Clinical Correlates

Question 1

What is Erb’s Palsy a result of? How does it present?

Answer 1

Excessive increase in angle between shoulder and neck
Upper plexus injury - C5, C6
Upper limb hangs at side, medial rotation, extended arm at elbow, posterior facing hand
“Waiter’s Tip”
Paralyzed axillary, suprascapular & musculocutaneous nerves

Question 2

What is Klumpke Palsy a result of and how does it present?

Answer 2

Damage to C8 & T1
Damaged long thoracic can cause winging of scapula, inability to rotate scapula during abduction over 90 degrees
Muscles of anterior forearm innervated by median nerve will be weak

Question 3

Physical presentation of damage to axillary nerve

Answer 3

Rounded contour of shoulder disappears
Slight hollow inferior to acromion
Loss of sensation to lateral side of proximal arm (supplied by superior lateral cutaneous nerve)
Could be caused by fracture to surgical neck

Question 4

Physical presentation of damage to radial nerve

Answer 4

Wrist drop!

Sensory changes where it innervates (back of hand)

Question 5

Physical presentation of damage to the median nerve

Answer 5

Ape hand
Paralyzed muscles of thenar eminence
Thumb laterally rotated & adducted

Question 6

Physical presentation of damage to ulnar nerve

Answer 6

Small muscles of hand paralyzed
Can’t adduct & abduct fingers - can’t grip paper between fingers
Claw hand
Froment’s sign

Question 7

Froment’s Sign Test

Answer 7

Tests for ulnar nerve palsy, specifically the action of adductor pollicis
Patient asked to hold an object (piece of paper) between thumb and index finger - patient won’t be able to hold the paper when being tugged away

Question 8

Carpal Tunnel Syndrome

Answer 8

Results from median nerve compression within carpal tunnel
Numbness/tingling, pain, autonomic symptoms, weakness & clumsiness
Can do carpal compression test or Phalen’s test

Question 9

Mallet Finger

Answer 9

Loss of extensor tendon continuity at distal interphalangeal joint
Causes joint to rest in abnormally flexed position

Question 10

Scaphoid Fracture

Answer 10

Force on outstretched hand
Swelling/pain in anatomical snuff box
Pain with radial flexion

Question 11

What passes below and above flexor retinaculum

Answer 11

Below: Median nerve & flexor digitorum superficialis
Above: Palmar cutaneous branch of median nerve & ulnar nerve