hand + neuropathies Flashcards
palmaris brevis origin
palmar aponeurosis and the flexor retinaculum
palmaris brevis insertion
skin on ulnar side of the palm
palmaris brevis action
wrinkles + tenses the skin over the hypothenar (pinky) eminence
palmaris brevis innervation
superficial branch of ulnar n
canal of guyon contents
ulnar n, ulnar a, ulnar v
abductor pollicis brevis origin
flexor retinaculum + tubercle of the trapezium
abductor pollicis brevis insertion
base of proximal phalanx of the thumb
abductor pollicis brevis action
abducts the thumb
abductor pollicis brevis innervation
recurrent branch of median n
flexor pollicis brevis origin
deep head: trapezoid + capitate
superficial head: flexor retinaculum + tubercle of trapezium
opponens pollicis origin
flexor retinaculum, scaphoid + trapezium
opponens pollicis insertion
entire lat. border of 1st metacarpal
opponens pollicis action
opposes the thumb to the other fingers
opponens pollicis innervation
recurrent branch of median n
abductor digiti minimi brevis origin
pisiform bone + flexor carpi ulnaris tendon
abductor digiti minimi brevis insertion
base of proximal phalanx of digit 5
abductor digiti minimi brevis action
abducts the little finger
abductor digiti minimi brevis innervation
deep branch ulnar n
flexor digiti minimi origin
hamulus of the hamate + flexor retinaculum
flexor digiti minimi insertion
base of proximal phalanx of digit 5
flexor digiti minimi action
flexes the little finger
flexor digiti minimi innervation
deep branch ulnar n
opponens digiti minimi origin
hamulus of hamate + flexor retinaculum
opponens digiti minimi insertion
medial side of digit 5
opponens digiti minimi action
brings little finger into opposition w/the thumb
opponens digiti minimi innervation
deep branch ulnar n
lumbricals origin
tendons of flexor digitorum profundus
lumbricals insertion
radial side of dorsal digital expansion for digits 2-5
lumbricals action
flexion of MCP + extension of PIP + DIP joints
lumbricals 1-2 innervation
recurrent median n
lumbricals 3-4 innervation
deep ulnar n
adductor pollicis origin
oblique head: capitate + base of metacarpal 2-3
transverse head: palmar surface of metacarpal 3
adductor pollicis insertion
common insertion of ulnar side of base of proximal phalanx of thumb
adductor pollicis action
adducts thumb
adductor pollicis innervation
deep ulnar branch n
palmar interossei 1 origin
ulnar side of metacarpal 2
palmar interossei 2 + 3 origin
radial side of metacarpals 4 + 5
palmar interossei 1 insertion
ulnar side of base of proximal phalanx digit 2
palmar interossei 2 + 3 insertion
radial side of base of proximal phalanges digits 4 + 5
palmar interossei action
adduct digits 2, 4, + 5
palmar interossei innervation
deep branch ulnar n
dorsal interossei origin
arise by two heads from adjacent sides of the metacarpals
dorsal interossei digits 2-3 insertion
radial side of the bases of proximal phalanges and dorsal digital expansion digits 2-3
dorsal interossei digits 3-4 insertion
ulnar side of bases of proximal phalanges + dorsal digital expansion of digits 3-4
dorsal interossei action
abduct medial 4 digits + assists lumbricals
dorsal interossei innervation
deep branch ulnar n
neurapraxia
interruption of nerve conduction without loss of continuity of axon
what is another name for neurapraxia?
saturday night palsy
axonotmesis
axonal degeneration
neurotmesis
nerve is completely disrupted by contusion, traction, or lacerations
What is usually the cause of brachial plexus lesions?
Trama related events
Cardinal signs of brachial plexus injuries
Weakness in arm, diminished reflexes + sensory deficits
Erb-Duchenne Palsy
Effects C5/C6 spinal roots/superior trunk. Motor + sensory deficits.
What is another name for Erb-Duchenne Palsy?
Waiters tip deformity
Who is most affected by Erb-Duchenne Palsy? + why?
Infants due to trama during birth
How does Erb-Duchenne Palsy present?
Abduct + externally rotate humerus. Paresis or paralysis
What muscles does Erb-Duchenne Palsy effect?
Brachioradialis, ECRL, scapula muscles, Teres minor + major
Hypesthesia
Decreased sensitivity of shoulder
Dejerine-Klumpke
Involves T1 more than C8. Motor deficit of intrinsic hand muscles
What is another name for Dejerine-Klumpke?
“Claw hand” deformity
What muscles are affected by Dejerine-Klumpke?
FDS, FDP, FCR, FCU, + FPL
Horner’s syndrome
Drooping eyelid (ptosis), unequal pupil sizes, decreased sweating on affected side of face (anhydrosis)
Where is sensation disturbed in Horner’s syndrome?
Lower lesions
What causes arm hyper abduction?
Parturition trauma
Pope’s hand
Thenar atrophy. Can’t FLEX digits 2 + 3
Ulnar claw hand
Hypothenar atrophy. Can’t EXTEND digits 4 + 5
Thoracic outlet syndrome causes
Physical trauma, repetitive strain injuries (overhead), anatomical defects
Long thoracic nerve lesions
C5-C7, paralysis, causes winging of scapula
What causes long thoracic n lesions?
Injury from sports, breast cancer surgery, carrying heavy bags over shoulder
Axillary n lesions
C5-C6, atrophy of deltoid, Teres minor paralysis
What causes Axillary n lesions?
Anterior shoulder dislocation, compression of quadrangular space, surgical neck of humerus fracture
suprascapular n lesions
C5-C6, common motor deficits, no sensory deficits
what causes suprascapular n lesions?
shoulder dislocation
musculocutaneous n lesions
C5-C7. motor deficit, upper BP lesion, traumatic etiology
radial n lesions
C5-T1. distal lesions effect wrist, proximal lesions effect triceps
what is another name for distal radial n lesions?
wrist drop
what causes radial n lesions?
trauma, chronic pressure, compression syndromes
causes of radial paralysis
humerus fraction, using crutches, falling on arm, tight bracelet/watch
crutch palsy
wrist + triceps paralysis from radial n
median n lesions
C5-T1. high lesion effects FDP + FCU
preacher’s hand/benediction sign
patient cannot make a fist. proximal lesion of median n
bottle sign
patient unable to oppose thumb. distal lesions of median n
carpal tunnel syndrome
swelling of tunnel, swelling of fascia around tunnel, + swelling of tendons in tunnel
what is the most common cause of carpal tunnel syndrome?
occupational stress for people that use wrists a lot
brachialgia paresthetica nocturna
arm pain/numbness at night. common with carpal tunnel syndrome
Nevin’s syndrome
patient unable to flex distal thumb + index finger to make an “o” shape. AIN lesion from median n
ulnar n lesions
C8-T1. muscular atrophy
cubital varus
internal rotation of elbow
cubital valgus
external rotation of elbow