Lesions of UE Flashcards
What parts of the brachial plexus are affected in a C5, C6 lesion?
Superior Trunk
Posterior and Anterior Division
Lateral and Posterior Cord
Axillary Nerve
Median Nerve
Musculocutaneous N
Radial N
In a C5/C6 Lesion, what is there a loss of?
Biceps Brachii
Deltoid
Brachialis
Supra and Infraspinatus
Rhomboids
What is a C5/C6 Lesion called?
Erb-Duchenne/Erb’s Palsy
Arm is down and pronated
“Waiters Tip” posture
What structures of the brachial plexus are affected in a C8, T1 lesion?
Inferior Trunk
Anterior and posterior divisions
Posterior and Medial Cord
Ulnar nerve
Axillary Nerve
Median Nerve
Radial Nerve
What is a C8/T1 lesion called?
Klumpke’s Palsy
What does a C8/T1 Lesion result in a loss of?
- All intrinsic muscles of the hand including lumbricals
- Flexor cari ulnaris
- Results in weakness of flexor digitorum profundus
What position does the hand go into with Klumpke’s Palsy?
Due to loss of lumbricals, the MP joints will be extended and the IP joints flexed
“monkey claw hand”
What is a posterior cord lesion called?
“crutch palsy?
Posterior cord lesion/crutch palsy results in the loss of what?
Extensors of the arm, forearm and hand
* if axillary nerve is affected, shoulder abduction will be weak also
What is the resultant posture of crutch palsy called?
wrist drop
what can crutch palsy also be caused by?
radiation fibrosis
What can cause axillary nerve lesions?
- crutch injuries
- fracture of the surgical neck of the humerus
What does axillary nerve lesion result in?
- motor loss in deltoid and teres minor muscles (weakness of shoulder abduction and lateral rotation of the arm)
- Sensory loss: parathesia in the superior and lateral arm
Long thoracic nerve lesion
- caused by external pushing, shoving or crush injury
- results in scapular winging
radial nerve lesion
- “Saturday Night Palsy”
- loss of extensors to forearm, hand and fingers
What is the resultant posture of radial nerve lesion?
“wrist drop” with weakness in ab and adduction of the wrist
What can an injury to the radial nerve within the forearm result in?
Injury to deep branch of radial nerve
- inability to extend thumb and metacarpophalangeal joints
- No sensory nerve loss
- weakened supination, wrist extension, ulnar deviation
Musculocutaneous Nerve Lesion
- rarely damaged
- loss of all muscles in the anterior compartment of the arm
- Weakness of arm and forearm flexion and supination
- loss of sensation along lateral forearm
- decreased or absent bicep tendon reflex
What does a median nerve lesion result in?
- loss of pronation, opposition of thumb
- weakness of flexion of all PIP and DIP and MP joints of digits 2 and 3 (FDS, FDP, and Lumbricals 1 and 2)
- weakness of radial deviation
- sensory loss to radial half of palm and palmar surfaces of 3 1/2 digits
What is the resultant posture of median nerve lesion called?
ape hand
- If patient is asked to make a fist, digits 2 and 3 remain extended (“hand of benediction”)
- Hand lies supinated and deviated to ulnar side
Where is a common site for entrapment of the median nerve ?
between the two heads of the pronator teres
Injury to the ulnar nerve can occur in 4 places:
- medial epicondyle
- cubital fossa between heads of FCU
- ulnar tunnel
- Hand
Injury at the elbow results in:
- Weakness of wrist flexion and ulnar deviation (FCU)
- Weakness of ulnar deviation
- Loss of flexion of distal phalanges of ring and little fingers (ulnar ½ FDP).
- Loss of abduction, adduction of fingers at MCP joints (interossei).
- Loss of thumb adduction (Adductor pollicis). 6. Atrophy and loss of fuction of hypothenar muscles (FDMB,ADM,ODM).
- Loss of sensation over ulnar side of palm and 1 ½ fingers.
- Failure of the fingers to flex at the MCP or extend at IP joints, especially ring
and little finger. (interossei and lumbricals) producing an “ulnar claw” hand
Ulnar nerve lesion results in:
- Loss of ab- and adduction of digits 2-5, adduction of thumb
- Resultant posture is called “claw hand” due to the fact that digits are extended at MP and flexed at IP joints – most profound for digits 4 & 5
