Flashcards in Upper Limb Nerve Lesions Deck (15):
How can the superior trunk get injured?
Separation of head / shoulder during fall, accident or botched delivery, bullet wound, results in tearing / stretching of roots or trunk of C5/6
What is Waiter's tip?
loss of flexion, abduction, lateral rotation at shoulder joint.
Medial rotation predominates -> infraspinatus and teres minor are the two lateral rotators that cannot be used
among other muscles
What is wrist-drop?
person is unable to extend forearm, hand, or digits due to affected muscles innervated by radial nerve
How can you get a posterior cord injury?
Poorly fitting crutches or "saturday night palsy" when an intoxicated person hands their arm over the back of a chair while unconscious. compresses radial nerve
How can an inferior trunk injury be caused?
Sudden upward pulling of upper limb, or cervical rib or pulmonary carcinoma. Usually affects ulnar nerve function and can cause claw hand
What can long thoracic nerve injury cause?
Winged scapula - serratus anterior is not working. Scapula cannot be held against thoracic wall, arm cannot be fully abducted due to lack of scapular rotation
What can musculocutaneous nerve injury cause?
Weakness of upper limb flexion (coracobrachialis), severe weakness of forearm flexion, weakness when supinating the forearm from a partially flexed position
What can a radial nerve injury cause at the humerus level?
Minimal loss of forearm extension (radial nerve innervates triceps from axilla) but wrist drop will occur
What can a radial nerve injury cause at the neck of the radius?
Less limited wrist extension (ECRL and ECRB are innervated prior to this) but still have loss of digital extension of proximal phalanges and thumb impairments)
What happens if you injure the median nerve in the axilla or arm?
Loss of wrist flexion, pronation, wasting of thenar eminance, loss of digital and palmar sensation and loss of sweating on lateral palm
What is pronator teres or anterior interosseous syndrome?
Entrapment of anterior interosseous nerve as it exits pronator teres, loss of deep compartment muscles. Causes hand of benediction -> affects only digits I and II from FDP flexion, also no thumb flexion from FPL
What can carpal tunnel syndrome cause?
Wasting of thenar eminance, and loss of sensation due to loss of palmar branch of median nerve and recurrent branch
What is claw hand?
due to ulnar damage. digits 4 and 5 are hyperextended at MP joint and flexed at IP joints due to loss of lumbricals to those digits. Also cannot abduct or adduct digits 2-5 because of loss of interosseous muscles.
When injured at wrist rather than medial epicondyle the FDP will be active so baseline flexion of digits 3-4 will be even worse, but you can close your fist
How can you test for sensory loss at each nerve level of the brachial plexus?
1. C5 - lateral side of cubital fossa - lateral cutaneous nerve of forearm (from musculocutaneous)
C6 - back of thumb - from superficial branch of radial nerve
C7 - middle finger - from superficial branch of radial nerve
C8 - pinkie - from dorsal branch of ulnar nerve
T1 - Medial side of cubital fossa - medial antebrachial cutaneous