Nerve palsies Flashcards

1
Q

Peripheral nerves in upper limb

A
musulocutaneous 
median 
axillary 
radial 
ulnar
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2
Q

Peripheral nerves in lower limb

A

LFCN
sciatic
common peroneal
femoral

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3
Q

Spinal level and myotomes
C5.6.7.8.T1
L2,3,4,5S1

A
elbow flexors 
wrist extensors 
elbow extensors 
finger extensors 
intrinsic muscles of the hand 
hip flexors 
knee extensors 
ankle dorsiflexors 
long toe extensors 
plantarflexors
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4
Q

3 types of nerve palsies associated with brachial plexus

A

Erb’s
Klumpke’s
total brachial plexus

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5
Q

Erb’s palsy spinal level

A

C5,6

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6
Q

Klumpke’s palsy spinal level

A

C8,T1

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7
Q

Erb’s palsy

A

common, traction of C5/6 in labour

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8
Q

appearance of Erb’s palsy

A

waiter’s tip –> shoulder adducted and internal rotation, elbow extended and pronated wrist flexed

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9
Q

Is Erb’s or Klumpke’s palsy more common?

A

erb

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10
Q

Causes and appearance of klumpke’s palsy

A

falling out of tree, delivered hand first

small muscles of hand - claw hand

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11
Q

spinal nerve roots of MCN nerve

A

C5,6,7

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12
Q

MCN cord

A

lateral

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13
Q

What muscle does MCN pierce?

A

coracobrachialis

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14
Q

What 2 muscles does MCN run inferiorly between and supply?

A

biceps brachii

brachialis

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15
Q

What joint does MCN supply?

A

elbow

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16
Q

How does MCN terminate?

A

as lateral cutaneous nerve to forearm

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17
Q

Hiltons law

A

a sensory nerve supplying a joint also supplies muscles moving joint and skin overlying muscle insertions

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18
Q

axillary nerve cord

A

posterior

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19
Q

What does the axillary nerve wrap around?

A

surgical neck of humerus

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20
Q

what muscles does the axillary nerve supply?

A

deltoid and teres minor

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21
Q

what skin does axillary nerve supply?

A

over lateral arm - regimental badge area

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22
Q

When can the axillary nerve be damaged and what are the signs?

A

shoulder dislocation and fracture of the surgical neck of the humerus
deltoid atrophy

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23
Q

Radial nerve spinal level

A

C5-T1

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24
Q

Axillary nerve spinal level

A

C5.6

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25
Q

Radial nerve cord

A

posterior

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26
Q

What muscles does the radial nerve supply?

A

triceps, brachioradialis, ECRB,ECRL

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27
Q

What groove does the radial nerve run in?

A

radial groove of humerus going from the medial to lateral side

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28
Q

What does the radial nerve divide into?

A

posterior interosseous nerve

superficial radial nerve

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29
Q

PIN supplies - motor or sensory?

A

motor

30
Q

SRN supplies - motor or sensory?

A

sensory

31
Q

2 causes of radial nerve palsy

A

entrapment eg fracture of humerus

compression eg Saturday night palsy

32
Q

radial nerve palsy in axilla

A

loss of elbow and wrist extension, sensory changes in forearm and hand

33
Q

radial nerve palsy in arm

A

loss of wrist extension and sensory loss

34
Q

Radial nerve palsy in forearm

A

loss of finger extension - PIN

35
Q

Radial nerve palsy in wrist

A

sensory loss - SRN eg handcuff

36
Q

median nerve spinal level

A

C5-T1

37
Q

median nerve cords

A

median and lateral

38
Q

Median nerve supplies…

A

flexors of forearm (bar FCU and medial FDP), LOAF muscles

39
Q

LOAF muscles

A

lateral 2 lumbricals, opponens pollicus, abductor pollicus brevis and flexor pollicus brevis (thenar)

40
Q

median nerve sensation

A

radial 3.5 digits

41
Q

floor, roof and contents of carpal tunnel

A

floor - carpal bones
roof - flexor retinaculum
contents - median nerve, 4 xFDS, 4X FDP and FPL

42
Q

Causes of carpal tunnel syndrome

A
developmental 
swelling eg ganglion 
trauma eg distal radius fracture 
inflammatory eg rheumatoid, gout, TB 
metabolic eg pregnancy
43
Q

symptoms and signs of carpal tunnel syndrome

A

nocturnal pain and paraesthesia in part or all of median nerve distribution
wasting of thenar muscles

44
Q

2 special tests for carpal tunnel syndrome

A

tinnels and phalens

45
Q

Treating carpal tunnel syndrome

A

release flexor retinaculum

46
Q

Ulnar nerve spinal level

A

C8, T1

47
Q

ulnar nerve cord

A

medial

48
Q

Does ulnar nerve have branches in arm?

A

no

49
Q

How does ulnar nerve enter forearm?

A

between 2 heads of FCU

50
Q

Ulnar nerve supplies

A

medial half of FDP, FCU and all intrinsic hand muscles but not LOAF
ulnar 1.5 digits sensation

51
Q

Where is the cubital tunnel?

A

between medial epicondyle and olecranon with FCU as roof

52
Q

symptoms of cubital tunnel syndrome

A

numb on ulnar side of hand and difficult with fine tasks

53
Q

wasted muscles in ulnar nerve palsy

A

1st webspace
guttering
hypothenar

54
Q

ulnar claw hand

A

hyperextended MCPJ and flexed IPJ’s

55
Q

ulnar paradox

A

distal lesions worse clawing due to intact long flexors`

56
Q

Froment’s test

A

ulnar nerve not working so cheat and use FPL supplied by median nerve instead of AP

57
Q

sacral plexus nerves

A

sciatic –> common peroneal and tibial

58
Q

Lumbar plexus nerve

A

femoral

59
Q

sacral plexus level

A

ventral rami of L4-S4

60
Q

superior gluteal nerve supplies

A

gluteus medius, minimus and TFL

61
Q

inferior gluteal nerve supplies

A

gluteus maximus

62
Q

sciatic nerve supplies

A

hamstrings in post compartment of thigh

63
Q

What does the common peroneal nerve wrap around?

A

neck of fibula

64
Q

what does common peroneal nerve divide into?

A

deep and superficial peroneal nerve

65
Q

deep peroneal nerve supplies

A

anterior compartment of leg

66
Q

superficial peroneal nerve supplies

A

lateral compartment of leg

67
Q

common peroneal nerve palsy

A

foot drop as impairs dorsiflexion

68
Q

Lumbar plexus roots

A

L1-5

69
Q

main branches of lumbar plexus

A

LFCN, femoral and obturator

70
Q

meralgia parasthetica

A

altered sensation and pain in lateral thigh as LFCN compressed as it travels under lateral border of inguinal ligament