nerve palsies Flashcards
erb duchenne paralysis
porter/waiters tip
during child birth injury to brachial plexus
or fall on side of neck
babies can fully recover
downward traction
klumpkes palsy
all second joints bent in
upward traction
pulling on arm
breech delivery
inferior trunk damage (C8,T1)
axillary nerve palsy
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
radial nerve palsy
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
radial nerve palsy in axilla
loss of elbow extension, wrist extension and sensory changes
radial nerve palsy in arm
loss of wrist extension, sensory loss
radial nerve palsy in forearm
loss of finger extension
radial nerve palsy in wrist
loss of sensation
median nerve palsy
test middle of palm
carpal tunnel syndrome
causes of carpal tunnel syndrome
developmental thickening
gout
TB
amyloid
pregnancy
hypothyroidism
tumours
distal radius fracture
signs and symptoms of carpal tunnel syndrome
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
treatment carpal tunnel
treat underlying cause
steroid injection into site
relief of pressure to median nerve surgery- local anaesthetic, day care
ulnar nerve test area
pinky and below to wrist on both sides of hand
cubital tunnel syndrome
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
cubital tunnel treatment
steroid injection or release tunnel
ulnar nerve palsy signs
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
treatment of lateral cutaneous of thigh compression
steroid or operate to release tunnel (would lose sensation to lateral side of thigh)
what nerve must you be careful of when injection intra gluteal region, where would you inject
just below iliac crest
sciatic nerve
ulnar supplies
medial half of FDP
FCU
all intrinsic muscles of hand
sensation to ulnar 1.5 digits
median supplies
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
lateral femoral cutaneous supplies
sensory to lateral aspect of thigh
radial supplies
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
axillary supplies
deltoid
teres minor
skin over regimental badge area
sciatic supplies
hamstring muscles
part of adductor magnus
all lower leg and foot muscles via terminal branches tibial and common fibular
sciatic nerve is at risk from
posterior dislocation of hip
IM injections
during surgery
