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MMB > Brachial plexus injuries > Flashcards

Brachial plexus injuries Flashcards

1
Q

Prevalence of Complete lesions : involving all the roots of the Brachial plexus ?

A

Rare

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2
Q

Complications of a Complete lesion ; involving all the roots of the Brachial plexus ?

A

-Result in complete paralysis of all limb muscles except (Trapezius)

  • Complete loss of sensation except : (on upper half of deltoid) and (floor of axilla)
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3
Q

Erb Duchenne palsy ?

A

Upper trunk lesion of the Brachial plexus ; at erb’s point C5,C6

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4
Q

Name the common Brachial plexus injury ; that is a complication of brachial plexus stretching during delivery

A

Upper trunk lesion : Erb Duchenne palsy

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5
Q

Nerves affected in : Erb Duchenne palsy ?

A

-Nerve to subclavius

-Suprascapular nerve

-Axillary nerve

-Musculocutaneous nerve

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6
Q

Presentation of Erb Duchenne palsy ?

A

The limb is adducted, medially rotated and pronated:

”waiter ’s tip” deformity ;

+loss of sensation down the lateral side of the arm.

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7
Q

Name the Brachial plexus injury : associated with excessive abduction or traction of arm

A

Lower trunk lesion : Klumpke’ s paralysis

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8
Q

Brachial roots affected in Klumpke’ s paralysis ?

A

C8 and T1

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9
Q

Paralysis associated with “Klumpke’ s paralysis” ?

A

-Paralysis of interossei and lumbricals

-Paralysis of flexor carpi ulnaris ;

-and ulnar half of flexor digitorum profundus

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10
Q

Major presentation of Klumpke’ s paralysis ?

A

-Claw hand and ;

-Horner syndrome (T1 affection)

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11
Q

A common cause of : Suprascapular nerve lesion ?
(Not plexus related)

A

Entrapment

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12
Q

Complications of Suprascapular nerve lesion ?

A

-Wasting

-Weakened abduction and lateral rotation

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13
Q

Causes of : Long thoracic nerve lesion ?

A

-During mastectomy

-Carrying heavy object on shoulder

-Chest tube insertion

-Stab wound

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14
Q

Complications of : Long thoracic nerve lesion ?

A

-Winging of scapula

-Difficulty raising arm above shoulder

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15
Q

Name the condition , and the nerve injury associated with it

A

Shoulder dislocation ;

  • Axillary nerve palsy
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16
Q

Two major causes : of Axillary nerve palsy ?

A

-Surgical neck fracture of the humerus

-Shoulder dislocation

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17
Q

Presentation of Axillary nerve palsy ?

A

-Wasting of deltoid

-Weakened abduction

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18
Q

Causes of Median nerve injury at elbow ?

A

-Supracondylar fracture

-Entrapment (Struther ’s ligament)

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19
Q

Define the lesion and the nerve injury associated with it

A

Supracondylar fracture ;

  • Median nerve injury
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20
Q

Define the lesion and the nerve injury associated with it

A

Entrapment by (Struther ’s ligament) ;

  • Median nerve injury
21
Q

Motor complications of : Median nerve injury at elbow ?

A

-Hand of benediction

-Ape hand deformity

-Loss of pronation and weak wrist

22
Q

Sensory complications associated with : Median nerve injury at elbow ?

A
23
Q

Causes of Median nerve injury at wrist ?

A
  • Colle’s fracture

-Stab wound

24
Q

Define the condition and the nerve injury associated

A

Colle’s fracture ;

  • Median nerve injury at wrist
25
Q

Define the condition and the nerve injury associated

A

Carpal tunnel syndrome

26
Q

Major causes of Carpal tunnel syndrome ?

A

•arthritic changes (arthritis)

•tenosynovitis

•Carpal dislocation

•diabetes

•thyroid dysfunction

•fluid retention from pregnancy

27
Q

A common occupational cause of : Carpal tunnel syndrome ?

A

Typing :

28
Q

Presentation of Carpal tunnel syndrome ?

A
  1. burning pain or “pins and needles” followed by sensory loss
  2. weakness and flattening
29
Q

Treatment of Carpal tunnel syndrome ?

A

The condition is dramatically relieved by decompressing the tunnel making a longitudinal incision through the flexor retinaculum

30
Q

….. is a nerve of no cutaneous or motor branches in the axilla or in the arm

A

The ULNAR NERVE

31
Q

Root value of ulnar nerve ?

A

• The ulnar nerve arises from the medial cord of the brachial plexus (C7, C8 and T1)

32
Q

Causes of : Ulnar Nerve lesion at elbow ?

A

-Supracondylar fracture

-Medial epicondyle fracture

-Entrapment (cubital tunnel)

33
Q

Paralysis associated with : Ulnar Nerve lesion at elbow ?

A
  1. Flexor carpi ulnaris: week flexion of wrist with radial deviation
  2. Medial ½ of flexor digitorum profundus: no flexion at distal interphalyngeal joints of 4 th and 5 th finger
  3. Hypothenar muscles: atrophy
  4. Interossei
  5. Adductor pollicic: loss of adduction of thumb
34
Q

Motor presentation of Ulnar Nerve lesion at elbow ?

A

-Incomplete claw hand ;

+flattening of hypothenar eminence

+hollowing between metacarpal bones due to wasting

35
Q

Sensory loss associated with : Ulnar Nerve lesion at elbow ?

A

Sensory loss:

-Palmar cutaneous branch

-Palmar digital branch

-Dorsal cutaneous branch

36
Q

Vasomotor changes associated with : Ulnar Nerve lesion at elbow ?

A

loss of sympathetic control&raquo_space; warm, dry skin

37
Q

Trophic changes associated with : Ulnar Nerve lesion at elbow ?

A

dry, scaly, atrophy of pulp, cracking nails

38
Q

Causes of : Ulnar Nerve lesion at wrist ?

A

Cut and Stab wound (Guyon’s canal)

39
Q

Motor affection associated with : Ulnar Nerve lesion at wrist ?

A

Same as lesion at elbow ,, but forearm muscles are spared

40
Q

Compare between the severity of deformity seen in : Ulnar nerve injury at elbow/vs/ at wrist

A

Worse at wrist

41
Q

Why is the incomplete claw hand worse in ulnar nerve injury at wrist ?

A

due to contraction of distal interphalangeal joints of 4 th and 5 th digits

42
Q

Sensory loss associated with : Ulnar Nerve lesion at wrist ?

A

Same except dorsal aspect of palm and proximal phalanges are spared

43
Q

Summarize ulnar nerve injury at elbow

A

1- Weak flexion

2- Loss of wrist adduction

3- Inability to adduct thumb

4- Inability to put the hand in writing position

  • Sensory loss
  • Partial claw hand deformity
44
Q

Summarize ulnar nerve injury above wrist

A

1- No Weak flexion

2- No Loss of adduction

3- Inability to adduct thumb

4- Inability to put the hand in writing position

  • Sensory loss to fingers only
  • Partial claw hand deformity is more prominent (Ulnar paradox)
45
Q

Common causes of Radial nerve injury at axilla ?

A
46
Q

Complications of Radial nerve injury at axilla ?

A
47
Q

Two causes of Radial nerve injury at spiral groove ?

A
  • Humeral fractures at spiral groove
  • Posterior interosseous nerve entrapment
48
Q

Name the hidden structure and mention the condition in which it can be injured

A

Posterior interosseous nerve entrapment&raquo_space; proximal radial nerve injury

MMB (72 decks)

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