UE Neurology Clincal Notes

Question 1

Injury to the superior part of the brachial plexus (upper plexus injuries) typically affect what?

Answer 1

C5-6 anterior rami and are usually the result of dramatically increasing the angle between the neck and the shoulder
Can stretch, rupture or avulse the spinal roots off of the spinal cord

Question 2

What will an individual with an upper plexus injury have?

Answer 2

An adducted and medially rotated arm and an extended elbow which is also known as Erb-duchenne palsy or waiters tip position

Question 3

Injury to the inferior part of the brachial plexus is less common but is usually the result of what?

Answer 3

Dramatically increasing the angle between the trunk and upper limb
Typically affects the short muscles of the hand and results in claw hand when the individual tries to make a fist also known as Klumpke paralysis

Question 4

Compression of the cords of the brachial plexus usually result from what?

Answer 4

Prolonged periods of working with the UE extended over the head
Results in pain radiating down the arm, loss of sensation, tingling of the arms and weakness of the hands

Question 5

Injury to the musculocutaneous N is possible with what?

Answer 5

Blunt force trauma and renders the anterior brachial muscles paralyzed
Rare

Question 6

Injury to the axillary N results in what?

Answer 6

Atrophy of the deltoid muscle and loss of sensation over the superolateral arm where the superior lateral brachial cutaneous N exists

Question 7

Injury to the median N in the wrist results in what?

Answer 7

An adduced thumb and thenar eminence atrophy known as Ape’s hand

Question 8

Injury to the median N at the elbow joint inhibits what?

Answer 8

Flexion of 2nd and 3rd digits known as Hand of Benediction as well as the sx of Ape’s hand

Question 9

What are the 4 places where injury to the ulnar N can occur?

Answer 9

Posterior to medial humeral epicondyle, between the ulnar and humeral heads of the flexor carpi ulnaris (cubital tunnel), at the wrist or in the hand

Question 10

What is the result of injury to the ulnar N at any of the 4 common places of injury?

Answer 10

Extensive loss of sensory and motor control in the hand, and when an individual tries to make a fist it appears as a claw hand

Question 11

The ulnar N can be compressed when what occurs?

Answer 11

Pressure is placed on the hamulus of the hamate bone like when riding a bike
Produces sensory loss on the medial side of the hand and weakness of the intrinsic hand muscles
Often referred to as handlebar neuropathy

Question 12

Injury to the radial N results in what condition?

Answer 12

Wrist drop including impairment of elbow extension and thumb abduction and extension