Nerve Injury Flashcards
How does a patient with long thoracic nerve damage present
Difficulty abducting
Winged scapula - medial border and inferior angle protrude
What does the axillary nerve supply? Skin and muscles
Skin- regimental badge area
Muscles- deltoid and teres minor
Give a cause of axillary nerve damage
Traction injuries in shoulder displacement.
Inferior displacement of numeral head
What movement is impaired in axillary nerve damage
Abduction at shoulder (deltoid)
Give causes of radial nerve injury
Falling asleep with one arm over back of chair (intoxication)
Fractures of dislocation of prox. Humerus
In groove at time of shaft fracture
Give the sensory loss in radial nerve injury
Posterolateral surface of lower arm and forearm
Lateral surface of dorsum of hand
Dorsal surface of Roos of lateral 3.5 fingers
Muscles lost in radial nerve injury at elbow
Posterior forearm muscles
Triceps intact
Muscles lost in proximal radial nerve injury
All extensions of posterior upper limb
What movements are impaired in radial nerve damage
Unable to extend elbow or wrist
Unopposed flexion of wrist = wrist drop
Unable to make grip
Give the sensory loss in a musculocutaneous nerve injury
Lateral side of forearm
Give the motor loss in a musculocutaneous nerve injury
Weakened flexion of arm (deltoid and pec. Major still in tact)
Weakened forearm flexion (loss of brachialis)
Give causes of median nerve injury
Supra condylar fracture of humerus
Stab wounds proximal to flexor retinaculum between FCR and FDS
Give sensory loss in median nerve lesion at elbow
Sensation lost of palmar aspect of lateral 3.5 fingers and corresponding palmar surface of the hand.
Give the muscles paralysed in median nerve injury at elbow
PT FCR PL FDS radial half of FDP FPL PQ thenar eminence, lumbricals 1&2
Give the position of the limb in median nerve injury at elbow
Forearm supinated
Weak wrist flexion, accompanied by adduction
No flexion of IP joints of 2 and 3
(4 & 5 = ulnar FDP) - hand of benediction when making a fist
No opposition - ape hand
Sensory loss in median nerve damage at wrist
Distal part of dorsal 3.5 fingers
Palmar sparing due to branching earlier than carpal tunnel
Motor loss in median nerve injury at wrist
LLOAF
thumb is laterally rotated and adducted
Weak flexion of MCP of 1&2
Cause of ulnar injury at elbow
Fracture of medial humeral epicondyle
Sensory loss in ulnar injury at elbow
Medial 1.5 fingers and hand
Which muscles are paralysed in ulnar damage at elbow
FCU, ulnar half of FDP, intrinsically hand except LLOAF
Clinical presentation of ulnar damage at elbow
Ulnar claw
Paralysed lumbricals 3&4 unopposed extension at MCP and unopposed flexion at PIP.
BUT no flexion at DIP due to paralysed FDP.
Can’t opposed FCR so flexion of wrist is accompanied by abduction.
Causes of ulnar damage at wrist
Laceration of wrist
Sensory loss in ulnar damage at wrist
Palmar Medial 1.5 digits and palmar surface of hand
Dorsal sparing.
Motor loss and presentation of ulnar damage at wrist
Prominent claw hand
FDP is not lost so PIP of 3&4 are flexed
Abduction/adduction of fingers impossible
