UE nerve lesions

Question 1

Arm hangs by side and is medially rotated, extended, and pronated. Lesion?

Answer 1

Erb palsy: Upper trunk (C5/6 roots)

Question 2

Total claw hand. Lesion?

Answer 2

Klumpke palsy: lower trunk (C8-T1)

Question 3

Atrophied intrinsic hand muscles + arm is edematous, painful, ischemic. Lesion?

Answer 3

Thoracic outlet syndrome: compression of lower trunk + subclavian vessels

Question 4

Winged scapula + can’t abduct arm above horizontal position

Answer 4

LTN: C5-C7

Question 5

Lateral traction on neck during delivery… Lesion?

Answer 5

Erb palsy: Upper trunk (C5/6 roots)

Question 6

Guy falls and lands on spot btwn head and shoulder… Lesion?

Answer 6

Erb palsy: Upper trunk (C5/6 roots)

Question 7

Pull baby out up its arm during delivery. Lesion?

Answer 7

Klumpke palsy: lower trunk (C8-T1)

Question 8

Bird lady falls out of a tree and grabs a branch to break her fall. Lesion?

Answer 8

Klumpke palsy: lower trunk (C8-T1)

Question 9

2 common causes of thoracic outlet syndrome?

Answer 9

Pancoast tumor and cervical rib injury

Question 10

2 common causes of winged scapula?

Answer 10

Axilary node dissection post-mastectomy. Getting stabbed.

Question 11

Flattened deltoid; loss of arm aBduction >15 degrees; loss of sensation over delt and lateral arm. Nerve lesion?

Answer 11

Axillary

Question 12

Axillary roots?

Answer 12

C5-C6

Question 13

Loss of forearm flexion and supination; loss of sensation over lateral forearm. Nerve lesion?

Answer 13

Musculocutaneous

Question 14

Musculocutaneous roots?

Answer 14

C5-C7

Question 15

Loss of elbow, wrist, finger extension (wrist drop); decreased grip strength; loss of sensation over posterior arm/FA and dorsal hand. Nerve lesion?

Answer 15

Radial

Question 16

Radial n roots?

Answer 16

C5-T1

Question 17

Loss of wrist and lateral finger flexion, thumb opposition, lumbricals of 2nd and 3rd digits. Ulnar deviation on wrist flexion. Loss of sensation over thenar eminence, and lateral 3.5 digits. Nerve lesion?

Answer 17

Proximal median n

Question 18

Median n roots?

Answer 18

C5-T1

Question 19

Loss of wrist and lateral finger flexion, thumb opposition, lumbricals of 2nd and 3rd digits. Ulnar deviation on wrist flexion. +Tinel sign. Nerve lesion?

Answer 19

Distal median n (Carpel tunnel)

Question 20

Clawing on digit extension. Radial deviation of wrist on flexion; loss of flexion of wrist and medial fingers; loss of abduction and adduction of fingers; loss of sensation of medial 1.5 fingers + hypothenar eminance. Nerve lesion?

Answer 20

Proximal ulnar n lesion

Question 21

Ulnar n roots?

Answer 21

C8-T1

Question 22

Clawing on digit extension; loss of flexion of wrist and medial fingers; loss of abduction and adduction of fingers; loss of sensation of medial 1.5 fingers + hypothenar eminance. Nerve lesion?

Answer 22

Distal ulnar n lesion

Question 23

Ape hand (loss of opposition, abduction and flexion of thumb) w/ no loss of sensation. Nerve lesion?

Answer 23

Recurrent branch of median n

Question 24

Fractured surgical neck of humerus can cause what nerve lesion?

Answer 24

Axillary

Question 25

Anterior dislocation of the humerus can cause what nerve lesion?

Answer 25

Axillary

Question 26

Midshaft fracture of humerus can cause what nerve lesion?

Answer 26

Radial

Question 27

Crutches can cause what nerve lesion?

Answer 27

Radial

Question 28

Sleeping w/ arm over back of chair can cause what nerve lesion?

Answer 28

Radial

Question 29

Supracondylar fracture of humerus can cause what nerve lesion?

Answer 29

Median (prox)

Question 30

Carpal tunnel can cause what nerve lesion?

Answer 30

Median

Question 31

Wrist laceration can cause what nerve lesion?

Answer 31

Median (distal)

Question 32

Fracture of the medial epicondyle of the humerus can cause what nerve lesion?

Answer 32

Ulnar (prox)

Question 33

Fracture of hook of hamate can cause what nerve lesion?

Answer 33

Ulnar (distal)

Question 34

Elbow dislocation w/ posterior displacement of ulna can cause what nerve lesion?

Answer 34

Ulnar

Question 35

Superficial laceration of palm can cause what nerve lesion?

Answer 35

Recurrent branch of median n

Question 36

Guyon canal syndrome can cause what nerve lesion?

Answer 36

Ulnar

Question 37

Who gets guyon canal syndrome?

Answer 37

Cyclists (from pressure of handlebars)

Question 38

Dislocation of what wrist bone can cause acute carpal tunnel syndrome?

Answer 38

Lunate