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M&M Test 1 > B6-011 Nerve Lesions of the Upper Extremity > Flashcards

B6-011 Nerve Lesions of the Upper Extremity Flashcards

1
Q

prime supinator at shoulder and elbow

A

biceps brachii

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2
Q

prime flexor of the forearm

A

brachialis

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3
Q

forearm flexor when the forearm is in mid pronation

A

brachioradialis

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4
Q

wrist flexor and abductor (radial deviation)

A

flexor carpi radialis

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5
Q

wrist flexor and adductor (ulnar deviation)

A

flexor carpi ulnaris

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6
Q

the muscles that flex the wrist are innervated by [3]

A

median
anterior interosseous
ulnar

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7
Q

innervates most muscles in the anterior compartment of the forearm

A

median

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8
Q

innervates the deep muscles of the anterior compartment of forearm

A

anterior interosseous

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9
Q

innervates the medial half of the FDP and the FCU and the intrinsic muscles of the hand

A

ulnar

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10
Q

innervates the muscles in the anterior compartment of the arm

A

musculocutaneous

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11
Q

innervates the posterior compartments of the arm and forearm

A

radial

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12
Q

the radial nerve is involved in [movement]

A

extension

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13
Q

lateral rotators of the arm [3]

A

teres minor
infraspinatus
posterior head of deltoid

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14
Q

medial rotators of arm [4]

A

latissimus dorsi
pec major
anterior head of deltoid
subscapularis

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15
Q

abductors of the arm [2]

A

supraspinatus
middle head of deltoid

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16
Q

the radial nerve innervates the […] compartment of the arm

A

posterior

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17
Q

innervates deltoid and teres minor

A

axillary

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18
Q

the median nerve innervates the […] compartment of the forearm and thenar muscles

A

anterior

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19
Q

the musculocutaneous nerve innervates the […] compartment of the arm

A

anterior

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20
Q

innervates coracobrachialis, biceps, and brachialis

A

musculocutaneous

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21
Q

the ulnar nerve innervates the […] half of FDP and the FCU and intrinsic muscles of the hand

A

medial

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22
Q

provides sensation to the medial forearm

A

medial antebrachial cutaneous

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23
Q

supplies sensation to the medial arm [2]

A

intercostal-T2
medial brachial cutaneous. - medial cord

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24
Q

supplies sensation to the lateral arm

A

inferior lateral brachial cutaneous (radial)

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25
Q

provides sensation to lateral forearm

A

lateral antebrachial cutaneous

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26
Q

the lateral antebrachial cutaneous branches from the

A

musculocutaneous

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27
Q

the medial antebrachial cutaneous branches from the […]

A

medial cord

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28
Q

the medial brachial cutaneous branches from the [..]

A

medial cord

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29
Q

provides sensation to palmar and dorsal hand, 5th digit, half of 4th digit

A

ulnar

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30
Q

provides sensation to medial palm and digits 1-3, half of 4th, and nail beds

A

median

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31
Q

provides sensation to dorsum of hand, digits 1-3 and half of 4th on the dorsal side

A

superficial branch of the radial nerve

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32
Q

what muscles extend the DIP?

A

interossei and lumbricals

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33
Q

the lumbricals and interossei […] the MCP and […] the DIP/PIP joints

A

extend MCP
flex DIP/PIP

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34
Q

extends IP joint of thumb

A

extensor pollicis longus

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35
Q

produces opposition of the thumb

A

opponens pollicis

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36
Q

flexes DIP joints

A

flexor digitorum profundus

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37
Q

flexes PIP

A

flexor digitorum superficialis

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38
Q

abduct fingers

A

dorsal interossei

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39
Q

adduct fingers

A

palmar interossei

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40
Q

flex MCP and extend DIP/PIP joints

A

lumbricals

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41
Q

where is the axillary nerve in contact with bone?

A

surgical neck of humerus

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42
Q

where is the radial nerve in contact with bone?

A

radial groove of humerus

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43
Q

where is the suprascapular nerve in contact with bone?

A

suprascapular notch

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44
Q

where is the ulnar nerve in contact with bone? [2]

A

between the hook of hamate and the pisiform
medial epicondyle of humerus

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45
Q

what muscle can entrap the medial pectoral nerve?

A

pectoralis minor

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46
Q

what muscle can entrap the median nerve?

A

pronator teres

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47
Q

what muscle can entrap the musculocutaneous nerve?

A

coracobrachialis

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48
Q

what muscle can entrap the posterior interosseus nerve?

A

supinator

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49
Q

what muscle can entrap the ulnar nerve?

A

flexor carpi ulnaris

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50
Q

damage to the median nerve results in loss of […] of thumb

A

opposition

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51
Q

loss of abduction/adduction of the digits results from damage to the

A

ulnar nerve

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52
Q

loss of extension of the forearm results from damage of the

A

radial nerve

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53
Q

weakness of supination results from damage to the [2]

A

musculocutaneous- biceps
radial -supinator

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54
Q

weakness of flexion of the DIPs of digits 4 and 5 results from damage to the

A

ulnar nerve

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55
Q

innervates the medial portion of flexor digitorum profundus

A

ulnar nerve

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56
Q

damage to the ulnar nerve at the cubital tunnel would result in

A

loss of extension of 4 and 5 DIPs

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57
Q

loss of thumb abduction would be due to damage of the

A

median nerve

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58
Q

abnormal sensation to the anterior lateral palm and first 3.5 digits including nail bed would result from damage to

A

median nerve

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59
Q

abnormal sensation to the medial forearm would result from damage to the

A

medial antebrachial cutaneous nerve

(from medial chord of brachial plexus)

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60
Q

abnormal sensation to the posterior lateral hand and first 3.5 digits excluding the nail would result in damage to the

A

radial nerve

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61
Q

loss of wrist extension is due to damage of the

A

radial nerve

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62
Q

if pronator teres spasms, […] can become entrapped

A

median nerve

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63
Q

if coracobrachialis spasms, […] can become entrapped

A

musculocutaneous n

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64
Q

if flexor carpi ulnaris spasms, […] can become entrapped

A

ulnar n

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65
Q

if supinator spasms, […] can become entrapped

A

deep branch of radial n

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66
Q

what is anatomical insurance?

A

each muscle receives fibers from more than one spinal nerve

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67
Q

[…] division does extensors and abductors

A

posterior

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68
Q

[…] division does flexors and adductors

A

anterior

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69
Q

dorsal rami provide motor to

A

axial muscles

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70
Q

C5 myotome

A

shoulder

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71
Q

C6 myotome

A

anterior arm

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72
Q

C7 myotome

A

posterior arm

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73
Q

C8 myotome

A

forearm

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74
Q

T1 myotome

A

hand

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75
Q

dermatomal pattern of C6

A

deltoid to thumb

axillary, radial, lateral antebrachial, and median all supplied by C6

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76
Q

a peripheral nerve pattern tells you the […] has been damaged

A

peripheral nerve

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77
Q

a dermatomal pattern tells you the […] has been damaged

A

anterior rami

(ex. roots of brachial plexus, trunk, or dorsal rami)

78
Q

C6 is always the [..] for dermatomal patterns

A

thumb

79
Q

C8 is always the […] for dermatomal patterns

A

pinky

80
Q

C7 usually includes […] for dermatomal patterns

A

middle finger

81
Q

a motor deficit in a section of spinal nerve results in

A

weakness

82
Q

a motor deficit in a section of peripheral nerve results in

A

paralysis

83
Q

[…] of the limb after motor injury depends on antagonistic action of intact muscles

A

position

84
Q

loss of vasomotor supply to blood vessel in limbs leads to

A

flushing of skin

85
Q

loss of innervation to sweat glands produces

A

anhidrosis (dry skin)

86
Q

where is the lesion?
weakness of scapular elevation and retraction

A

dorsal scapular

87
Q

where is the lesion?
winged scapula

A

long thoracic

88
Q

where is the lesion?
weakness in first 15 degrees of abduction, weakness with lateral rotation

A

suprascapular

89
Q

where is the lesion?
weakness of adduction and medial rotation

A

pectoral

90
Q

where is the lesion?
weakness of adduction and medial rotation

A

pectoral

91
Q

where is the lesion?
weakness of arm extension, adduction, and medial rotation of arm; weakness of scapular depression

A

thoracodorsal

92
Q

where is the lesion?
weakened flexion and supination of the forearm, loss of sensation on lateral forearm

A

musculocutaneous

93
Q

how would a patient with a lesion in the musculocutanous nerve?

A

extended and pronated

94
Q

what nerve/artery are affected by a surgical neck fracture?

A

axillary nerve
posterior circumflex artery

95
Q

what motor deficits would a lesion in the axillary nerve present with?

A

weakness of abduction- loss of deltoid
weakness of external rotation -loss of teres minor and deltoid
weakened shoulder flexion- loss deltoid
weakened arm extension- loss of posterior delt
weakened medial rotation -loss of deltoid

96
Q

what sensory pattern would a lesion in the axillary nerve present with?

A

lateral deltoid

97
Q

“square shoulder” is due to

A

deltoid atrophy from axillary lesion

98
Q

what artery and nerve is at risk in a suprachondylar fracture?

A

median nerve
brachial artery

99
Q

why does a proximal median nerve lesion cause loss of pronation?

A

loss of pronator teres and pronator quadratus

100
Q

why does a proximal median nerve lesion cause weakness of flexion and abduction of the wrist?

A

FCU still intact
ECR longus and brevis can still abduct

101
Q

why does a proximal median nerve lesion cause loss of flexion of the IP joints of lateral 2 fingers?

A

FDS and FDP are out

102
Q

why does a proximal median nerve lesion cause weakness of flexion of IP joints of medial 2 fingers?

A

FDP still intact

103
Q

why does a proximal median nerve lesion cause impairment of thumb movement?

A

loss of opp
weakness of abduction

104
Q

Benediction sign indicates […] injury

A

proximal median nerve

105
Q

ask patient to [..] to evaluate for benediction sign

A

make a fist

106
Q

what sensory pattern would a lesion in the proximal median nerve exibit?

A

palmar thumb and 2-4.5 fingers, dorsal nail beds of same digits

107
Q

what position would the arm be in with a proximal median nerve injury?

A

forearm supinated
lateral 2 fingers extended
ape hand (limited thumb movement)

108
Q

damage to the distal median nerve would cause what deficits?

A

loss of opposition
weakness of thumb flexion
weakness of thumb abduction

109
Q

what deficits would a patient have if the anterior interosseus was damaged?

A

loss of flexion of DIPs -FDP
weakened pronation -pronator quadratus

**pinched OK sign

110
Q

what does a “pinched OK sign” indicate?

A

anterior interosseus nerve damage

111
Q

where is the nerve damage if a patient presents with weakness of flexion of the wrist?

A

proximal ulnar

112
Q

why would damage to the proximal ulnar nerve cause weakness of wrist adduction and flexion?

A

loss flexor carpi ulnaris, other flexors intact
extensor carpi ulnaris can still adduct

113
Q

why would damage to the proximal ulnar nerve cause loss of flexion of the DIPs of ulnar 2fingers?

A

loss of flexor digitorum profundus

114
Q

why would damage to the proximal ulnar nerve cause weakness of flexion of MCPs?

A

loss of lumbricals and interossei but flexor digitorum superficialis (innervated by median) still intact

115
Q

loss of extension of the IP joints of ulnar two fingers and weakness of extension of radial 2 fingers?

A

loss of lumbricals and interossei, but lumbricals 2 and 3 are innervated by median

116
Q

why would damage to the proximal ulnar nerve cause loss of ab/adduction of fingers?

A

loss of interosseus muscles

117
Q

why would damage to the proximal ulnar nerve cause loss of adduction of the thumb?

A

loss of adductor pollicis

118
Q

atrophy of […] is a sign of ulnar nerve damage

A

1st dorsal interossei

119
Q

how would the hand look with a proximal ulnar nerve lesion?

A

ulnar claw

clawing of digits 4 and 5

120
Q

what sensory pattern is affected in proximal ulnar nerve injury?

A

4.5-5 digit palmar and dorsal sides

121
Q

how do you differentiate between ulnar claw and hand of benediction?

A

hand of benediction is ACTIVE, occurs when you ask the patient to make a fist
ulnar claw is passive

122
Q

full claw occurs when […] has been damaged

A

lower brachial plexus

123
Q

partial claw is due to […] injury

A

ulnar nerve

124
Q

artery that travels with median nerve

A

brachial

125
Q

why would damage to the radial nerve in the axilla cause loss of forearm extension?

A

loss of triceps

126
Q

why would damage to the radial nerve in the axilla cause weakness of arm extension?

A

loss of triceps

127
Q

why would damage to the radial nerve in the axilla cause weakness of forearm flexion?

A

loss brachialis and brachioradialis

128
Q

why would damage to the radial nerve in the axilla cause loss of wrist extension?

A

loss of extensors

129
Q

why would damage to the radial nerve in the axilla cause loss of extension of MCP joints?

A

loss of extensor digitorum

130
Q

why would damage to the radial nerve in the axilla cause weakened ab/adduction of the hand? (radial and ulnar deviation)

A

loss of extensor carpi radialis and ulnaris

but flexors remain

131
Q

why would damage to the radial nerve in the axilla cause limited thumb movements?

A

loss of extensor pollicis longus and brevis, and abductor pollicis longus

still have weak abduction from abductor pollicis brevis

132
Q

why would damage to the radial nerve in the axilla cause weakness of supination?

A

loss of supinator but biceps still intact

133
Q

when you see loss of wrist extension think

A

radial nerve injury

134
Q

flexor carpi ulnaris does

A

adduction (ulnar) deviation

135
Q

flexor carpi radialis does

A

abduction (radial) deviation

136
Q

if the damage to the radial nerve occurs in the radial grove, what muscles are spared?

A

long and lateral head of triceps, forearm extension only weakened

137
Q

what sensory pattern would a patient with a proximal radial nerve lesion (axillary) exhibit?

A

posterior arm, posterior forearm, dorsum of hand

**nail beds still intact

138
Q

wrist drop indicates injury to

A

radial nerve

139
Q

caused by downward traction (widen neck angle)
common with birth injuries and falls

A

Erb’s palsy (upper root injury)

140
Q

what peripheral nerves are affected by Erb’s palsy?

A

axillary
musculocutaneous
radial
median
suprascapular
thoracodorsal

141
Q

what muscles abduct the upper limb?

A

deltoid and supraspinatus

142
Q

what muscles externally rotate the arm?

A

infraspinatus, teres minor

143
Q

sensory pattern for Erb’s palsy?

A

shoulder to thumb

**dermatomal pattern indicates roots

144
Q

what posturing would a patient with Erb’s palsy present with?

A

waiter’s tip

loss of abduction (arm close to body)
loss of lateral rotation (arm medially rotated)
weakness of forearm flexors (forearm extended)
weakness of supination (forearm pronated)

145
Q

more common with breech delivery, break fall, or cervical ribs?

A

Klumpke’s paralysis (lower root injury)

146
Q

claw hand of all digits can indicate […] paralysis

A

Klumpke’s

**due to loss of thenar/hypothenar muscles, lumbricals, and interossei

147
Q

where’s the lesion?
dropped shoulder, weak radial pulse, flat weak hand

A

spinal accessory

148
Q

what nerve can be injured during breast biopsy?

A

spinal accessory

149
Q

where’s the lesion?
square shoulder, weakness of abduction

A

axillary

150
Q

use of crutches can damage the […] nerve

A

axillary

151
Q

damage to the […] can weaken biceps and brachialis

A

musculocutaneous

152
Q

hand somewhat extended, flat thumb
ulnar deviation on wrist flexion
forearm rests in partial supination

A

pronator teres syndrome

153
Q

full claw occurs when […] has been damaged

A

lower brachial plexus

154
Q

painful wrist
numbness and tingling in first three digits
cannot oppose thumb
fine motor skill affected

A

carpal tunnel syndrome

155
Q

full claw occurs when […] has been damaged

A

lower brachial plexus

156
Q

wrist drop indicates damage to the

A

radial nerve

157
Q

benediction sign when asked to make a fist indicates damage to the

A

proximal median nerve

158
Q

partial claw hand indicates damage to the

A

ulnar nerve

159
Q

damage to musculocutaneous n. would present with

A

waiter’s tip posturing

160
Q

damage to the […] eventually results in square shoulder

A

axillary

161
Q

flexor digitorum profundus is innervated by the […], allowing index and middle digit DIP flexion and is innervated by the […] allowing DIP flexion of the ring and little fingers

A

median
ulnar

162
Q

innervates hypothenar muscles

A

ulnar

163
Q

innervates the thenar muscles

A

median

164
Q

what nerve innervates supinator?

A

radial

165
Q

what nerve innervates adductor pollicis?

A

ulnar

166
Q

what nerve innervates biceps brachii?

A

musculocutaneous

167
Q

what nerve supplies deltoid and teres minor?

A

axillary

168
Q

long term injury of the axillary nerve results in

A

square shoulder

deltoid wasting and loss of rounded contour of shoulder

169
Q

long term injury of the ulnar nerve results in

A

partial claw

wasting of third and fourth digits and across body of hand
**thenar eminence is spared

170
Q

supplies most muscles in the anterior compartment

A

median nerve

171
Q

wasting of thenar eminence and a flattened “ape hand” indicate damage to

A

median nerve

172
Q

waiter’s tip posturing indicates damage to

A

musculocutaneous

173
Q

long standing radial nerve injury is expressed as

A

wrist drop

174
Q

stretching of the C5/C6 nerve root can cause

A

Erb’s palsy

175
Q

stretching of the C8/T1 nerve root can cause

A

Klumpke’s palsy

176
Q

baby lying with arm at side in pronated position

A

Erb’s

177
Q

what muscles does musculocutaneous supply?

A

biceps brachii
coracobrachialis
brachialis

178
Q

supplies pronator quadratus, flexor pollicis longus, and lateral flexor digitorum profundus

A

anterior interosseus nerve (median)

179
Q

damage to […] results in a pinched OK sign

A

anterior interosseus

180
Q

weakness of 2nd digit, thumb abduction and loss of thumb extension indicates damage to

A

posterior interosseus (radial)

181
Q

provides sensation to dorsum of the lateral hand, digits 1-4.5 without nailbeds

A

superficial branch of the radial

182
Q

provides sensation to the palmar side of the medial hand and 4.5-5 digits

A

ulnar

183
Q

the radial nerve branches in the cubital fossa to […] and […]

A

superficial radial nerve
deep radial nerve

184
Q

superficial radial nerve provides sensory innervation to:

A

dorsal aspect of proximal lateral hand including digits 1-4.5 except for nail beds

185
Q

sensation on the ventral aspect of the proximal medial hand is supplied by the [..] n.

A

ulnar nerve

186
Q

sensation on the ventral aspect of the central palm is supplied by […] n.

A

palmar cutaneous branch of the median

187
Q

thumb extension is done by […] nerve

A

posterior interosseus (radial)

188
Q

thumb adduction is done by the … nerve

A

deep branch of ulnar

189
Q

entrapment of the musculocutaneous in coracobrachialis would result in what defecits?

A

weakened arm flexion, forearm flexion, and supination

190
Q

weakness in arm extension could be caused by [2]

A

triceps (radial nerve)
latissimus dorsi (thoracodorsal n)

191
Q

innervates hypothenar muscles

A

ulnar

192
Q

full claw occurs when […] has been damaged

A

lower brachial plexus

M&M Test 1 (15 decks)

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