Brachial Plexus and Nerve Lesions Flashcards Preview

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Flashcards in Brachial Plexus and Nerve Lesions Deck (65):
1

What does Randy Travis Drinks Cold Beer mean?

Roots
Trunks
Divisions
Cords
Branches

2

Spinal levels in upper trunk

C5-C6

3

Spinal levels in Middle Trunk

C7

4

Spinal levels in Lower Trunk

C8-T1

5

Spinal levels in posterior cord

C5-T1

6

Spinal levels in musculocutaneous nerve

C5-C7

7

Spinal levels in Median nerve

C5-T1

8

Spinal levels in Ulnar nerve

C8-T1

9

What nerves branch off the posterior cord?

axillary and radial

10

Injury to upper trunk.

Erb palsy (waiter's tip)

11

Injury to lower trunk

Klumpke palsy (claw hand)

12

Injury to posterior cord

Wrist drop

13

Injury to Axillary nerve

Deltoid paralysis

14

Injury to Radial nerve

"Saturday night palsy" (wrist drop)

15

Injury to Musculocutaneous Nerve

Problems flexing elbow

16

Damage to median nerve

"Pope's blessing" (decreased thumb function)

17

Damage to Ulnar nerve

Claw hand

18

Damage to long thoracic nerve

winged scapula

19

What causes "waiter's tip" in Erb palsy?

Deficits in:
-Deltoid/supraspinatus (so arm is ADDucted)
-Infraspinatus (so arm is MEDIALY rotated)
-Biceps brachii (arm extended and pronated)

20

What injuries cause Klumpke palsy?

-Infants (upward force on arm during delivery)
-Adults (grabbing tree branch while falling)

21

What causes the claw hand in Klumpke palsy?

deficits in intrinsic hand muscles (no lumbricles, so MCPs are extended and DIPs/PIPs are flexed)

22

What injuries cause thoracic outlet syndrome?

-Pancoast tumor

23

What is the deficit in thoracic outlet syndrome?

compression of lower trunk and subclavian vessels (give same deficits as Klumpke palsy with atrophy of intrinsic hand muscles and pain from vascular compression)

24

What injury leads to Winged scapula?

-Axillary node dissection after mastectomy
-Stab wounds

25

Why does your scapula "wing" with thoracic nerve injury?

Inability of the serratus anterior to anchor scapula to thoracic cage (and cannot abduct arm above horizontal plane)

26

What injuries affect the axillary nerve?

-Fractured surgical neck of humerus
-Anterior dislocation of humerus

27

What is the presentation of axillary nerve lesion?

-Flat deltoid
-Loss of abduction at shoulder (>15 degrees)
-Loss of sensation over deltoid and lateral arm

28

What is the presentation of musculocutaneous nerve damage?

-Loss of forearm flexion and supination
-Loss of sensation over lateral forearm

29

What injuries cause radial nerve damage?

-Midshaft fracture of huemrus
-Compression of axilla (crutches or sleeping with arm over chair)

30

What is the presentation of radial nerve damage?

-Wrist drop (lose all extension past elbow)
-Decrease grip strength
-Loss of sensation over posterior arm/forearm and dorsal hand

31

What injuries cause median nerve damage?

-Supracondylar fracture of humerus (proximal lesion)
-Carpal tunnel syndrome and wrist laceration (distal lesion)

32

What is the presentation of median nerve damage?

-Ape hand (lose thumb opposition, and flexion of wrist and lateral fingers)
-Lose sensation over thenar eminence and dorsal/palmar aspects of lateral 3.5 fingers

33

What injuries cause ulnar nerve injury?

-Fracture of medial epicondyle of humerus (funny bone)
-Fractured hook of hamate

34

What is the presentation of ulnar nerve injury?

-Claw on digit extension
-Radial deviation of wrist on flexing (proximal lesion)
-Loss of flexion of wrist and medial fingers; abduction/adduction of fingers, actions of medial 2 lumbrical muscles
-Loss of sensation of medial 1.5 fingers and hypothenar eminence

35

What causes injury to the recurrent branch of the medial nerve?

-Superficial laceration of palm

36

What is the presentation of injury to recurrent branch of median nerve?

-Ape hand
-No loss of sensation

37

What cervical levels are in the axillary nerve?

C5-C6

38

What cervical levels are in the ulnar nerve?

C8-T1

39

Spinal levels for obturator

L2-L4

40

Spinal levels for femoral

L2-L4

41

Spinal levels for common peroneal

L4-S2

42

Spinal levels for tibial

L4-S3

43

Spinal levels for superior gluteal

L4-S1

44

Spinal levels for inferior gluteal

L5-S2

45

Cause of obturator injury

pelvic surgery

46

Presentation of obturator injury

-Poor adduction
-Loss of medial thigh sensation

47

Cause of femoral nerve injury

pelvic fracture

48

Presentation of femoral nerve injury

-Poor thigh flexion and leg extension

49

Cause of common peroneal nerve injury

-Compression of lateral leg aspect
-Fibular neck fracture

50

Presentation of common peroneal nerve injury

-Food drop (plantar flexed and inverted)
-Steppage gait
-Loss of dorsal foot sensation

51

Cause of tibial nerve injury

-Knee trauma
-Baker cyst (proximal)
-Tarsal tunnel syndrome (distal)

52

Presentation of tibial nerve injury

-Inability to curl toes
-Loss of sensation to sole of foot
-(Proximal lesion)- foot everted and dorsiflexed

53

Cause of superior gluteal nerve injury

-Posterior hip dislocation
-Shot in superior medial butt
-Polio

54

Presentation of superior gluteal nerve injury

-Trendelenburg sign/gait (contralateral hip drop when patient putting weight on side that is injured)

55

Cause of inferior gluteal nerve injury

Posterior hip dislocation

56

Presentation of inferior gluteal nerve injury

-Difficulty climbing stairs or rising from seat
-Loss of hip extension

57

PED TIP

Peroneal Everts & Dorsiflexes
Tibial Inverts and Plantarflexes

58

Levels of sciatic nerve

L4-S3

59

What does the sciatic nerve split into?

-Common peroneal nerve
-Tibial nerve

60

Artery running with long thoracic at axilla/lateral thorax

Lateral thoracic

61

Artery running with axillary nerve at surgical neck of humerus

Posterior circumflex

62

Artery running with radial nerve at midshaft of humerus

Deep brachial

63

Artery running with median nerve at distal humerus/cubital fossa

Brachial

64

Artery running with tibial nerve through popliteal fossa

Popliteal

65

Artery running with tibial nerve posterior to medial malleolus

posterior tibial