Brachial Plexus Flashcards
nerve root involvement leads to
dermatomal loss
myotomal loss
root reflex loss
cervical radicular cluster
what is the cervical radicular cluster
ipsilateral rotation <60°
positive spurling
distraction relieve symptoms
ULTTM
lesion leading to Erb’s Palsy
C5,6 Trunk
what motor/sesnory loss is seen in those with Erb’s Palsy? what motions are lost?
dermatomal and myotomal loss
- shoulder ER, Flexion, elbow flexion
lesion leading to Klumpkie’s
C8-T1 trunk
what motor/sensory losses are seen in klumpkie’s palsy? what muscles are affected?
dermatomal and myotomal
- finger flexors/extensors
- intrinsic hand muscles
what position is seen in Erb’s
waiter’s tip position
what position is seen in klumpke’s palsy
claw hand deformity
what are the symptoms of thoracic outlet syndrome
paresthesias
non specific weakness
+/- vascular entrapment
TOS observed due issues involving the scalenes would indicate what involvement
root
TOS observed due issues involving the clavicle/1st rib would indicate what involvement
trunk
TOS observed due issues involving the pectoralis minor would indicate what involvement
branch
what are the radial nerve entrapment sites
saturday night palsy
radial tunnel syndrome
posterior interosseous nerve
subjective report associated with saturday night palsy
falling asleep with arm extended
possibly due to axillary crutch use
explain sensory deficits associated with saturday night palsy
paresthesia to dorsal hand & fingers 1-3 up to nail beds
explain motor deficits associated with saturday night palsy
wrist drop
decreased finger extension
explain tricep innervation associated with saturday night palsy
triceps are spared
subjective reports associated with radial tunnel syndrome
pain with wrist flexion and pronation
pain with resisted supination
aching distal to lateral epicondyle
sensory deficits associated with radial tunnel syndrome
paresthesia of radial distribution
-no complete loss of sensory, more so abnormal
motor deficits associated with radial tunnel syndrome
no true motor deficits
subjective report associated with posterior interosseous nerve
pain with resisted supination
vague forearm pain
sensory loss associated with posterior interosseous nerve palsy
none - sensory spared
motor loss associated with posterior interosseous nerve palsy
loss/weakness of PIN innervated muscles
thumb abduction weakness
what muscles does posterior interosseous nerve innervate
abductor pollicis longus
extensor pollicis brevis
extensor pollicis longus
extensor digiti minimi
extensor carpi ulnaris
median nerve entrapment sites
pronator teres
carpal tunnel syndrome
subjective report associated with pronator teres entrapment
gradual onset
observed after repetitive pronation/supination
vague forearm pain
paresthesias, N/T weakness
sensory loss associated with pronator teres
sensory in palm
digits 1-3
radial slide of 4th digit
pain over thenar eminence
motor deficits associated with pronator teres entrapment
no OK sign, playboy bunny sign
weakness of thumb, index, and middle finger
FDP loss – but no true motor deficit
subjective report associated with carpal tunnel sydnrome
paresthesia / achey pain in hands
overuse when wrist is extension
can be due to obesity/pregnancy
sensory loss associated with carpal tunnel syndrome
digits 1-3 & half of digit 4
palm sensation spared
motor loss associated with carpal tunnel syndrome
weakness of 1/2 of LOAF
what is the acronym LOAF? what is it associated with?
lateral 2 lumbricals
opponens pollicis
abductor pollicis brevis
flexor pollicis brevis
entrapment sites associated with ulnar nerve
cubital tunnel
guyons canal
sbjective report associated with cubital tunnel entrapment
worse in the morning
clumsy grip
can be due to traction injury
can be due to valgus at elbow
sometimes snapping and popping
sensory loss associated with cubital tunnel entrapment
paresthesia of 4/5th digit
- palmar and dorsal side
motor loss associated with cubital tunnel entrapment
weakness of intrinsics
digit/thumb adduction
weakness in opposition
sensory loss associated with guyon’s canal entrapment
palm sensation sparred
- paresthesia in 4th and 5th digit
both palmar and dorsal
motor loss associated with guyon’s canal entrapment
froment’s sign
decreased grip and pinch
compare a C8 lesion to cubital tunnel and guyon’s canal entrapment
- subjective
- sensory
- motor
subjective - neck pain and radicular cluster
sensory - in C8 dermatome
motor - myotomal weakness (ulnar dev and thumb extension)
– FDP weakness
what nerves come off the brachial plexus roots / what are their nerve roots
Phrenic (C3,4,5)
Dorsal Scapular (C5)
Long Thoracic (C5,6,7)
what nerves come from the trunks of the brachial plexus? what are their roots?
suprascapular (C5,6)
nerve to subclavius (C5,6)
what nerves come off the lateral cord of the brachial plexus
musculocutaneous (C5,6)
lateral pectoral (C5,6,7)
what nerves come off of the posterior cord of brachial plexus and nerve roots?
upper subscapular (C5,6)
throacodorsal nerve (C6,7,8)
lower subscapular (C5,6)
what nerves come from the medial cord of brachial plexus and nerve roots
medial pectoral (C8,T1)
medial cutaneous of arm (C8,T1)
medial cutaneous of forearm (C8,T1)
nerve roots of axillary nerve
C5,6
nerve root of radial nerve
C5-T1
nerve roots of ulnar nerve
C8,T1
