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OCT 720 > Chapter 3C (Nerve Injuries of the Upper Extremity) > Flashcards

Chapter 3C (Nerve Injuries of the Upper Extremity) Flashcards

1
Q

Dermatomes are

A

unilateral areas/strips of the skin innervated by a single spinal nerve

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2
Q

____ ____ ___ in each spinal nerve supply a dermatome segment, with the exception of the ____ and _____, which are innervated by the cranial nerves (CN V)

A

GSA nerve fibers; the face and scalp

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3
Q

Dermatomes allow the clinician to determine where there is ____ ____ to the spinal cord, as well as the __________.

A

Sensory damage; extent of the injury

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4
Q

(Dermatomes of the UE)

C3, C4

A

Region of the base of neck, extending laterally over shoulder

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5
Q

(Dermatomes of the UE)

C5

A

Lateral aspect of arm (I.e., superior aspect of abducted arm)

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6
Q

(Dermatomes of the UE)

C6

A

Lateral forearm and thumb

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7
Q

(Dermatomes of the UE)

C7

A

Middle and ring fingers (or middle three fingers) and center for posterior aspect of forearm

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8
Q

(Dermatomes of the UE)

C8

A

Little finger, medial side of hand and forearm (i.e., inferior aspect of abducted arm)

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9
Q

(Dermatomes of the UE)

T1

A

Medial aspect of forearm and inferior arm

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10
Q

(Dermatomes of the UE)

T2

A

Medial aspect of superior arm and skin of axilla

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11
Q

A cutaneous nerve supplies an area of skin that is related to a ____ ______

A

Peripheral nerve

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12
Q

(Cutaneous Innervation)

Any cutaneous nerve may …

A

contain fibers from several individual spinal nerves.

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13
Q

(Cutaneous Innervation)

A cutaneous nerve area will be generally ____ and ____ than an area supplied by a single spinal (dermatome ) nerve.

A

broader and wider

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14
Q

(Cutaneous Innervation)

The arm and forearm have …

A

Posterior, lateral, and medial cutaneous nerves

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15
Q

(Cutaneous Innervation)

Medial cutaneous nerves are branches of the ____ ____

A

Medial cord

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16
Q

(Cutaneous Innervation)

Posterior cutaneous nerves are branches of the ____ ____

A

Radial nerve

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17
Q

Nerve branches distal to a lesion will be affected while the …

A

branches proximal to the injury will not be affected

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18
Q

Carpal tunnel syndrome results from any ____________ that significantly __________

A

lesion at the wrist; reduces the size of the carpal tunnel.

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19
Q

(Carpal tunnel syndrome)

The median nerve is the ____ ____ ____ in the tunnel and prone to compression.

A

Most sensitive structure.

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20
Q

(Carpal tunnel syndrome)

Symptoms

A

Paresthesia (tingling), hypoesthesia (diminished sensation), or anesthesia (absence of sensation) to the lateral 3 fingers, sensation in the central palm will remain unaffected.

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21
Q

(Carpal tunnel syndrome)

Treatment

A

Conservative treatment may include splinting the wrist in a neutral position when performing repetitive activity, median nerve/tendon gliding exercise.

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22
Q

Pronator syndrome is also known as

A

Pronator teres syndrome

23
Q

(Pronator syndrome)

Nerve entrapment caused by ____________ between the two heads of the pronator teres.

A

Compression of the median nerve near the elbow

24
Q

(Pronator syndrome)

Symptoms

A

Symptoms may include pain and tenderness in the proximal aspect of the anterior forearm, hyesthesia (decreased sensation) of the palmar aspect of the radial 3 1/2 digits and palm.
- May appear following activities involving repeated pronation

25
Q

(Pronator syndrome)

Treatment

A

Conservative treatment may include an elbow splint with the forearm in neutral

26
Q

Guyon Canal syndrome results form a ___________

A

ulnar nerve compression at the wrist.

27
Q

(Guyon Canal Syndrome)

Symptoms

A

Symptoms include hypesthesia (reduced sensation of touch) in the medial 1 1/2 fingers and weakness of the intrinsic muscles of the hand.

28
Q

(Guyon Canal Syndrome)

____ of the 4th and 5th digits may occur, however, will still have the ability to flex the 4th and 5th digits

A

Clawing (hyperextension of MCP joints with flexion of the PIP/DIP)

29
Q

(Guyon Canal Syndrome)

Treatment

A

Conservative treatment may include wearing a wrist splinting neutral and activity modifications

30
Q

The cubital tunnel is formed by the ____ ____ connecting the _____ and ____ heads of the FCU.

A

tendinous arch; humeral and ulnar

31
Q

(Cubital Tunnel Syndrome)

The ____ most common nerve compression

A

Second

32
Q

(Cubital Tunnel Syndrome)

Results from the compression of the ____ ____ in the cubital tunnel

A

Ulnar nerve

33
Q

(Cubital Tunnel Syndrome)

Symptoms

A

Symptoms may include numbness and tingling along the ulnar aspects of the forearm and hand, pain at the elbow with extreme flexion, and weakness of power grip.

34
Q

(Cubital Tunnel Syndrome)

Treatment

A

Conservative treatment include splinting at night to prevent extreme flexion or pad to decrease compression when leaning on elbows

35
Q

Radial Nerve Palsy is also known as

A

Saturday night palsy described by sleeping in a position that places stress on the radial nerve.

36
Q

(Radial Nerve Palsy)

Caused by a…

A

Compression of the radial nerve from sleeping in a position that places stress on the radial nerve or a humeral shaft fracture

37
Q

(Radial Nerve Palsy)

Symptoms

A

May include weakness or paralysis of the extensors to the wrist, MCP’s, and thumb

38
Q

(Radial Nerve Palsy)

Depending on the severity, may cause

A

wrist drop

39
Q

(Radial Nerve Palsy)

Treatment

A

Conservative treatment include using a dynamic extension splint and strengthening the wrist and finger extensors when motor function returns

40
Q

(Lacerations of the Median Nerve)

Sensory loss at:

A
  • Central palm (thumb to radial 1/2 of ring finger/digit 4
  • Palmar surface of thumb to radial 1/2 of ring finger
  • Dorsal surface of the middle and distal phalanges of thumb to radial 1/2 ring finger
41
Q

(Lacerations of the Median Nerve)

Motor loss at low lesion at the wrist affecting

A

Lumbricals 1 and 2 and thenar compartment

42
Q

(Lacerations of the Median Nerve)

Clinically presents with

A

Ape hand deformity

43
Q

(Lacerations of the Median Nerve)

Motor loss at a high lesion at or proximal to the elbow affecting:

A
  • All the muscles affected by a low lesion of the median nerve
  • FDP to index and middle finger, and FPL (flexion of DIP of digits 2 and 3 and thumb)
  • FCR (inability to flex to radial aspect of the wrist/radial deviation)
44
Q

(Lacerations of the Median Nerve)

Clinically resents

A

Benediction sign

45
Q

(Lacerations of the Median Nerve)

Functional loss of median nerve lacerations

A
  • Loss of thumb opposition

- Weakness of pinch

46
Q

(Lacerations of the Ulnar Nerve)

Sensory loss at:

A
  • Ulnar aspects of palmar and dorsal surfaces

- Ulnar 1/2 ring and little fingers on palmar and dorsal surfaces

47
Q

(Lacerations of the Ulnar Nerve)

Motor loss at the low lesion at the wrist affecting:

A
  • Palmar and dorsal interossei (adduction and abduction of MCP joints)
  • Lumbricals III and IV (MCP flexion of digits 4 and 5)
  • FPB and adductor pollicis (flexion and adduction of thumb)
  • ADM, ODM, FDM (adduction, opposition, and flexion of the 5th digit)
48
Q

(Lacerations of the Ulnar Nerve)

Motor loss at the high lesion above wrist affecting:

A
  • All the muscles affected by a low lesion of the ulnar nerve
  • FCU (ulnar deviation)
  • FDP IV and V (flexion of DIP of digits 4 and 5
49
Q

(Lacerations of the Ulnar Nerve)

Both types of low and high lesion will present with

A

Claw hand deformity and flattened metacarpal arch

50
Q

(Lacerations of the Radial Nerve)

Sensory loss at high lesions at the level of the humerus:

A
  • Medial aspect of dorsal forearm, radial aspect of dorsal palm, thumb, and index, middle and radial 1/2 of ring finger
  • *NOTE: Distal lesions will not affect sensation as the deep branch of the radial nerve is entirely a muscular distribution
51
Q

(Lacerations of the Radial Nerve)

Motor loss at the low lesion at the wrist affecting:

A
  • Loss of wrist extension due to impaired ECU
  • EDC, EI, EDM (MCP extension)
  • EPB, EPL, APL (thumb extension)
52
Q

(Lacerations of the Radial Nerve)

Motor loss at the high lesion above the wrist:

A
  • All the muscles affected by a low lesion of the radial nerve
  • Including ECRB, ECRL, and brachioradialis
  • If at the level of axilla, loss of triceps (elbow extension)
53
Q

(Lacerations of the Radial Nerve)

Both types of low and high lesion will present with

A

Wrist drop

OCT 720 (73 decks)

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