Upper Limb Flashcards
(23 cards)
Medical Research Council (MRC) muscle power scale
0/5 - no movement
1/5 - barest flicker, not enough to move structure
2/5 - voluntary movement but not against gravity
3/5 - voluntary movement against gravity, not resistance
4/5 - voluntary movement against ‘some’ resistance
5/5 - normal strength
Shoulder abduction muscle, nerve and nerve root
Deltoid
Axillary nerve
C5
Shoulder adduction muscle, nerve and nerve root
Pectoralis major
Thoracodorsal nerve
C6/7
Elbow flexion muscle, nerve and nerve root
Biceps brachii and brachialis
Musculocutaneous and radial nerves
C5/C6
Elbow extension muscle, nerve and nerve root
Triceps brachii
Radial nerve
C7
Wrist extension muscle, nerve and nerve root
Wrist extensors
Radial nerve
C6
Wrist flexion muscle, nerve and nerve root
Superficial wrist flexors of forearm
Median nerve
C6/C7
Biceps reflex nerve root
C5/C6
Triceps reflex nerve root
C7/C8
Supinator (brachoradialis) reflex nerve root
C6
What should inspection of the upper limb include?
SWIFT
scars, muscle wasting, involuntary movements, fasciculation, tremor
How do UMN lesions present on examination?
No fasciculations
No wasting
Hypertonia
Weakness
Hyperreflexia
How do LMN lesions present on examination?
Fasciculations
Wasting
Hypotonia
Weakness
Hyporreflexia
What is tone?
The amount of tension in a muscle
Muscles are always partially contracted as they have tone
Can be tested by passive movement
What is a reflex?
Involuntary response to a stimulus
Draw the brachial plexus
Where do afferent and efferent components of a reflex arc start and end?
Afferent - sensory receptors in the muscle spindle to spinal cord
Efferent - anterior grey columns of spinal cord to effector muscle
Are myotatic reflexes mono or multi synaptic?
Monosynaptic
What is the law of reciprocal innervation?
Flexors and extensors cannot simultaneously contract… so efferent nerves that cause flexion have branches to inhibit the extensor contraction
What causes mononeuropathies in upper limb?
Mechanical injury (carpal tunnel syndrome - median nerve, ulnar nerve at elbow, radial nerve at spiral groove)
Malignancy
Inflammation
Which nerve injury causes ape hand?
Median nerve injury
Which nerve injury causes wrist drop?
Radial nerve injury
Which nerve injury causes claw hand?
Ulnar nerve injury
The closer to the paw the worse the claw
