Nerve Injuries of Upper Limb Flashcards
(25 cards)
What is the cause of Erb’s Palsy?
Injury to the upper trunk of the brachial plexus from a wide separation between teh head and the shoulder
Results in tearing of C5 and C6 spinal nerves
What are the most commonly involved muscles in Erb’s Palsy?
Infraspinatus and Supraspinatus
Teres minor
Biceps brachii
Brachialis
Deltoid
What motor deficits are associtated with Erb’s Palsy?
Loss of Lateral rotation of arm
Abduction of arm
Supination of forearm
Flexion of forearm
Leads to waiters tip position
What loss of senstation is experienced with Erb’s palsy?
Loss of sensations of lateral side of arm, forearm, and thrumb
C5 and C6 dermatomes
What causes Klumpke palsy?
Injury to the lower brachial plexus resulting from hyperabduction of the arm
Results in tearing of T1 and some C8 spinal nerves
What muscles are innervated mostly by T1?
Intrinsic muscles of the hand
Interosseous muscles and lumbricals
What motor deficits are associated with Klumpke palsy?
Fingers hyperextended at MP joints due to loss of flexion
Fingers flexed at PIP and DIP joints due to loss of extension at PIP and DIP joints
Clinical presentation: Claw hand
What sensory deficits are associated with Klumpke palsy?
Loss of sensation on medial side of arm and forearm
What results from injury to the Long thoracic nerve?
Inability to rotate the scapulat for abduction of the arm above the horizontal plane
Winged scapula
What results from injury to the axillary nerve?
Loss of function of deltoid - inability to abduct arm past 15 degrees
Loss of sensory innervation to upper lateral arm
How can injury to the axillary nerve occur?
Inferior displacement of the head of the humerus in shoulder dislocation or from fracture of surgical neck of humerus
What motor deficits result from radial nerve injury in the axilla?
Loss of extension of forearm at elbow - triceps deficit
Unopposed flexors of wrist - deficit of wrist and digit extensors
Wrist-drop - loss of wrist and digit extensors
What motor deficits result from radial nerve injury in the humerus?
Wrist drop
*Triceps not affected
What sensory loss occurs as a result of radial nerve injury in the humerus?
Dorsolateral hand and dorsum of proximal part of lateral 3.5 fingers
What motor loss occurs as a result of injury to the median nerve at the elbow?
Very weak flexion and loss of pronation, may weaken abduction
Loss of flexion at MP, PIP and DIP joints of index and middle finger - Hand of Benediction
Loss of thenar muscles
What sensory loss occurs as a result of injury to median nerve at the elbow?
Lateral 2/3 of palm of hand
Palmar side and nail beds of lateral 3.5 fingers
What motor loss occurs as result of Injury of median nerve at wrist?
Loss of opposition of thumb an flattened thenar eminence
What occurs from severance of the recurrent branch of median nerve?
Loss of opposition of thumb and atrophy of thenar muscles
No sensory loss
What motor deficits result from carpal tunnel?
Progressive weakness of thenar muscles
What sensory deficits result from carpal tunnel?
Anesthesia, Hypoesthesia, or paresthesia (abnormal) of distal lateral 2/3 of palm and palmar side and nail beds of lateral 3.5 fingers
What is the treatment for carpal tunnel?
Reduce inflammation and limit repetitivie movements
Carpal tunnel release - surgical decompression of the nerve by severing the flexor retinaculum
What muscle function is lost as a result to damage of the ulnar nerve at the elbow?
Loss of flexor carpi ulnaris
Medial half of flexor digitorum profundus
Interosseous muscles
Ulnar claw hand
What sensory loss occurs as a result of damage to the ulnar nerve at the elbow?
Palmar side of proximal part of medial 1/3 of hand
Palmar side of distal part of medial 1/3 of palm and medial 1.5 digits
Dorsal 1/3 of hand and dorsal side of 1.5 digits
What motor loss occurs as a result of damage to the ulnar nerve at the wrist?
Paralysis of most intrinsic muscles of han
Loss of adduction-abduction of fingers
Claw hand
