nerve compression in upper limb

Question 1

ulna nerve

Answer 1

Ulnarnerve comes from the medial cord of the brachial plexus (C8-T1)

Supply
forearm
FCU
FDP ring and small

thenar
adductor pollicis
deep head of flexor pollicis brevis (FPB)

fingers
interossei (dorsal &palmar)
3rd & 4th lumbricals

hypothenar muscles
abductor digiti minimi
opponens digiti minimi
flexor digiti minimi

Question 2

median nerve

Answer 2

Medial and lateral cord of the brachial plexus (C5-T1 nerve roots)
Supply

Superficial group
Pronator teres
Flexor carpi radialis
Palmaris longus

intermediate group
Flexor digitorum superficialis

deep group
Flexor digitorum profundus (lateral)
Flexor pollicis longus
Pronator quadratus

hand
- 1 st and 2nd lumbricals
- opponents pollicis
- abductor pollicis brevis
- flexor pollicis brevis

Question 3

radial nerve

Answer 3

radial nerve proper
triceps
anconeus
ECRL
ECRB
brachioradialis

PIN
- ED
- supinator
-EDM
- ECU
-APL
EPL
EPB
EIP

Question 4

peripheral nerve test REMS

Answer 4

Median Nerve
Thumb abduction
Ulna Nerve
Finger abduction
Radial Nerve
Wrist extension

Question 5

Carpal tunnel syndrome

Answer 5

Symptoms
Pain and altered sensation in a median nerve distribution
Shaking hand classically relieves symptoms
Can waken patients at night
Worse when the wrist is flexed

Examination
Thenar wasting
Tinel’s test
Durkans test
Phalen’s test

Question 6

treatment for carpal tunnel syndrome

Answer 6

Splints
Steroid injection (diagnostic vs therapeutic)
Carpal tunnel decompression
Patient selection

Question 7

guyons canal

Answer 7

• distal ulna nerve compression

symptoms
Numbness and tingling in an ulna nerve distribution
Pain
Weakness

Test
Tinel’s over the ulna palm

Question 8

cubital tunnel

Answer 8

symptoms
Reduced sensation ulna nerve in hand
Intrinsic muscle weakness and wasting

Tests
Tinel’s at elbow