Upper Limb Nerve Injuries Flashcards Preview

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

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

Peripheral nerves

2

The rate of peripheral nerve regeneration averags about

1 cm per week

3

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

Proximal

4

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

Forearm

5

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

Erb's Palsy

6

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

Erbss Palsy

7

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

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

8

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

C5 and C6 dermatomes

9

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

Waiters tip sign

10

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)

Klumpke's Palsy

11

What is affected by Klumpke's Palsy?

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

12

Thenar mucles and the interossei may be atrophied in

Klumpke's Palsy

13

What are some visual suggestors of Klumpke's Palsy?

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

14

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

C8 and T1 dermatomes

15

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

Axillary nerve injury

16

Axillary nerve injury results in denervation of the

Deltoid

17

Results in sensory loss on the skin overlying the deltoid

Axillary nerve injury

18

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

Radial nerve injury

19

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

Radial nerve injury

20

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

Dorsum of radial portion of hand

21

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

Proximal

22

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

Median nerve injuries

23

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

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

24

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

Median nerve lesions

25

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

Flexor pollicis longus and abductor pollicis longus

26

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

Elbow

27

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

Flexor carpi radialis

28

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

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

29

Proximal median nerve injury results in a hand shape called the

Hand of benediction

30

Proximal median nerve injury results in sensory loss to the

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

31

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

Ulnar nerve injury

32

What are some physical symptoms of ulnar nerve injury?

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

33

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)

Proximal Ulnar injury

34

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

Musculocutaneous nerve injury

35

A musculocutaneous injury my occur by a

Penetrating wound

36

What are some physical symptoms of a musculocutaneous nerve injury?

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

37

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

Brachioradialis

38

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

Medial side of the hand

39

With a musculocutaneous injury, there is sensory loss to the

Lateral side of the forearm

40

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

Lateral antebrchial cutaneous nerve

41

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

Long Thoracic Nerve

42

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

Long thoracic nerve injury

43

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

Upward rotation of scapula

44

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

No

45

A thoracodorsal injury would present with

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

46

Is there any cutaneous sensory loss for a thoracodorsal injury?

No

47

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

Spinal accessory nerve injury

48

The physical symptoms of a spinal accessory nerve injury are?

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

49

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

No

50

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

Compression of the axon

51

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

Approximately 2 weeks

52

Provide a pathway for axon regeneration

Endoneurium and Schwann cells

53

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

Long Thoracic Nerve

54

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

Winging

55

The more distal the radial nerve injury, the

Less severe

56

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

Wrist Extension

57

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

Carpel Tunnel

58

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

Antagonistic muscles

59

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

Lumbrical paralysis

60

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

Ulnar nerve

61

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

C5 and C6

62

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

C8 and T1

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