Clinical Correlations Flashcards

1
Q

Winged scapula involves lesions of roots. What roots are affected? What nerve?

A

C5-C7; Long thoracic nerve

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2
Q

What muscles are affected by winged scapula? This leads to what lost actions?

A

serratus anterior; anchoring of scapula to thoracic cage, protraction

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3
Q

In regards to winged scapula, what is the position of the injured limb?

A

posterior protrusion of medial aspect of scapula

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4
Q

What are some examples of injuries leading to winged scapula?

A

stab woud, axillary lymph node dissection during a mastectomy

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5
Q

Injury to another nerve could also cause winged scapula. Which one?

A

Dorsal scapular nerve

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6
Q

Injuries to the back would cause winged scapula by the ____ _____ nerve and injuries to the lateral side of the thorax or axilla region would cause winged scapula by ___ ___ nerve

A

dorsal scapular; long thoracic

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7
Q

In this palsy, roots C5-C6 are affected. Possible muscles affected are deltoid, suprispinatus, infraspinatus, and biceps brachii.

A

Erb-Duchenne Palsy

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8
Q

What are the actions lost in Erb-Duchenne Palsy?

A

elbow flexion, external rotation, abduction, supination

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9
Q

What is the position of the injured limb in Erb-Duchenne Palsy?

A

adducted, pronated, internally rotated, elbow extension

note: “waiter’s tip”

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10
Q

What is an example injury causing Erb-Duchenne Palsy?

A

infants - lateral traction on neck during delivery

adult - trauma

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11
Q

In this palsy, roots C8-T1 (lower trunk) are affected. The muscles affected are lumbricals, interpose, thinner, and hypothenar intrinsic hand muscles

A

klumpke palsy

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12
Q

What actions are lost in Klumpke palsy?

A

MP joint flexion, PIP/DIP joint extension

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13
Q

What is the position of the injured limb in Klumpke palsy?

A

MCP joint extended, PIP and DIP joint flexed

note: “bear claw hand’

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14
Q

What are some examples of injury resulting in Klumpke palsy?

A

infant - upward force on arm during delivery

adult - trauma

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15
Q

Why are all intrinsic hand muscles affected in Klumpke palsy?

A

because C8-T1 are roots found in the radial, median, and ulnar nerve

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16
Q

What roots are affected in Radial nerve palsy? Where is the location of the lesion?

A

C5-T1; arm/axilla

17
Q

What are the possible muscles affected by radial nerve palsy?

A

triceps brachii and posterior forearm muscles

18
Q

What action is lost in radial nerve palsy?

A

extension of elbow, wrist, and fingers

19
Q

What is the position of the injured limb in radial nerve palsy?

A

flexion of elbow, wrist, and fingers

20
Q

What are some examples of injuries resulting in radial nerve palsy?

A

mid-shaft fracture of humerus, compression of the axilla

21
Q

A lesion near the wrist involving the ulnar nerve would be considered what nerve palsy?

A

ulnar claw

22
Q

What roots are involved in ulnar claw?

A

C8-T1

23
Q

What muscles are involved in ulnar claw?

A

interossei, lumbricals (4th and 5th digit), adductor pollicis, opponens digiti minimi, flexor digiti minimi, abductor digiti minimi

24
Q

What are the lost actions involved in ulnar claw?

A

flexion of MP (4th and 5th digits), extension of IP (digits 4 and 5), adduction of 1st digit, opposition, flexion, and abduction of 5th digit

25
Q

What is the position of the injured limb in Ulnar claw?

A

At rest digits 1-3 are neutral and balanced between extension and flexion. Digits 4 and 5 are hyperextended at MCP joint and flexed at DIP and PIP

26
Q

What are examples of injuries leading to ulnar claw?

A

handle bar palsy, knife juggling

27
Q

A lesion on the median nerve around the distal humerus would result in what nerve palsy?

A

pope’s blessing

28
Q

What roots are affected in pope’s blessing?

A

C5-T1

29
Q

What are the possible muscles affected in pope’s blessing?

A

palmaris longus, flexor digitorum superficialis, flexor digitorum profundus (lateral half), flexor pollics longus, flexor pollicis brevis, opponens pollicis, abductor pollicis brevis, lumbricals (2nd and 3rd digits)

30
Q

What are the lost actions due to pope’s blessing?

A

flexion at MCP, PIP, DIP in digits 1-3

31
Q

What is the position of the injured limb in pope’s blessing?

A

when asked to make a fist, unable to flex digits 1-3

32
Q

examples of injuries resulting in pope’s blessing

A

compression of flexor retinaculum, inflammation of tendons of flexor digitorum superficial, pronator teres compression