Nerve Lesions of the Upper Limb

Question 1

axillary nerve:

can be injured by ___ of badly adjusted crutches or ___ dislocations

paralysis of the ___ & ___ muscles

loss of ___ sensation over the lower half of the ___ muslce

Answer 1

pressure
shoulder joint

deltoid
teres minor

cutaneous
deltoid

Question 2

radial nerve:
injuries in the axilla:

can be injured by:

• ___ of badly adjusted crutches
• fractures & dislocation of the proximal ___
• by a drunkard falling asleep w/ one arm ___ (“___”)

Answer 2

pressure
humerus
over the back of a chair (“saturday night palsy”)

Question 3

radial nerve:
injuries in the axilla:

muscles paralyzed: (3) & all ___ muscles

Answer 3

triceps
brachioradialis
supinator
extensors

Question 4

radial nerve:
injuries in the axilla:

inability to extend the ___ joint or ___ joint

“___” or flexion of the ___ occurs b/c of the unapposed action of the ___

Answer 4

elbow
wrist

wristdrop
wrist
wrist flexors

Question 5

radial nerve:
injuries in the axilla:

supination is still performed well by the ___ muscle

loss of sensation down the (anterior/posterior) surface of the (upper/lower) part of the arm & down a narrow strip on the (front/back) of the forearm

sensory loss on the lateral part of the ___ & dorsal surface of the ___ of the lateral ___

Answer 5

biceps brachii

posterior
lower
back

dorsum of the hand
roots of the lateral 3.5 fingers

Question 6

radial nerve:
injuries in the radial groove:

fracture on the ___, prolonged ___ on the back of the arm

“___” or flexion of the ___ occurs b/c of the unapposed action of the ___

Answer 6

shaft of the humerus
pressure

wristdrop
wrist
wrist flexors

Question 7

radial nerve:
injuries in the radial groove:

___ of the elbow may not be impaired (damage usually occurs below the level of the ___ branches)

loss of sensation on the dorsal surface of the lateral part of the ___ & the dorsal surface of the ___ of the lateral ___

Answer 7

extension
triceps

hand
roots of the lateral 3.5 fingers

Question 8

median nerve:
injuries in the elbow region:

may be injured as the result of ___ fractures of the ___

paralyzed muscles:

• ___ of the forearm
• ___ of the wrist & fingers except ___ & medial 1/2 of the ___
• ___ of the hand
• first two ___

Answer 8

supracondylar
humerus

pronator
long flexor
flexor carpis ulnaris
flexor digitorum profundus
thenar
lumbrical

Question 9

median nerve:
injuries in the elbow region:

the forearm is kept in the (supine/pronated) position (due to loss of (supinator/pronator) muscles)

wrist (flexion/extension) is weak & is accompanied by (abduction/adduction) due to paralysis of the flexor carpi radialis

Answer 9

supine
pronator

flexion
adduction

Question 10

median nerve:
injuries in the elbow region:

no flexion is possible at the ___ joints of the index & middle finger due to paralysis of the ___ & ___ muscles

the muscles of the ___ eminence are paralyzed & wasted so that the eminence is ___ & the hand looks “___”

Answer 10

interphalangeal joints
flexor digitorum superficialis
flexor digitorum profundus

thenar eminence
flattened
“ape-like”

Question 11

median nerve:
injuries in the elbow region:

when the patient tries to make a fist, the index finger remains ___ & the middle finger ___

the ring & little finger ___ but are weakened by the loss of the ___(“___”)

Answer 11

straight
bends slightly

bend
flexor digitorum superficialis
“hand sign of papal benediction”

Question 12

median nerve:
injuries in the elbow region:

the thumb is (abducted/adducted)

inability to ___ the thumb

Answer 12

adducted

oppose

Question 13

median nerve:
injuries in the elbow region:

skin sensation is lost on the ___ or less of the palm of the hand & the palmar aspect of the ___

sensory loss also occurs on the distal part of the dorsal surfaces of the ___

Answer 13

lateral half
lateral 3.5 fingers

lateral 3.5 fingers

Question 14

median nerve:
injuries at the wrist:

most common site of injury where it lies in the interval b/n the tendons of the ___ & ___ muscles, overlapped by the ___ tendon

paralysis of the ___ muscles & first two ___

Answer 14

flexor carpi radialis
flexor digitorum superficialis
palmaris longus tendon

thenar
lumbricals

Question 15

median nerve:
injuries at the wrist:

the ___ eminence is wasted & flattened

the thumb is (abducted/adducted)

inability to ___ the thumb

Answer 15

thenar

adducted

oppose

Question 16

median nerve:
injuries at the wrist:

skin sensation is lost on the ___ or less of the palm of the hand & the palmar aspect of the ___

sensory loss also occurs on the distal part of the dorsal surfaces of the ___

Answer 16

lateral half
lateral 3.5 fingers

lateral 3.5 fingers

Question 17

median nerve:
carpal tunnel syndrome:

caused by compression of the ___ nerve in the carpal tunnel

most common compression ___

syndrome consists of burning pain or “pins & needles” along the distribution of the ___ nerve to the ___ & weakness of the ___ muscles

Answer 17

median nerve

neuropathy

median nerve
lateral 3.5 fingers
thenar muscles

Question 18

median nerve:
carpal tunnel syndrome:

excessive wrist ___ & ___ may exacerbate it

advanced cases may see progressive loss of strength & coordination of the ___

no sensory loss occurs of the ___ eminence b/c this area of skin is supplied by the ___ branch of the ___ nerve, which passes superficially to the ___

Answer 18

flexion & extension

thumb

thenar eminence
palmar cutaneous branch of the median nerve
flexor retinaculum

Question 19

ulnar nerve:
injuries at the elbow:

common sit of injury where it lies behind the ___

paralysis of the:

• ___ muscle
• medial 1/2 of the ___ muscle
• small muscles of the ___ except the ___ muscles
• first two ___ muscles

Answer 19

medial epicondyle

flexor carpi ulnaris
flexor digitorum profundus
hand, thenar
lumbrical

Question 20

ulnar nerve:
injuries at the elbow:

wrist ___ is weak & is accompanied by ___ due to paralysis of the flexor carpi ulnaris

flattening of the medial part of the forearm due to wasting of the ___ muscle & medial 1/2 of the ___ muscle

Answer 20

flexion
abduction

flexor carpi ulnaris
flexor digitorum profundus

Question 21

ulnar nerve:
injuries at the elbow:

___ & ___ of the fingers is not possible & the patient cannot grasp a piece of paper placed b/n the fingers due to paralysis of the ___ muslces

it is impossible to ___ the thumb due to paralysis of the ___

Answer 21

abduction & adduction
interosseous muscles

adduct
adductor pollicis

Question 22

ulnar nerve:
injuries at the elbow:

hyperextension of the ___ (___) joints due to unopposed action of the ___ b/c of paralysis of the ___ muscles & ___ 3 & 4

Answer 22

metacarpophalangeal (knuckle)
extensor digitorum
interosseous
lumbricals

Question 23

ulnar nerve:
injuries at the elbow:

flexion of the ___ joints due to unopposed action of the ___ & lateral 1/2 of the ___ b/c of paralysis of the ___ muscles & ___ 3 & 4

Answer 23

interphalangeal
flexor digitorum superficialis
flexor digitorum profundus
interosseous
lumbircals

Question 24

ulnar nerve:
injuries at the elbow:

b/c the 1st & 2nd ___ are not paralyzed (___ nerve), hyperextension of the metacarpophalangeal joints & flexion of the interphalangeal joints are most extensive in the ___ & ___ fingers

Answer 24

lumbricals
median nerve
4th & 5th

Question 25

ulnar nerve:
injuries at the elbow:

the hand assumes a characteristic “___” deformity

wasting of the muscles results in flattening of the ___ eminence

loss of skin sensation over the anterior & posterior surfaces of the medial ___ & the medial ___

Answer 25

claw

hypothenar eminence

1/3 of the hand
1.5 fingers

Question 26

ulnar nerve:
injuries at the wrist:

the small muscles of the hand will be paralyzed & show wasting except for the muscles of the ___ eminence & the first two ___ muscles

the “___” is much more obvious b/c the ___ is not paralyzed & marked flexion of the ___ occurs

loss of skin sensation will occur over the anterior & posterior surfaces of the medial ___ & the medial ___

Answer 26

thenar eminence
lumbrical

clawhand
flexor digitorum profundus
terminal phalanges

1/3 of the hand
1.5 fingers