Arm Nerve Fuck Ups Flashcards
Patient compressed his upper trunk
Musculocutaneous (C5 – C7) - EXTENSOR
Can’t flex + supinate forearm
Can’t feel lateral FOREarm
Patients got a
fractured surgical neck of humerus
Anterior humorous dislocation
Axillary (C5 – C6). axELEVENary
Deltoid flat
Can’t abduct arm @ shoulder >15°
Can’t feel over deltoid muscle/lateral arm
Patient has a
mid shaft fracture of humerus and
his axilla is compressed
Radial (C5 – T1) - EXTENSOR
Saturday night palsy - GAY ONE that’s so raaaad…
Wrist drop –
lose elbow/wrist/finger extension + ⬇️grip strength
Can’t feel over posterior arm/forearm/dorsal hand
Supracondylar fracture of humerus
Carpal tunnel syndrome
Wrist laceration
Median (C5 – T1) - FLEXOR MilF
Ape hand/Pope’s blessing
Can’t flex wrist/lateral fingers (thumb index middle)
Can’t oppose thumbs
Lose lumbicrals 2nd/3rd DIGITS
Can’t feel THENAR eminence + palmer/dorsal part of lateral 3.5 fingers
Patient has positive Tinel’s sign. What is this and what disease associated with
Tingling on percussion
Carpal tunnel syndrome
Superficial laceration of palm
Recurrent branch of the median nerve (C5 – T1)
Ape hand
Lose THENAR muscles:
Can’t oppose/flex/abduct thumb
SENSATION IS FINE!!!!!! NOT AFFECTED BY DAMAGE OF RECURRENT MEDIAN NERVE BRANCH
Medial epicondyle humerous fracture
Hamate hook fracture
Ulnar (C8–T1) ulnar claw FLAW @ extension
FLAW: Can't FLex wrist/medial fingers Abduct/adduct fingers – interossei Work medial 2 lumbicral muscles
Cant feel hypoTHENAR eminence- medial 1.5 fingers
A nurse pulls on a baby’s neck LATERALLY during delivery.
What is the brachial plexus lesion?
What are the muscle deficits?
What is the functional deficits?
C5 – C6 traction/tear of upper trunk – Erb palsy
Think LaterERBly…
Supraspinatus/deltoid, Infraspinatus, Biceps brachii
Can’t abduct, laterally rotate, flex bicep
During delivery nurse PULLS on the babies arm UPWARD/A man falls and tries to grab a tree branch and arm
What is the brachial plexus lesion?
What are the muscle deficits?
What is the functional deficits?
C8 – T1 lower trunk tear/traction - klumpke palsy
LITH
Lumbicrals, Interossei, THENAR, hypoTHENAR
Clawhand –
Lumbicrals can’t flex MCP joints
+
Extend DIP + PIP joints
Patient has a Pancoast tumour and a really annoying cervical rib too
What is the brachial plexus lesion?
What are the muscle deficits?
What is the functional deficits?
Lower trunk + Subclavian vessel compression
LITH atrophy/Ischaemia pain oedema !!!!!!!!!!!!!!!!!!
Lumbicrals, Interossei, THENAR, hypoTHENAR
Clawhand – Lumbicrals:
Can’t flex MCP joints
+
Can’t extend DIP + PIP joints
A patient undergoes AXILLARY node dissection after mastectomy and a stabbing
What is the brachial plexus lesion?
What are the muscle deficits?
What is the functional deficits?
Long thoracic nerve lesion
serratus anterior
Can’t anchor scapula to thoracic cage –>
can’t abduct arm above horizontal position
In terms of distortions of the hand,
with what type of lesions is ‘clawing’ seen best with?
DISTAL lesion of median/ulnar nerves
Patient extends fingers at rest. he successfully extends thumb, index and middle finger only. What’s the problem?
Distal ulnar lesion due to claw action!!!!
HypoTHENAR weakness
Patient makes the fist. He successfully flexes the medial two fingers only. What’s the problem?
Proximal median nerve problem – Pope’s blessing
Atrophy of the THENAR eminence – >
UNopposable thumb – >ape hand
Patient extends fingers at rest. He successfully extends the medial 2 fingers only. What’s the problem
Distal median nerve problem
Median claw
Atrophy of the THENAR eminence – >
UNopposable thumb – >ape hand
