nerve palsies

Question 1

erb duchenne paralysis

Answer 1

porter/waiters tip
during child birth injury to brachial plexus
or fall on side of neck
babies can fully recover
downward traction

Question 2

klumpkes palsy

Answer 2

all second joints bent in
upward traction
pulling on arm
breech delivery
inferior trunk damage (C8,T1)

Question 3

axillary nerve palsy

Answer 3

wraps around surgical neck of humerus
check regimental badge area
common with shoulder dislocation
leads to deltoid atrophy
wont be able to abduct arm
physio

Question 4

radial nerve palsy

Answer 4

saturday night palsy
can get entrapped in midshaft fracture of humerus
poorly fitted crutches
symptoms depend on site of lesion
test back of hand between thumb and forefinger

Question 5

radial nerve palsy in axilla

Answer 5

loss of elbow extension, wrist extension and sensory changes

Question 6

radial nerve palsy in arm

Answer 6

loss of wrist extension, sensory loss

Question 7

radial nerve palsy in forearm

Answer 7

loss of finger extension

Question 8

radial nerve palsy in wrist

Answer 8

loss of sensation

Question 9

median nerve palsy

Answer 9

test middle of palm
carpal tunnel syndrome

Question 10

causes of carpal tunnel syndrome

Answer 10

developmental thickening
gout
TB
amyloid
pregnancy
hypothyroidism
tumours
distal radius fracture

Question 11

signs and symptoms of carpal tunnel syndrome

Answer 11

nocturnal pain and parasthesia in part or all of median nerve area
wasting of thenar muscles
previous scars
deformity
weakness of grip strength
loss of sensation in palmar aspects and fingers of thumb, index and middle, lateral half of ring finger
loss of motor function in thenar muscles
weakness in power of thumb abduction
index finger dryness
positive tinnels test
positive phalens test

Question 12

treatment carpal tunnel

Answer 12

treat underlying cause
steroid injection into site
relief of pressure to median nerve surgery- local anaesthetic, day care

Question 13

ulnar nerve test area

Answer 13

pinky and below to wrist on both sides of hand

Question 14

cubital tunnel syndrome

Answer 14

second most common nerve entrapment
cubital tunnel between medial epicondyle and olecranon
patient has numbness on ulnar side of hand and difficulty with fine tasks

Question 15

cubital tunnel treatment

Answer 15

steroid injection or release tunnel

Question 16

ulnar nerve palsy signs

Answer 16

wasting of muscles in 1st webspace, hypothenar wasting
ulnar claw hand- hyperextension at MCPJ, flexion at IPJs- distal lesion worse than proximal
do froments test (piece of paper) if ulnar nerve not working, the patient will cheat and use FPL (median nerve) instead of adductor pollicis

Question 17

treatment of lateral cutaneous of thigh compression

Answer 17

steroid or operate to release tunnel (would lose sensation to lateral side of thigh)

Question 18

what nerve must you be careful of when injection intra gluteal region, where would you inject

Answer 18

just below iliac crest
sciatic nerve

Question 19

ulnar supplies

Answer 19

medial half of FDP
FCU
all intrinsic muscles of hand

sensation to ulnar 1.5 digits

Question 20

median supplies

Answer 20

flexors of forearm bar FCU and medial half of FDP
LOAF muscles- lateral two lumbricals.
opponens pollicis.
abductor pollicis brevis.
flexor pollicis brevis.

sensation to radial 3.5 digits

Question 21

lateral femoral cutaneous supplies

Answer 21

sensory to lateral aspect of thigh

Question 22

radial supplies

Answer 22

brachoradialis
extensor carpi radialis longus
posterior muscles of forearm- extensors and supinators
triceps

sensory
lateral aspect of the arm
posterior surface of the arm.
innervates the dorsal surface of the lateral three and half digits and the associated area on the dorsum of the hand

Question 23

axillary supplies

Answer 23

deltoid
teres minor
skin over regimental badge area

Question 24

sciatic supplies

Answer 24

hamstring muscles
part of adductor magnus
all lower leg and foot muscles via terminal branches tibial and common fibular

Question 25

sciatic nerve is at risk from

Answer 25

posterior dislocation of hip
IM injections
during surgery