Chapter 4: Upper Limb (continued) Flashcards
Another name for median nerve damage caused by an injury at the elbow?
Where is the injury found to cause damage of the median nerve?
supracondylar fracture of the humerus
Do lesions of median nerve at the wrist present with hand of benediction?
no they don’t
What are some locations that can lead to ulnar nerve injury?
elbow (medial epicondyle), wrist (lacerations), or fracture of hook of hamate, clavicle fracture
What are some symptoms caused by fracture of the surgical neck of the humerus or inferior dislocation of the shoulder damaging the axillary nerve?
- loss of abduction of the arm to the horizon
- sensory loss over the deltoid muscle
What is the major typical symptom of injury to the long thoracic nerve?
“winged scapula”
An injury to the suprascapular nerve would cause what symptoms?
- loss of shoulder abduction between 0 and 15 degrees (supraspinatus muscle)
- weakness of lateral roation of shoulder (infraspinatus muscle)
What nerve roots carry the axillary nerve?
C5, C6
What nerve roots carry the musculocutaneous nerves?
C5, C6, C7
What nerve roots carry the radial nerve?
C5, C6, C7, C8, T1
What nerve roots carry the median nerve?
C5, C6, C7, C8, T1
What nerve roots carry the ulnar nerve?
C8, T1
Where is altered sensation found when there is damage to the axillary nerve?
lateral arm
Where is the altered sensation felt in one who has damage to the musculocutaneous nerve?
lateral forearm
Where is the altered sensation felt in one with radial nerve damage?
dorsum of hand over first dorsal interosseous and anatomic snuffbox
Where is the altered sensation felt in one with damage to the median nerve?
lateral 3 1/2 digits; lateral palm
Where is altered sensation found in one with ulnar nerve damage?
medial 1 1/2 digits; medial palm
Where is motor weakness found in those with axillary nerve damage?
abduction of shoulder
Where is motor weakness found in one with musculocutaneous nerve damage?
flexion of forearm
supination
Where is motor weakness found in those with radial nerve damage?
wrist extension
metacarpo-phalangeal extension
supination
Where is motor weakness found in those with median nerve damage?
wrist flexion
finger flexion
pronation
thumb opposition
Where is motor weakness found in those with ulnar nerve damage?
wrist flexion
finger spreading
finger extension
thumb adduction
Common sign of a radial nerve lesion?
wrist drop
Common sign of a median nerve lesion?
ape hand
hand of benediction
ulnar deviation at wrist
What is a common sign of lesion at ulnar nerve?
claw hand
radial deviation at wrist
What are the causes of lesions at the axillary nerve?
- surgical fracture of the humerus
- dislocated humerus
What are causes of lesions at musculocutaneous nerve?
rarely lesioned
What are causes of lesions at radial nerve?
- saturday night palsy
- midshaft fracture of humerus
- subluxation of radius
- dislocated humerus
What are causes of lesions of the median nerve?
- carpal tunnel compression
- supracondylar fracture of humerus
- pronator teres syndrome
What are the causes of ulnar nerve lesions?
- fracture of medial epicondyle of humerus
- fracture of hook of hamate
- fracture of clavicle
Wrist lacerations?
The subclavian artery is a branch of what arteries on the right and left side of the body?
branch of brachiocephalic trunk on the right and aortic arch on the left
What locations on the body does the axillary artery run from?
from the 1st rib to the lower border of the teres major muscle
What are the 3 major branches of the axillary artery?
lateral thoracic artery
subscapular artery
posterior humeral circumflex artery
What does the lateral thoracic artery supply?
supplies mammary gland; runs with long thoracic nerve
Where is the posterior humeral circumflex artery located? What nerve does it run with?
at surgical neck with axillary nerve
The brachial artery runs with what nerve?
radial nerve
Deep palmer arch is supplied by what artery?
radial
Superficial palmer arch is supplied by what artery?
ulnar
Examples of collateral circulation at the shoulder?
subscapular branch of axillary a and suprascapular branch of subclavian artery
What is the tunnel in carpal tunnel bounded by?
anteriorly by the flexor retinaculum and posteriorly by the proximal row of carpal bones (lunate)
What does the carpal tunnel transmit? What structures?
9 tendons and the radial and ulnar bursae
(4 tendons of the flexor digitorum superficialis, 4 tendons of the flexor digitorum profundus, and the tendon flexor pollicis longus) and the median nerve
Are there any blood vessels that go through the carpal tunnel?
no
What are the rotator cuff muscles?
supraspinatus, infraspinatus, teres minor, and subscapularis (SITS)
What tendon is commonly affected in rotator cuff injury?
supraspinatus
Humeral surgical neck fracture could cause damage to what structures?
lacerate the posterior humeral circumflex artery and the axillary nerve
What does a midshaft humeral fracture lead to? (What structures may be damaged?)
radial nerve and profunda brachii artery (brachial artery) injury
What is the most frequently fractured of the carpal bones?
scaphoid bone
How is avascular necrosis of scaphoid caused?
separation of the proximal portion scaphoid from its blood supply (which enters the bone at the distal head)
What is the most commonly dislocated carpal bone?
lunate
A fall on the outstretched hand may fracture the hamate which may cause damage to which nerve?
ulnar nerve as it passes into the hand
