28: UE Neurology Flashcards
Cervical plexus levels
C1-4
Important cervical plexus nerve for the UE
Supraclavicular N
Three branches of the supraclavicular N and what it supplies
Lateral, middle, and medial supraclavicular N’s -> skin over neck and shoulder
Muscular branches of brachial plexus roots: innervate which four Muscles?
Anterior/middle/posterior scalenus + longus coli M
Injury to superior brachial plexus (C5 and C6): how does it occur?
Dramatically increasing the angle between the neck and shoulder
What can occur with injury to superior brachial plexus?
Stretch/rupture/avulsed spinal roots off the spinal cord
What would an individual with an upper brachial plexus injury look like?
Adducted + medially rotated arm, extended elbow = Erb-Duchenne Palsy (Waiter’s Tip Position)
How does injury to the inferior brachial plexus occur
Dramatically increasing the angle between trunk and upper limb
What is the result of inferior brachial plexus injury?
Affects short muscles in the hand -> Klumpke paralysis -> Claw hand
Nerve branches from the divisions
None
What two things does the medial antebrachial cutaneous N travel with
Ulnar N -> then basilic V
What can cause compression of brachial cords?
Prolonged periods of working with upper limb extended over the head (like painting a ceiling)
What happens if cords of the brachial plexus are compressed?
Pain radiating down arm, loss of sensation, tingling, and weakness of hands
How does injury to musculocutaneous N occur?
Is rare, but can happen with blunt force trauma
What happens if musculocutaneous N is injured?
Paralysis of anterior brachial muscles
What happens if the axillary N is injured?
Atrophy of deltoid, loss of sensation over superolateral arm (bc of superior lateral brachial cutaneous N)
What A does the median N travel with?
Brachial A
When does the palmar cutaneous branch of the median N appear?
Before the median N enters the carpal tunnel, and it travels superficial to the flexor retinaculum -> has some clinical significance on whether a sensory issue is arising from wrist or higher up
What happens with an injury of the median N in the wrist?
Adducted thumb, thenar eminence atrophy -> Ape’s Hand
What happens with median N injury at the elbow?
Inhibits flexion of 2nd and 3rd digits -> hand of benediction + Ape’s hand
Where does the ulnar N become superficial
When it enters the hand, passing over the flexor retinaculum
What does the palmar cutaneous branch of the ulnar N travel with?
Ulnar A
Four positions where the ulnar N can be injured
- Posterior to medial humeral epicondyle
- Between the two heads of flexor carpi ulnaris M (the cubital tunnel)
- Wrist
- In hand
Ulnar N injury results in??
Loss of sensory and motor in the hand -> Claw hand
If pressure is placed on the hamulus of the hamate bone, like when riding a bike? What happens?
Ulnar N is compressed -> loss of sensory to medial side of hand and weakness of intrinsic hand muscles -> handlebar neuropathy
Largest terminal branch of the brachial plexus
Radial N
What artery does the radial N run with?
Deep brachial A
What happens if the radial N is injured?
Impairment of elbow extension + thumb adduction and extension -> “wrist drop”
An important thoracic spinal nerve
Intercostobrachial N
What does the intercostobrachial N supply?
Cutaneous innervation to uppermost medial brachium
C5 dermatome
Over deltoid
C6 dermatome
Lateral antebrachium, hand
C7 dermatome
Central hand, posterior antebrachium, 3rd digit
C8 dermatome
Medial hand and antebrachium, 5th digit
T1 dermatome
Medial brachium
T2 dermatome
Anterior border of axilla
