Brachial Plexus and Nerve Lesions Flashcards Preview

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

What does Randy Travis Drinks Cold Beer mean?

A
Roots
Trunks
Divisions
Cords
Branches
2
Q

Spinal levels in upper trunk

A

C5-C6

3
Q

Spinal levels in Middle Trunk

A

C7

4
Q

Spinal levels in Lower Trunk

A

C8-T1

5
Q

Spinal levels in posterior cord

A

C5-T1

6
Q

Spinal levels in musculocutaneous nerve

A

C5-C7

7
Q

Spinal levels in Median nerve

A

C5-T1

8
Q

Spinal levels in Ulnar nerve

A

C8-T1

9
Q

What nerves branch off the posterior cord?

A

axillary and radial

10
Q

Injury to upper trunk.

A

Erb palsy (waiter’s tip)

11
Q

Injury to lower trunk

A

Klumpke palsy (claw hand)

12
Q

Injury to posterior cord

A

Wrist drop

13
Q

Injury to Axillary nerve

A

Deltoid paralysis

14
Q

Injury to Radial nerve

A

“Saturday night palsy” (wrist drop)

15
Q

Injury to Musculocutaneous Nerve

A

Problems flexing elbow

16
Q

Damage to median nerve

A

“Pope’s blessing” (decreased thumb function)

17
Q

Damage to Ulnar nerve

A

Claw hand

18
Q

Damage to long thoracic nerve

A

winged scapula

19
Q

What causes “waiter’s tip” in Erb palsy?

A

Deficits in:

  • Deltoid/supraspinatus (so arm is ADDucted)
  • Infraspinatus (so arm is MEDIALY rotated)
  • Biceps brachii (arm extended and pronated)
20
Q

What injuries cause Klumpke palsy?

A
  • Infants (upward force on arm during delivery)

- Adults (grabbing tree branch while falling)

21
Q

What causes the claw hand in Klumpke palsy?

A

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

22
Q

What injuries cause thoracic outlet syndrome?

A

-Pancoast tumor

23
Q

What is the deficit in thoracic outlet syndrome?

A

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
Q

What injury leads to Winged scapula?

A
  • Axillary node dissection after mastectomy

- Stab wounds

25
Q

Why does your scapula “wing” with thoracic nerve injury?

A

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

26
Q

What injuries affect the axillary nerve?

A
  • Fractured surgical neck of humerus

- Anterior dislocation of humerus

27
Q

What is the presentation of axillary nerve lesion?

A
  • Flat deltoid
  • Loss of abduction at shoulder (>15 degrees)
  • Loss of sensation over deltoid and lateral arm
28
Q

What is the presentation of musculocutaneous nerve damage?

A
  • Loss of forearm flexion and supination

- Loss of sensation over lateral forearm

29
Q

What injuries cause radial nerve damage?

A
  • Midshaft fracture of huemrus

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

30
Q

What is the presentation of radial nerve damage?

A
  • Wrist drop (lose all extension past elbow)
  • Decrease grip strength
  • Loss of sensation over posterior arm/forearm and dorsal hand
31
Q

What injuries cause median nerve damage?

A
  • Supracondylar fracture of humerus (proximal lesion)

- Carpal tunnel syndrome and wrist laceration (distal lesion)

32
Q

What is the presentation of median nerve damage?

A
  • 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
Q

What injuries cause ulnar nerve injury?

A
  • Fracture of medial epicondyle of humerus (funny bone)

- Fractured hook of hamate

34
Q

What is the presentation of ulnar nerve injury?

A
  • 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
Q

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

A

-Superficial laceration of palm

36
Q

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

A
  • Ape hand

- No loss of sensation

37
Q

What cervical levels are in the axillary nerve?

A

C5-C6

38
Q

What cervical levels are in the ulnar nerve?

A

C8-T1

39
Q

Spinal levels for obturator

A

L2-L4

40
Q

Spinal levels for femoral

A

L2-L4

41
Q

Spinal levels for common peroneal

A

L4-S2

42
Q

Spinal levels for tibial

A

L4-S3

43
Q

Spinal levels for superior gluteal

A

L4-S1

44
Q

Spinal levels for inferior gluteal

A

L5-S2

45
Q

Cause of obturator injury

A

pelvic surgery

46
Q

Presentation of obturator injury

A
  • Poor adduction

- Loss of medial thigh sensation

47
Q

Cause of femoral nerve injury

A

pelvic fracture

48
Q

Presentation of femoral nerve injury

A

-Poor thigh flexion and leg extension

49
Q

Cause of common peroneal nerve injury

A
  • Compression of lateral leg aspect

- Fibular neck fracture

50
Q

Presentation of common peroneal nerve injury

A
  • Food drop (plantar flexed and inverted)
  • Steppage gait
  • Loss of dorsal foot sensation
51
Q

Cause of tibial nerve injury

A
  • Knee trauma
  • Baker cyst (proximal)
  • Tarsal tunnel syndrome (distal)
52
Q

Presentation of tibial nerve injury

A
  • Inability to curl toes
  • Loss of sensation to sole of foot
  • (Proximal lesion)- foot everted and dorsiflexed
53
Q

Cause of superior gluteal nerve injury

A
  • Posterior hip dislocation
  • Shot in superior medial butt
  • Polio
54
Q

Presentation of superior gluteal nerve injury

A

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

55
Q

Cause of inferior gluteal nerve injury

A

Posterior hip dislocation

56
Q

Presentation of inferior gluteal nerve injury

A
  • Difficulty climbing stairs or rising from seat

- Loss of hip extension

57
Q

PED TIP

A

Peroneal Everts & Dorsiflexes

Tibial Inverts and Plantarflexes

58
Q

Levels of sciatic nerve

A

L4-S3

59
Q

What does the sciatic nerve split into?

A
  • Common peroneal nerve

- Tibial nerve

60
Q

Artery running with long thoracic at axilla/lateral thorax

A

Lateral thoracic

61
Q

Artery running with axillary nerve at surgical neck of humerus

A

Posterior circumflex

62
Q

Artery running with radial nerve at midshaft of humerus

A

Deep brachial

63
Q

Artery running with median nerve at distal humerus/cubital fossa

A

Brachial

64
Q

Artery running with tibial nerve through popliteal fossa

A

Popliteal

65
Q

Artery running with tibial nerve posterior to medial malleolus

A

posterior tibial