Brachial Plexus

Question 1

nerve root involvement leads to

Answer 1

dermatomal loss
myotomal loss
root reflex loss
cervical radicular cluster

Question 2

what is the cervical radicular cluster

Answer 2

ipsilateral rotation <60°
positive spurling
distraction relieve symptoms
ULTTM

Question 3

lesion leading to Erb’s Palsy

Answer 3

C5,6 Trunk

Question 4

what motor/sesnory loss is seen in those with Erb’s Palsy? what motions are lost?

Answer 4

dermatomal and myotomal loss
- shoulder ER, Flexion, elbow flexion

Question 5

lesion leading to Klumpkie’s

Answer 5

C8-T1 trunk

Question 6

what motor/sensory losses are seen in klumpkie’s palsy? what muscles are affected?

Answer 6

dermatomal and myotomal
- finger flexors/extensors
- intrinsic hand muscles

Question 7

what position is seen in Erb’s

Answer 7

waiter’s tip position

Question 8

what position is seen in klumpke’s palsy

Answer 8

claw hand deformity

Question 9

what are the symptoms of thoracic outlet syndrome

Answer 9

paresthesias
non specific weakness
+/- vascular entrapment

Question 10

TOS observed due issues involving the scalenes would indicate what involvement

Answer 10

root

Question 11

TOS observed due issues involving the clavicle/1st rib would indicate what involvement

Answer 11

trunk

Question 12

TOS observed due issues involving the pectoralis minor would indicate what involvement

Answer 12

branch

Question 13

what are the radial nerve entrapment sites

Answer 13

saturday night palsy
radial tunnel syndrome
posterior interosseous nerve

Question 14

subjective report associated with saturday night palsy

Answer 14

falling asleep with arm extended
possibly due to axillary crutch use

Question 15

explain sensory deficits associated with saturday night palsy

Answer 15

paresthesia to dorsal hand & fingers 1-3 up to nail beds

Question 16

explain motor deficits associated with saturday night palsy

Answer 16

wrist drop
decreased finger extension

Question 17

explain tricep innervation associated with saturday night palsy

Answer 17

triceps are spared

Question 18

subjective reports associated with radial tunnel syndrome

Answer 18

pain with wrist flexion and pronation

pain with resisted supination

aching distal to lateral epicondyle

Question 19

sensory deficits associated with radial tunnel syndrome

Answer 19

paresthesia of radial distribution
-no complete loss of sensory, more so abnormal

Question 20

motor deficits associated with radial tunnel syndrome

Answer 20

no true motor deficits

Question 21

subjective report associated with posterior interosseous nerve

Answer 21

pain with resisted supination

vague forearm pain

Question 22

sensory loss associated with posterior interosseous nerve palsy

Answer 22

none - sensory spared

Question 23

motor loss associated with posterior interosseous nerve palsy

Answer 23

loss/weakness of PIN innervated muscles

thumb abduction weakness

Question 24

what muscles does posterior interosseous nerve innervate

Answer 24

abductor pollicis longus
extensor pollicis brevis
extensor pollicis longus
extensor digiti minimi
extensor carpi ulnaris

Question 25

median nerve entrapment sites

Answer 25

pronator teres carpal tunnel syndrome

Question 26

subjective report associated with pronator teres entrapment

Answer 26

gradual onset observed after repetitive pronation/supination vague forearm pain paresthesias, N/T weakness

Question 27

sensory loss associated with pronator teres

Answer 27

sensory in palm digits 1-3 radial slide of 4th digit pain over thenar eminence

Question 28

motor deficits associated with pronator teres entrapment

Answer 28

no OK sign, playboy bunny sign weakness of thumb, index, and middle finger FDP loss -- but no true motor deficit

Question 29

subjective report associated with carpal tunnel sydnrome

Answer 29

paresthesia / achey pain in hands overuse when wrist is extension can be due to obesity/pregnancy

Question 30

sensory loss associated with carpal tunnel syndrome

Answer 30

digits 1-3 & half of digit 4 palm sensation spared

Question 31

motor loss associated with carpal tunnel syndrome

Answer 31

weakness of 1/2 of LOAF

Question 32

what is the acronym LOAF? what is it associated with?

Answer 32

lateral 2 lumbricals opponens pollicis abductor pollicis brevis flexor pollicis brevis

Question 33

entrapment sites associated with ulnar nerve

Answer 33

cubital tunnel guyons canal

Question 34

sbjective report associated with cubital tunnel entrapment

Answer 34

worse in the morning clumsy grip can be due to traction injury can be due to valgus at elbow sometimes snapping and popping

Question 35

sensory loss associated with cubital tunnel entrapment

Answer 35

paresthesia of 4/5th digit - palmar and dorsal side

Question 36

motor loss associated with cubital tunnel entrapment

Answer 36

weakness of intrinsics digit/thumb adduction weakness in opposition

Question 37

sensory loss associated with guyon's canal entrapment

Answer 37

palm sensation sparred - paresthesia in 4th and 5th digit both palmar and dorsal

Question 38

motor loss associated with guyon's canal entrapment

Answer 38

froment's sign decreased grip and pinch

Question 39

compare a C8 lesion to cubital tunnel and guyon's canal entrapment - subjective - sensory - motor

Answer 39

subjective - neck pain and radicular cluster sensory - in C8 dermatome motor - myotomal weakness (ulnar dev and thumb extension) -- FDP weakness

Question 40

what nerves come off the brachial plexus roots / what are their nerve roots

Answer 40

Phrenic (C3,4,5) Dorsal Scapular (C5) Long Thoracic (C5,6,7)

Question 41

what nerves come from the trunks of the brachial plexus? what are their roots?

Answer 41

suprascapular (C5,6) nerve to subclavius (C5,6)

Question 42

what nerves come off the lateral cord of the brachial plexus

Answer 42

musculocutaneous (C5,6) lateral pectoral (C5,6,7)

Question 43

what nerves come off of the posterior cord of brachial plexus and nerve roots?

Answer 43

upper subscapular (C5,6) throacodorsal nerve (C6,7,8) lower subscapular (C5,6)

Question 44

what nerves come from the medial cord of brachial plexus and nerve roots

Answer 44

medial pectoral (C8,T1) medial cutaneous of arm (C8,T1) medial cutaneous of forearm (C8,T1)

Question 45

nerve roots of axillary nerve

Answer 45

C5,6

Question 46

nerve root of radial nerve

Answer 46

C5-T1

Question 47

nerve roots of ulnar nerve

Answer 47

C8,T1