labyrinthitis
Vestibular neuritis + hearing loss → think labyrinthitis
⸻
Central vs Peripheral Vertigo
Peripheral
Severe vertigo → peripheral
Nausea/vomiting → peripheral
Unidirectional horizontal nystagmus → peripheral
Nystagmus suppressed by visual fixation → peripheral
Hearing symptoms may occur → peripheral
Central
Vertical nystagmus → central
Direction-changing nystagmus → central
Neurologic deficits → central
Severe gait ataxia → central
Nystagmus not suppressed by visual fixation → central
Cerebellar stroke → central vertigo
⸻
Eustachian Tube Dysfunction
Ear fullness after URI/flight → eustachian tube dysfunction
Retracted TM → eustachian tube dysfunction
Barotrauma during airplane descent → eustachian tube dysfunction
Difficulty equalizing pressure → eustachian tube dysfunction
⸻
Epistaxis ⭐
Most common site of anterior epistaxis → Kiesselbach plexus
Children + nose picking → anterior epistaxis
Visible bleeding vessel on anterior septum → Kiesselbach
Most common overall epistaxis → anterior
Posterior epistaxis → older adults, hypertension/atherosclerosis
Posterior bleeding → sphenopalatine artery
Blood flowing into posterior pharynx → posterior epistaxis
Posterior epistaxis often requires packing/ENT intervention
Management
First step → sit forward + pinch soft nose
Topical vasoconstrictor → oxymetazoline
Persistent visible anterior bleeding → cautery
Uncontrolled posterior bleeding → posterior packing + ENT
⸻
Nasal Fracture
Most common facial fracture → nasal fracture
Nasal trauma + deformity → nasal fracture
Septal hematoma → emergency
Fluctuant swelling of nasal septum → septal hematoma
Untreated septal hematoma → cartilage necrosis → saddle-nose deformity
Septal hematoma requires drainage → urgent ENT management
⸻
Sinusitis ⭐
Acute bacterial rhinosinusitis
Symptoms >10 days without improvement → bacterial sinusitis
Severe fever + purulent nasal discharge ≥3 days → bacterial sinusitis
“Double worsening” → bacterial sinusitis
Initial viral URI improves then worsens → bacterial sinusitis
Common organisms → S. pneumoniae, H. influenzae
First-line treatment when antibiotics indicated → amoxicillin-clavulanate
Chronic sinusitis
Symptoms ≥12 weeks → chronic rhinosinusitis | 303 |
| 13 | 👂 Whole ENT amc Buzzwords in one post 🔥
Otitis Media
Acute otitis media (AOM) → bulging, erythematous tympanic membrane + middle-ear effusion
Ear pain + fever + recent URI → AOM
Pneumatic otoscopy: decreased TM mobility → middle-ear effusion
Most common organism in children → Streptococcus pneumoniae
Other AOM organisms → H. influenzae, Moraxella catarrhalis
AOM after viral URI → bacterial superinfection
Antibiotic first-line → amoxicillin
Amoxicillin recently used / conjunctivitis → amoxicillin-clavulanate → β-lactamase-producing H influenzae
AOM + otorrhea through tympanostomy tube → topical fluoroquinolone ear drops
Otitis media with effusion
“Glue ear” → otitis media with effusion
Fluid behind TM without acute inflammation → OME
Conductive hearing loss after URI → OME
Usually no fever or significant ear pain → OME
Persistent unilateral middle-ear effusion in adult → evaluate for nasopharyngeal mass
Children + recurrent OME + speech delay → hearing evaluation ± tympanostomy tubes
⸻
Otitis Externa
“Swimmer’s ear” → acute otitis externa
Pain with tragal manipulation → otitis externa
Pain when pulling pinna → otitis externa
Ear canal edema + erythema → otitis externa
Most common organism → Pseudomonas aeruginosa
Treatment → topical antibiotic ear drops
Tympanic membrane perforation/tube present → use non-ototoxic fluoroquinolone drops
Avoid aminoglycoside-containing drops if TM perforation → risk of ototoxicity
Malignant otitis externa
Older patient + diabetes + severe otalgia → malignant otitis externa
Severe pain out of proportion → malignant otitis externa
Granulation tissue in external auditory canal → malignant otitis externa
Cranial nerve palsy → advanced malignant otitis externa
Typical organism → Pseudomonas
Treatment → systemic antipseudomonal antibiotics
⸻
Tympanic Membrane
Dull, bulging TM → AOM
Retracted TM → eustachian tube dysfunction
Air-fluid level/bubbles behind TM → middle-ear effusion
Perforated TM + purulent drainage → otitis media with perforation
Central TM perforation → usually chronic otitis media
Attic/marginal perforation + foul-smelling discharge → cholesteatoma
⸻
Cholesteatoma ⭐
Painless chronic otorrhea → cholesteatoma
Foul-smelling ear discharge → cholesteatoma
White keratin debris behind TM → cholesteatoma
Retraction pocket containing keratin → cholesteatoma
Conductive hearing loss + chronic ear disease → cholesteatoma
Erosion of ossicles → cholesteatoma
Can erode bone → cholesteatoma
Treatment → surgical removal
Classic clue:
Foul-smelling otorrhea + conductive hearing loss + white mass
⸻
Hearing Loss
Conductive
External/middle ear problem → conductive hearing loss
Otosclerosis → conductive hearing loss
Cerumen impaction → conductive hearing loss
Otitis media → conductive hearing loss
Tympanic membrane perforation → conductive hearing loss
Ossicular damage → conductive hearing loss
Sensorineural
Cochlea/CN VIII problem → sensorineural hearing loss
Presbycusis → bilateral high-frequency sensorineural hearing loss
Noise exposure → high-frequency SNHL
Ototoxic drugs → SNHL
Vestibular schwannoma → unilateral SNHL
⸻
Rinne & Weber ⭐⭐⭐
Rinne
Normal → air conduction > bone conduction
Conductive hearing loss → bone conduction > air conduction
Sensorineural hearing loss → air conduction > bone conduction
Weber
Conductive hearing loss → sound lateralizes to affected ear
Sensorineural hearing loss → sound lateralizes to unaffected ear
Easy rule:
Conductive → Weber goes toward the bad ear Sensorineural → Weber goes toward the good ear
⸻
Otosclerosis ⭐⭐⭐
Young/middle-aged adult + progressive hearing loss → otosclerosis
Usually conductive hearing loss → otosclerosis
Stapes fixation → otosclerosis
Normal TM + progressive conductive hearing loss → otosclerosis
Pregnancy may worsen symptoms → otosclerosis
Carhart notch at 2 kHz → otosclerosis
Treatment → hearing aid or stapedectomy/stapedotomy
⸻
Presbycusis
Elderly patient + gradual bilateral hearing loss → presbycusis
High-frequency hearing loss → presbycusis
Difficulty understanding speech, especially in noisy environments → presbycusis | 287 |
| 14 | Autosomal dominant usually
Mucocutaneous bleeding
Epistaxis
Menorrhagia
Easy bruising
↓ platelet adhesion
May cause ↑ PTT because vWF stabilizes factor VIII
Treatment → desmopressin
Buzzword: “Mucosal bleeding + normal platelets + desmopressin”
⸻
Bernard-Soulier Syndrome
Defective GpIb
Cannot bind vWF
Giant platelets
Thrombocytopenia
↑ bleeding time
Remember: Bernard-Soulier = GpIb
⸻
Glanzmann Thrombasthenia
Defective GpIIb/IIIa
Cannot bind fibrinogen
Impaired platelet aggregation
Normal platelet count
↑ bleeding time
Remember: Glanzmann = GpIIb/IIIa
⸻
⚡ Ultra-High-Yield “Instant Diagnosis” Lines
Auer rods → AML
Auer rods + DIC → APL
t(9;22) → CML
Smudge cells → CLL
Reed-Sternberg → Hodgkin
t(14;18) → Follicular lymphoma
t(8;14) → Burkitt
t(11;14) → Mantle cell
CRAB → Multiple myeloma
IgM + hyperviscosity → Waldenström
Spherocytes → hereditary spherocytosis / warm AIHA
Heinz bodies + bite cells → G6PD
Sickle cells → sickle cell disease
Schistocytes + thrombocytopenia → TTP/HUS/DIC
Bloody diarrhea + AKI → HUS
Neurologic symptoms + MAHA → TTP
↑ PT + ↑ PTT + ↓ fibrinogen → DIC
Hemarthrosis + ↑ PTT → Hemophilia
Mucosal bleeding + vWF problem → vWD
GpIb → Bernard-Soulier
GpIIb/IIIa → Glanzmann
Pancytopenia + hypocellular marrow → aplastic anemia
Microcytosis + low ferritin → iron deficiency
Microcytosis + high RBC count → thalassemia
Low iron + low TIBC + high ferritin → anemia of chronic disease | 285 |
| 15 | Acute Myeloid Leukemia — AML
Auer rods
Myeloperoxidase positive
Myeloblasts
Older adults
t(15;17) → acute promyelocytic leukemia
PML-RARA
Severe DIC
Treatment → ATRA
APL is a hematologic emergency
Buzzword: “Auer rods + DIC → APL → ATRA”
⸻
ALL
Most common leukemia in children
TdT positive
B-cell or T-cell lineage
Bone pain
Fever
Hepatosplenomegaly
CNS involvement
t(12;21) → favorable B-ALL
t(9;22) → worse prognosis
T-ALL
Adolescent male
Mediastinal mass
Thymic origin
Buzzword: “Child + lymphoblasts + TdT”
⸻
CML
t(9;22) Philadelphia chromosome
BCR-ABL
Constitutively active tyrosine kinase
Very high WBC
Basophilia
Splenomegaly
Low leukocyte alkaline phosphatase
Treatment → imatinib
Buzzword: “Massive leukocytosis + basophilia + splenomegaly → CML”
⸻
CLL
Most common leukemia in older adults
Smudge cells
CD5+
CD23+
B-cell malignancy
Hypogammaglobulinemia
Recurrent infections
Autoimmune hemolytic anemia
Can transform into aggressive lymphoma → Richter transformation
Buzzword: “Older adult + lymphocytosis + smudge cells”
⸻
🧫 Lymphomas
Hodgkin Lymphoma
Reed-Sternberg cells
CD15+
CD30+
Painless lymphadenopathy
B symptoms
Fever
Night sweats
Weight loss
Alcohol-induced lymph node pain
Contiguous spread
Often cervical lymph nodes
Buzzword: “Reed-Sternberg + CD15/CD30”
⸻
Non-Hodgkin Lymphoma
Usually noncontiguous spread
Extranodal involvement common
Multiple subtypes
Can involve GI tract, skin, CNS, bone marrow
⸻
Follicular Lymphoma
t(14;18)
BCL2 overexpression
Indolent
Painless lymphadenopathy
“Back-to-back” follicles
Buzzword: “t(14;18) → BCL2 → follicular lymphoma”
⸻
Burkitt Lymphoma
Extremely rapid growth
t(8;14)
MYC activation
“Starry-sky” appearance
African endemic → jaw mass
Sporadic → abdominal mass
Tumor lysis syndrome risk
Buzzword: “Fast-growing + starry sky + t(8;14)”
⸻
Mantle Cell Lymphoma
t(11;14)
Cyclin D1 ↑
CD5+
Older adults
GI involvement
Multiple lymphomatous polyposis
Buzzword: “CD5+ lymphoma + cyclin D1 + t(11;14)”
⸻
Multiple Myeloma
Older adult
CRAB
Calcium ↑
Renal dysfunction
Anemia
Bone lesions
Lytic bone lesions
“Punched-out” lesions
Monoclonal IgG
Rouleaux formation
M-spike
Bence Jones proteins
β2-microglobulin → prognosis
Bone marrow → plasma cells
Recurrent infections
Buzzword: “CRAB + punched-out lesions + M-spike”
⸻
MGUS
Monoclonal protein
❤ g/dL
Bone marrow plasma cells <10%
No CRAB features
Precursor to multiple myeloma
⸻
Waldenström Macroglobulinemia
IgM
Lymphoplasmacytic lymphoma
Hyperviscosity
Headache
Blurred vision
Neurologic symptoms
No lytic bone lesions
No hypercalcemia typically
Buzzword: “IgM + hyperviscosity + no lytic lesions”
⸻
🩸 Platelet Disorders
ITP
Isolated thrombocytopenia
Petechiae/purpura
Normal PT/PTT
Large/young platelets
Autoimmune destruction
Children → often after viral infection
Adults → chronic
Associated with HIV/SLE
Treatment → steroids ± IVIG
Buzzword: “Isolated low platelets + normal PT/PTT”
⸻
TTP
Think MAHA + thrombocytopenia + neurologic/renal findings
Thrombocytopenia
Renal dysfunction
Anemia/MAHA
Fever
Neurologic symptoms
Schistocytes
↓ ADAMTS13
Usually normal PT/PTT
Treatment → plasma exchange immediately
Buzzword: “Schistocytes + thrombocytopenia + neurologic symptoms → TTP”
⸻
HUS
MAHA
Thrombocytopenia
Acute kidney injury
Often follows bloody diarrhea
Shiga toxin → EHEC
Children
Normal PT/PTT
Treatment usually supportive
Buzzword: “Bloody diarrhea → AKI + thrombocytopenia + schistocytes”
⸻
DIC
Consumption of clotting factors + platelets
Bleeding and thrombosis
↑ PT
↑ PTT
↑ D-dimer
↓ fibrinogen
↓ platelets
Schistocytes
Causes:
Sepsis
Trauma
Obstetric complications
Malignancy
APL
Buzzword: “Bleeding + prolonged PT/PTT + low fibrinogen + high D-dimer”
⸻
Hemophilia A
Factor VIII deficiency
X-linked recessive
Hemarthroses
Deep tissue bleeding
↑ PTT
Normal PT
Normal bleeding time
Treatment → factor VIII
Desmopressin can help mild disease
Buzzword: “Male + hemarthroses + isolated ↑ PTT”
⸻
Hemophilia B
Factor IX deficiency
X-linked
Clinically similar to hemophilia A
Christmas disease
⸻
von Willebrand Disease
Most common inherited bleeding disorder | 271 |
| 16 | 🩸 Whole HY Hematology in one post 🔥✅
Iron Deficiency Anemia
Microcytic, hypochromic anemia
↓ Ferritin = most specific clue
↓ Serum iron
↑ TIBC
↑ RDW
Pica → especially ice (pagophagia)
Koilonychia → spoon-shaped nails
Chronic blood loss → think GI bleeding
Premenopausal woman → menstrual blood loss
Most common cause in adult men/postmenopausal women → GI blood loss until proven otherwise
⸻
Anemia of Chronic Disease
Usually normocytic, sometimes microcytic
↓ Serum iron
↓ TIBC
↑/normal ferritin
↑ Hepcidin
Chronic infection, inflammation, malignancy
Iron trapped inside macrophages
Think: “Iron is there, but unavailable.”
⸻
Thalassemia
Severe microcytosis out of proportion to anemia
↑ RBC count despite anemia
Normal/↑ ferritin
Target cells
Basophilic stippling may occur
β-thalassemia major: severe anemia beginning in infancy
“Chipmunk facies”
“Crew-cut” skull
Hepatosplenomegaly
Transfusion dependence
β-thalassemia minor: mild anemia, often asymptomatic
Hb electrophoresis: ↑ HbA₂ → β-thalassemia trait
α-thalassemia → HbH / Hb Bart’s
⸻
🧬 Hemolytic Anemias
General Hemolysis
Think:
↑ LDH + ↑ indirect bilirubin + ↓ haptoglobin + ↑ reticulocytes
Jaundice
Splenomegaly
Dark urine may occur
Extravascular hemolysis
Spleen/macrophages
↑ indirect bilirubin
Splenomegaly
Spherocytes
Intravascular hemolysis
RBC destruction inside blood vessels
Hemoglobinuria
↓↓↓ haptoglobin
Hemosiderinuria
↑ LDH
⸻
Hereditary Spherocytosis
Spherocytes
↑ MCHC
Extravascular hemolysis
Splenomegaly
Autosomal dominant
Defect in RBC membrane proteins
Ankyrin/spectrin/band 3
Positive family history
Eosin-5-maleimide binding ↓
Splenectomy → definitive treatment in severe disease
Pigment gallstones
Buzzword: “Spherocytes + increased MCHC + family history”
⸻
G6PD Deficiency
Episodic hemolysis
Oxidative stress triggers:
Sulfonamides
Dapsone
Primaquine
Nitrofurantoin
Fava beans
Infection
Heinz bodies
Bite cells
X-linked recessive
African/Mediterranean ancestry can be a clue
G6PD protects RBCs by generating NADPH
↓ glutathione → oxidative damage
Buzzword: “Fava beans/drug + hemolysis + bite cells/Heinz bodies”
⸻
Sickle Cell Disease
HbS
β-globin mutation: Glu → Val
Autosomal recessive
Vaso-occlusive crises
Severe pain
Acute chest syndrome
Dactylitis
Autosplenectomy
Increased risk of encapsulated bacteria
Salmonella osteomyelitis
Pigment gallstones
Aplastic crisis → Parvovirus B19
Howell-Jolly bodies
Hydroxyurea → ↑ HbF
Pain crisis → hydration + analgesia
Acute chest → oxygen + antibiotics + analgesia ± transfusion
Classic triggers
Dehydration
Infection
Hypoxia
Acidosis
Buzzword: “Pain + autosplenectomy + Howell-Jolly bodies”
⸻
Sickle Cell Trait
Usually asymptomatic
Hematuria
Renal papillary necrosis
Splenic infarction at high altitude
Usually does not cause severe vaso-occlusive disease
⸻
Pyruvate Kinase Deficiency
↓ ATP production
Hemolytic anemia
Echinocytes/burr cells
↑ 2,3-BPG
Autosomal recessive
Splenomegaly
Chronic hemolysis
Buzzword: “Hemolysis + echinocytes + ↑ 2,3-BPG”
⸻
Autoimmune Hemolytic Anemia
Warm AIHA
IgG
Extravascular hemolysis
Spherocytes
Positive direct Coombs
Associated with:
SLE
CLL
Methyldopa
Treatment → glucocorticoids
Buzzword: “IgG + 37°C + spherocytes”
Cold AIHA
IgM
Complement-mediated
Agglutination
Associated with:
Mycoplasma pneumoniae
EBV
Symptoms worse with cold
Treat underlying disease ± rituximab
Buzzword: “Cold exposure + IgM + RBC agglutination”
⸻
PNH — Paroxysmal Nocturnal Hemoglobinuria
Intravascular hemolysis
Hemoglobinuria
Thrombosis
Abdominal pain
Pancytopenia
PIGA mutation
Defective GPI anchor
↓ CD55 and CD59
Complement-mediated RBC destruction
Treatment → eculizumab/ravulizumab
Buzzword: “Hemolysis + thrombosis in unusual sites + pancytopenia”
⸻
🩸 Bone Marrow Disorders
Aplastic Anemia
Pancytopenia
Hypocellular bone marrow
Few/no hematopoietic cells
No splenomegaly
Causes:
Benzene
Radiation
Drugs
Viral infections
Autoimmune
Parvovirus B19 usually causes pure red cell aplasia, not classic aplastic anemia
Treatment → stem-cell transplant in appropriate young patients
Buzzword: “Pancytopenia + empty/hypocellular marrow”
⸻ | 253 |
| 17 | Triceps → elbow extension
Musculocutaneous → anterior arm
Radial → posterior arm/forearm
Median → most anterior forearm
Ulnar → most intrinsic hand muscles
FDS → PIP flexion
FDP → DIP flexion
PAD/DAB → ulnar nerve
Gluteus maximus → hip extension
Gluteus medius → hip abduction
Superior gluteal nerve → Trendelenburg
Quadriceps → knee extension → femoral nerve
Hamstrings → knee flexion → sciatic nerve
Anterior leg → dorsiflexion → deep fibular
Lateral leg → eversion → superficial fibular
Posterior leg → plantarflexion → tibial | 268 |
| 18 | If left side of pelvis drops → right gluteus medius/minimus weakness → right superior gluteal nerve lesion.
Gluteus minimus
Hip abduction + medial rotation
Superior gluteal nerve.
TENSOR FASCIAE LATAE
Hip abduction + medial rotation
Tightens iliotibial tract
Nerve → superior gluteal nerve.
HIP FLEXORS
Iliopsoas
Main hip flexor
Psoas major + iliacus
Nerve → femoral nerve + direct branches of lumbar plexus
Sartorius
Flexes hip
Abducts hip
Laterally rotates hip
Flexes knee
Nerve → femoral nerve.
Mnemonic:
Tailor’s muscle → sartorius.
THIGH — ANTERIOR COMPARTMENT
Main nerve → Femoral nerve
Quadriceps
Rectus femoris
Knee extension
Hip flexion
Vastus lateralis
Knee extension
Vastus medialis
Knee extension
Helps stabilize patella.
Vastus intermedius
Knee extension
All:
→ Femoral nerve → L2–L4.
THIGH — MEDIAL COMPARTMENT
Main action → hip adduction
Main nerve → Obturator nerve
Adductor longus
→ adduction
Adductor brevis
→ adduction
Adductor magnus
Adduction
Hamstring portion → hip extension
Gracilis
Hip adduction
Knee flexion
Medial rotation of leg
Obturator nerve.
THIGH — POSTERIOR COMPARTMENT
Main nerve → Sciatic nerve
Hamstrings
Semitendinosus
Hip extension
Knee flexion
Medial rotation
Semimembranosus
Hip extension
Knee flexion
Medial rotation
Biceps femoris
Hip extension
Knee flexion
Lateral rotation
Nerve
Semitendinosus → tibial division of sciatic
Semimembranosus → tibial division
Biceps femoris long head → tibial division
Biceps femoris short head → common fibular division
LEG — ANTERIOR COMPARTMENT
Main nerve → Deep fibular nerve
Main action → dorsiflexion
Tibialis anterior
Dorsiflexion
Inversion
Deep fibular nerve
Extensor hallucis longus
Extension of great toe
Dorsiflexion
Extensor digitorum longus
Extension of toes
Dorsiflexion
Deep fibular nerve injury
→ foot drop
LEG — LATERAL COMPARTMENT
Main nerve → Superficial fibular nerve
Main action → eversion
Fibularis longus
→ eversion
Fibularis brevis
→ eversion
Superficial fibular nerve injury
→ weak eversion.
LEG — POSTERIOR COMPARTMENT
Main nerve → Tibial nerve
Main action → plantarflexion
Gastrocnemius
Plantarflexion
Knee flexion
Soleus
Plantarflexion
Important postural muscle.
Plantaris
Weak plantarflexion + knee flexion.
Tibialis posterior
Plantarflexion
Inversion
ACHILLES TENDON
Gastrocnemius + soleus → Achilles tendon.
Achilles reflex: → S1–S2 → tibial nerve.
Achilles rupture
→ difficulty plantarflexing.
FOOT INVERSION vs EVERSION
Inversion
Tibialis anterior + Tibialis posterior
Eversion
Fibularis longus + Fibularis brevis
Easy memory:
TA + TP = inversion
FL + FB = eversion
NECK MUSCLES
Sternocleidomastoid
Unilateral → rotates face to opposite side
Lateral flexion to same side
Bilateral → neck flexion
Nerve → CN XI
Sensory/proprioceptive contribution → C2–C3.
CN XI injury
→ difficulty turning head against resistance → shoulder droop due to trapezius weakness.
TRAPEZIUS
Elevates scapula → upper fibers
Retracts scapula → middle fibers
Depresses scapula → lower fibers
Upward rotation → upper + lower fibers
Nerve → CN XI
Clinical
CN XI injury → difficulty shrugging shoulder.
SERRATUS ANTERIOR
Protracts scapula
Upward rotation of scapula
Keeps scapula against thoracic wall
Nerve → long thoracic nerve
Roots → C5–C7
Injury
→ winged scapula
Classic cause: axillary lymph node surgery / trauma
RHOMBOIDS
Scapular retraction
Downward rotation
Nerve → dorsal scapular nerve
Root → C5.
DIAPHRAGM
Main muscle of inspiration
Nerve → phrenic nerve
Roots → C3–C5
Mnemonic:
C3, 4, 5 keep the diaphragm alive.
Phrenic nerve injury
→ ipsilateral diaphragmatic paralysis.
EXTRAOCULAR MUSCLES
LR6 SO4, 3 all the rest
Lateral rectus → CN VI
Superior oblique → CN IV
All others → CN III
Superior rectus
→ elevation + medial rotation + adduction
Inferior rectus
→ depression + lateral rotation + adduction
Superior oblique
→ depression + medial rotation + abduction
Inferior oblique
→ elevation + lateral rotation + abduction.
20 MUSCLE FACTS TO MEMORIZE FOR USMLE
Supraspinatus → initiates abduction
Deltoid → abducts 15–90°
Axillary nerve → surgical neck of humerus
Biceps → supination | 280 |
| 19 | 💪 HIGH-YIELD MUSCLES TESTED IN EVERY MEDICAL EXAMS 💯🔥
ROTATOR CUFF-> SITS
Supraspinatus
Action → initiates abduction (0–15°)
Nerve → Suprascapular nerve
Root → C5–C6
Injury → difficulty initiating shoulder abduction
Most commonly injured rotator cuff tendon.
Infraspinatus
Action → external/lateral rotation
Nerve → Suprascapular nerve
Root → C5–C6
Teres minor
Action → external rotation
Nerve → Axillary nerve
Root → C5–C6
Subscapularis
Action → internal/medial rotation
Nerve → Upper and lower subscapular nerves
Root → C5–C7
Classic question
Cannot initiate abduction → supraspinatus/suprascapular nerve.
Cannot abduct arm from 15–90° → deltoid/axillary nerve.
DELTOID
Action → abduction 15–90°
Nerve → Axillary nerve
Roots → C5–C6
Axillary nerve injury → loss of shoulder abduction
Associated fracture → surgical neck of humerus
Sensory loss → regimental badge area
Sequence of abduction
0–15° → supraspinatus
15–90° → deltoid
90° → trapezius + serratus anterior
BICEPS BRACHII
Action → elbow flexion
Strongest action → forearm supination
Nerve → Musculocutaneous nerve
Roots → C5–C6
Long head → originates from supraglenoid tubercle
Short head → originates from coracoid process
Clinical
Musculocutaneous nerve injury → weak elbow flexion + weak supination → sensory loss over lateral forearm.
BRACHIALIS
Main action → elbow flexion
Nerve → Musculocutaneous nerve
Root → C5–C6
It is the primary flexor of the elbow regardless of forearm position.
TRICEPS ⭐⭐⭐
Action → elbow extension
Nerve → Radial nerve
Roots → C6–C8
Long head → originates from infraglenoid tubercle.
Classic
Radial nerve lesion → weak elbow/wrist/finger extension.
CORACOBRACHIALIS
Action → shoulder flexion + adduction
Nerve → Musculocutaneous nerve
Root → C5–C7
Musculocutaneous nerve pierces coracobrachialis.
FOREARM — ANTERIOR COMPARTMENT
Superficial muscles
Pronator teres
Action → pronation
Nerve → Median nerve
Roots → C6–C7
Flexor carpi radialis
Action → wrist flexion + abduction
Nerve → median nerve
Palmaris longus
Action → wrist flexion
Nerve → median nerve
Frequently absent.
Useful clinically for tendon grafting.
Flexor carpi ulnaris
Action → wrist flexion + adduction
Nerve → ulnar nerve
Roots → C8–T1
ANTERIOR FOREARM
Flexor digitorum profundus
Flexes DIP joints
Lateral half → median nerve / anterior interosseous nerve
Medial half → ulnar nerve
Classic USMLE
Cannot flex DIP of index/middle finger → anterior interosseous nerve lesion.
Cannot flex DIP of ring/little finger → ulnar nerve lesion.
Flexor digitorum superficialis
Flexes PIP joints
Nerve → median nerve.
Remember:
FDS → PIP
FDP → DIP
Flexor pollicis longus
Flexes thumb IP joint
Nerve → anterior interosseous nerve
Pronator quadratus
Main pronator
Nerve → anterior interosseous nerve
POSTERIOR FOREARM
Main nerve → Radial nerve / posterior interosseous nerve
Extensor carpi radialis longus
Wrist extension + abduction
Extensor carpi radialis brevis
Wrist extension + abduction
Extensor carpi ulnaris
Wrist extension + adduction
Extensor digitorum
Extends fingers.
Extensor pollicis longus
Extends thumb.
Extensor pollicis brevis
Extends thumb.
HAND — THENAR MUSCLES
LOAF
Lateral 3½ digits → median nerve
Lumbricals 1 & 2
Median nerve
Flex MCP
Extend IP joints.
Lumbricals 3 & 4
Ulnar nerve.
Thenar muscles
Abductor pollicis brevis → median
Flexor pollicis brevis → median
Opponens pollicis → median
Classic
Thenar atrophy + loss of thumb opposition → median nerve lesion.
HAND — HYPOTHENAR
Abductor digiti minimi → ulnar
Flexor digiti minimi → ulnar
Opponens digiti minimi → ulnar
Most intrinsic hand muscles
→ Ulnar nerve
Mnemonic:
PAD/DAB
PAD → Palmar interossei ADduct
DAB → Dorsal interossei ABduct
Both → ulnar nerve
GLUTEAL MUSCLES
Gluteus maximus
Action → hip extension
Also lateral rotation
Nerve → inferior gluteal nerve
Roots → L5–S2
Clinical
Difficulty climbing stairs/rising from chair → gluteus maximus weakness.
Gluteus medius
Action → hip abduction
Stabilizes pelvis during walking
Nerve → superior gluteal nerve
Roots → L4–S1
Trendelenburg sign
Patient stands on right leg. | 401 |
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