Nerve Lesions Flashcards
Nerve damaged by fracture to surgical neck of humerus
Axillary N
N damaged by fracture at midshaft of humerus
Radial N
N damaged by fx at supracondylar ridge of humerus
Median N
Humerus Fractures: Nerves damaged: Superior –> Inferior
ARM
Axillary, Radial, Median
Hand Lesions mnemonic
DR CUMA
Nerve damaged to cause Drop Hand
Radial N
N damaged to cause claw hand
Ulnar N
N damaged to cause Ape Hand
Median N
Lesion in C5,6 N root
Nerves affected: upper brachial plexus
limb hangs limply & medially rotated w/ forearm pronated
sensory loss to lateral forearm
Mm affected: rotator cuff, ant arm muscles, teres major, rhomboids
Cause: difficult delivery; blow to shoulder
Waiter's Tip Hand Erb Duchenne (Erb's) Palsy
Lesion in C8,T1 nerve root
Nerves affected: Lower brachial plexus
hyperextended MP joints, flexed IP joints, sensory loss to medial side of arm and forearm
Mm affected: Intrinsic mm of hand, FCU, FDP (medial)
Cause: excess abduction of arm (falling from tree, grab limb), cervical rib, rumors of deep cervical lymph nodes
Claw Hand
Klumpke’s Palsy
Lesion in quadrangular space
Nerves affected: Axillary N (C5,6)
Loss of ABduction of arm, loss of shoulder contour, unstable shoulder joint, sensory loss to skin over lower 1/2 of deltoid m
Muscles affected: Deltoid
Cause: Fx of surgical neck of humerus; displacement of humeral head b/c of shoulder dislocation–often pinched when reducing shoulder dislocation
Axillary N. paralysis
Lesion on Median N above elbow
Nerve affected: Median N (C5-T1)
Weakened elbow flexion, loss of pronation, tendency toward adduction, weakened flexion at wrist, no flexion of IP joints of index and middle fingers; ring and little finger in natural(ish) position
Occurs w/ Ape Hand (sensory loss to palmar surface and nail beds of lateral 3.5 fingers)
Cause: Medial Supracondylar Fracture
Mm affected: Ant forearm, thenar mm.
Hand of Papal Benedition
Median N paralysis
Lesion in Thenar Eminence
N affected: Recurrent branch of median N (C5-T1)
Decreased flexion and abduction, loss of opposition of thumb–rotated laterally & adducted; most serious disability=inability to oppose thumb
Cause: medial supracondylar fracture of humerus
Mm affected: PT, FCR, PL, FDS (superficial mm of ant forearm), lateral forarm, thenar eminence
Ape Hand
Recurrent branch of the median nerve paralysis
Median N compression at wrist N affected: Median N burning pain along lateral 3.5 fingers, weakened thenar mm, restricted and painful movement of FDS and FDP tendons Cause: compression of nerve by ligament Mm affected: Flexor Digitorums thenar mm
Carpal Tunnel Syndrome
Median N paralysis
Lesion at or above elbow
N affected: (C8-T1)
No flexion of distal phalance of ring & little fingers, loss of abduction/adduction of fingers, losso f thumb adduction, + Froment’s sign, Claw Hand, sensory loss of palmar and dorsal aspects of medial 1.5 fingers
Cause: Fx of medial epicondyle of elbow, blows to “funny bone”, cuts/stab wounds
Mm affected: FDP (medial), FCU, intrinsic hand mm
Ulnar N paralysis
Lesion at axilla
N affected: C5-T1
loss of extension of elbow, wrist, and finger joints, weakened flexion at elbow and supination
sensory loss to posterior and lateral arm, narrow strip on post forearm, dorsal lateral 3.5 digits (not nail beds)
cause: Fx of lateral epicondyle or humeral shaft
Mm affected: posterior arm and forearm
Radial N. Paralysis:
Saturday Night Paralysis
Crutch Paralysis
Lesion at Axilla
N affected: C8-T1
Cause: Fx of lateral epicondyle or humeral shaft
causes pronation and flexion, loss of power
Mm affected: post arm and forearm
Radial N Paralysis:
Wrist drop
Lesion of radial N at elbow
Mm affected: post forearm
Same sxs as lesion at axilla but would not affect triceps
