Nerve Palsies of the Limbs

Question 1

how can nerves be damaged?

Answer 1

trapped
injured
compressed

Question 2

myotome: C5

Answer 2

elbow flexors

Question 3

myotome: C6

Answer 3

wrist extensors

Question 4

myotome: C7

Answer 4

elbo extensord

Question 5

myotome: C8

Answer 5

finger extensors

Question 6

myotome: T1

Answer 6

intrinsic hand muscles

Question 7

myotome: L2

Answer 7

hip flexors

Question 8

myotome: L3

Answer 8

knee extensors

Question 9

myotome: L4

Answer 9

ankle dorsiflexors

Question 10

myotome: L5

Answer 10

long toe extensors

Question 11

myotome: S1

Answer 11

ankle plantar flexors

Question 12

brachial plexus injuries result in:

Answer 12

Erb’s palsy
Klumpke’s palsy
total brachial plexus

Question 13

cause of nerve palsy: axillary

Answer 13

secondary to trauma

Question 14

cause of nerve palsy: radial

Answer 14

secondary to compression or entrapment

Question 15

cause of nerve palsy: medial

Answer 15

carpal tunnel syndrome

Question 16

cause of nerve palsy: ulnar

Answer 16

cubital tunnel syndrome

Question 17

draw the brachial plexus

Answer 17

see notes

Question 18

what does C5,6 brachial plexus injury result in?

Answer 18

Erb’s palsy

Question 19

what does C8-T1 brachial plexus injury result in?

Answer 19

klumpke’s palsy

Question 20

describe an erb’s palsy

Answer 20

waiter’s tip - shoulder adducted and IR, elbow extended and pronated, wrist flexed

Question 21

describe a Klumpke’s palsy

Answer 21

small muscles of hand - claw hand

Question 22

nerve roots of musculocutaneous nerve

Answer 22

C5,6,7

Question 23

what cord does the musculocutaneous nerve come from?

Answer 23

lateral

Question 24

describe the course of the musculocutaneous nerve

Answer 24

pierces coracobrachialis, then runs inferiorly between biceps and brachialis

Question 25

what does the musculocutaneous nerve terminate as?

Answer 25

lateral cutaneous nerve of the forarms

Question 26

what does the musculocutaneous nerve supply?

Answer 26

anterior capsule of elbow | BBC and skin overlying the insertions of these muscles

Question 27

what is Hilton's law?

Answer 27

a sensory nerve supplying a joint also supplies the muscles moving the joint and the skin overlying the insertions of these muscles

Question 28

nerve roots of the axillary nerve

Answer 28

C5,6

Question 29

what cord does the axillary nerve come from?

Answer 29

posterior

Question 30

fracture of what part of the humerus may cause injury to the axillary nerve?

Answer 30

surgical neck

Question 31

what does the axillary nerve supply?

Answer 31

deltoid teres mino skin over lateral arm

Question 32

injury to the axillary nerve results in atrophu of what muscle?

Answer 32

deltoid

Question 33

nerve roots of the radial nerve

Answer 33

C5,6,7,8,T1

Question 34

what cord does the radial nerve come from?

Answer 34

posterior

Question 35

where does the radial nerve rum?

Answer 35

radial groove of humerus as it passes from edial to lateral

Question 36

what does the radial nerve supply?

Answer 36

triceps brachioradialis ECRL ECRB

Question 37

radial nerve palsy: axilla

Answer 37

loss of elbow extension, wrist extension, and sensory changes in forearm and hand

Question 38

radial nerve palsy: arm

Answer 38

loss of wrist extension and sensory loss

Question 39

radial nerve palsy: forearm

Answer 39

loss of finger extension (PIN)

Question 40

radial nerve palsy: wrist

Answer 40

loss of sensation (SRN) e.g. handcuffs

Question 41

nerve roots of medial nerve

Answer 41

C5,6,7,8,T1

Question 42

what cord does the median nerve come from?

Answer 42

medial and lateral

Question 43

what does the median nerve supply

Answer 43

flexors of the forearm except FCU and medial half of FDP LOAF - lat 2 lumbricals, APB, OP, FDB sensation to radial 3.5 digits

Question 44

floor of carpal tunnel

Answer 44

carpal bones

Question 45

roof of carpal tunnel

Answer 45

flexor retinaculum

Question 46

contents of carpal tunnel

Answer 46

FDS x 4 FDP x 4 FPL median nerve

Question 47

causes of carpal tunnel syndrome

Answer 47

``` developmental trauma distal radius fracture ganglion fibroma lipoma inflammatory - rheumatoid, Gout, TB, amyloid metabolic - pregnancy, mucopolysaccharidoses, hypothyroidism ```

Question 48

signs and symptoms of carpal tunnel syndrome

Answer 48

nocturnal pain parasethesia in part or all of the median nerve distribution wasting of the thenar muscles

Question 49

tests for carpal tunnel syndrome

Answer 49

tinnels | phalen's

Question 50

nerve roots of the ulnar nerve

Answer 50

C8, T1

Question 51

what cord does the ulnar nerve come from?

Answer 51

medial cord

Question 52

how does the ulnar nerve enter the forearm

Answer 52

between the two ends of FCU

Question 53

what does the ulnar nerve supply?

Answer 53

medial half of FDP FCU intrinsic muscles of hand except LOAF sensation to ulnar 1.5 digits

Question 54

where is the cubital tunnel found?

Answer 54

between medial epicondyle and olecranon with fascial bands from FCU as roof

Question 55

symptoms of cubital tunnel syndrome

Answer 55

``` • Patient has numbness on ulnar side of hand and difficulty with fine tasks • Wasting of muscles o 1st webspace o Guttering o Hypothenar wasting ```

Question 56

describe ulnar claw hand

Answer 56

hyperextension at MCPJ, flexion at IPJs

Question 57

what is the ulnar paradox?

Answer 57

a distal lesion has worse clawing than a proximal lesion due to intact long flexors

Question 58

the sacral plexus is formed from the ventral rami of?

Answer 58

L4-S4

Question 59

what does the superior gluteal nerve supply?

Answer 59

gluteus medius and minimus | TFL

Question 60

what does the inferior gluteal nerve supply?

Answer 60

gluteus maximus

Question 61

nerve roots of sciatic nerve?

Answer 61

L4,5,S1,2,3

Question 62

what does the sciatic nerve divide into?

Answer 62

tibial and common peroneal nerve

Question 63

what does the sciatic nerve supply?

Answer 63

hamstring muscles in posterior comparment of thigh

Question 64

where does the common peroneal nerve wrap around?

Answer 64

neck of fibula

Question 65

what nerve supplies the anterior leg compartment?

Answer 65

deep peroneal

Question 66

what nerve supplies the lateral leg compartment?

Answer 66

superficial peroneal

Question 67

name the main branches of the lumbar lexus

Answer 67

LFCN femoral obturator

Question 68

what is meralgia parasthetica?

Answer 68

• Altered sensation and pain in the lateral thigh • Compression of lateral femoral cutaneous nerve of thigh as it travels under lateral border of inguinal ligament