Upper Limb Nerve Injuries Flashcards Preview

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Flashcards in Upper Limb Nerve Injuries Deck (62)
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1
Q

Can regenerate if damaged as long as the cell body is not damaged and there is a pathway to travel upon to reach the deinnervated organ

A

Peripheral nerves

2
Q

The rate of peripheral nerve regeneration averags about

A

1 cm per week

3
Q

When a nerve that contains many axons is damaged, what will regain function first, proximal or distal structures innervated by that nerve?

A

Proximal

4
Q

If the median nerve is lesioned at the level of the elbow, what will regain function first, the forearm or hand?

A

Forearm

5
Q

Can be caused by stretch of the UPPER trunk caused by forceful separation of the shoulder away from the neck

A

Erb’s Palsy

6
Q

The proximal limb muscles, i.e. intrinsic shoulder muscles and most muscles of the axillary wall are affected by

A

Erbss Palsy

7
Q

In Erb’s Palsy, the limb tends to be held such that the shoulder is in an

A

Extended, adducted, and internally rotated position and forearm is pronated

8
Q

In Erb’s Palsy, sensory loss is along the lateral side of the distal arm and proximal forearm, in other words, at the

A

C5 and C6 dermatomes

9
Q

The appearance of the arm in Erb’s Palsy is called the

A

Waiters tip sign

10
Q

Can be caused by stretch or compression of the LOWER trunk such as by upward traction on the limb or compression in the region of the “thoracic outlet” (e.g. cervical rib)

A

Klumpke’s Palsy

11
Q

What is affected by Klumpke’s Palsy?

A

The distal limb (i.e. intrinsic muscles of the hand) are affected

12
Q

Thenar mucles and the interossei may be atrophied in

A

Klumpke’s Palsy

13
Q

What are some visual suggestors of Klumpke’s Palsy?

A

Clawing of digits II-V and loss of abduction/adduction in the fingers

14
Q

Klumpke’s Palsy results in sensory loss along the medial side of the distal arm and proximal forearm, i.e. the

A

C8 and T1 dermatomes

15
Q

May be caused by a fracture of the surgical neck of the humerus or a glenohumeral dislocation

A

Axillary nerve injury

16
Q

Axillary nerve injury results in denervation of the

A

Deltoid

17
Q

Results in sensory loss on the skin overlying the deltoid

A

Axillary nerve injury

18
Q

May be caused by a fracture of the shaft of the humerus, fracture or dislocation of the head of the
radius, dislocation of the head of the humerus, or upward pressure in the floor of the axilla

A

Radial nerve injury

19
Q

May cause wrist drop and difficulty in making a fist because of the inability to stabilize the wrist

A

Radial nerve injury

20
Q

With a radial nerve injury, cutaneous sensory loss may occur on the

A

Dorsum of radial portion of hand

21
Q

Which type of radial nerve injury results in more motor/sensory loss, a more proximal or a more distal injury?

A

Proximal

22
Q

May be caused by trauma in the cubital fossa (e.g. supracondylar fracture) or at the wrist (e.g.
laceration), compression in the carpal tunnel or compression passing through the pronator teres

A

Median nerve injuries

23
Q

Long term denervtion cause by a median nerve injury may result in

A

Thenar atrophy, loss of opposition, unapposed thumb (ape hand), and clawing of digits II and III

24
Q

Can result in clawing of digits II and III and ape hand

A

Median nerve lesions

25
Q

If the median nerve injury is at the level of the wrist, then flexion and abduction of the thumb is still possible because of the

A

Flexor pollicis longus and abductor pollicis longus

26
Q

The flexor pollicis longus will be paralyzed and thumb flexion will not be possible if the median nerve injury is at the level of the

A

Elbow

27
Q

Proximal median nerve injury results in ulnar deviation of the hand upon flexion at the wrist due to the paralysis of the

A

Flexor carpi radialis

28
Q

Proximal median nerve injury results in ulnar deviation of the hand upon flexion at the wrist due to the loss of flexion of digits I through III resulting from paralyzed

A

Flexor pollicis longus and brevis, flexor digitorum superficialis and radial half of flexor digitorum profundus

29
Q

Proximal median nerve injury results in a hand shape called the

A

Hand of benediction

30
Q

Proximal median nerve injury results in sensory loss to the

A

Lateral portion of palmar surface of the hand and digits I-III

31
Q

May be caused by trauma in the region of the medial epicondyle of the humerus or at the heel of the hand

A

Ulnar nerve injury

32
Q

What are some physical symptoms of ulnar nerve injury?

A

Loss of abduction and adduction of digits II-V (interosseous muscles), and clawing most prominently in digits IV and V (lumbrical muscles)

33
Q

Results in radial deviation of hand upon flexion at the wrist (paralysis of flexor carpi ulnaris) and loss of flexion
of the DIP of digits IV and V (flexor digitorum profundus)

A

Proximal Ulnar injury

34
Q

An uncommon injury. Not likely to be injured by skeletal injuries such as fractures or dislocations

A

Musculocutaneous nerve injury

35
Q

A musculocutaneous injury my occur by a

A

Penetrating wound

36
Q

What are some physical symptoms of a musculocutaneous nerve injury?

A

Loss of function of anterior arm muscles, i.e. weakness of shoulder flexion, extreme weakness of elbow flexion, and weak supination

37
Q

Which elbow flexor can still be used when there is a musculocutaneous injury?

A

Brachioradialis

38
Q

With an ulnar nerve injury, there is cutaneous sensory loss on the

A

Medial side of the hand

39
Q

With a musculocutaneous injury, there is sensory loss to the

A

Lateral side of the forearm

40
Q

The distal continuation of the musculocutaneous nerve, which results in sensory loss when musculocutaneous nerve is injured

A

Lateral antebrchial cutaneous nerve

41
Q

May be caused by trauma to the chest wall or surgical injury during axillary surgery

A

Long Thoracic Nerve

42
Q

Presents as winging of the scapula due to loss of the serratus anterior muscle

A

Long thoracic nerve injury

43
Q

With a long thoracic nerve injury, there will be limitation in

A

Upward rotation of scapula

44
Q

Is there any cutaneous sensory loss with a long thoracic nerve injury?

A

No

45
Q

A thoracodorsal injury would present with

A

Weakness of shoulder extension, adduction, and internal rotation due to loss of latissimus dorsi

46
Q

Is there any cutaneous sensory loss for a thoracodorsal injury?

A

No

47
Q

May be caused by trauma in the posterior triangle of the neck or at the base of the skull

A

Spinal accessory nerve injury

48
Q

The physical symptoms of a spinal accessory nerve injury are?

A

Shoulder drop and inability to fully abduct or flex at the shoulder due to loss of the trap

49
Q

Is there any cutaneous sensory loss with a spinal accessory nerve injury?

A

No

50
Q

May stimulate the axon or may interfere with transmission along the axon

A

Compression of the axon

51
Q

What is the delay period before a damaged axon will begin to regenerate?

A

Approximately 2 weeks

52
Q

Provide a pathway for axon regeneration

A

Endoneurium and Schwann cells

53
Q

Can be caused by downward force on the scapula and downward pull on the serratus anterior

A

Long Thoracic Nerve

54
Q

Because the serratus anterior attaches the medial border of the scapula to the chest wall, paralysis of this muscle results in

A

Winging

55
Q

The more distal the radial nerve injury, the

A

Less severe

56
Q

If you want to test one motor function to see if the radial nerve is injured, test

A

Wrist Extension

57
Q

Houses 4 tendons of the flexor digitorum superficialis, 4 tendons of the flexor digitorum profundus, the tendon of the palmaris longus, and the median nerve

A

Carpel Tunnel

58
Q
If a nerve is injured, the digit with the injured nerve will be pulled in the direction opposite of the
function of the denervated muscle, because of
A

Antagonistic muscles

59
Q

In a median nerve injury, we see clawing of the digits due to

A

Lumbrical paralysis

60
Q

Does not go through the caprel tunnel, but goes through the Guyon’s canal under the palmar carpel ligament

A

Ulnar nerve

61
Q

Erb’s Palsy is an injury to which spinal nerve?

A

C5 and C6

62
Q

Klumpke’s Palsy is an injury to which spinal nerves?

A

C8 and T1

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