Nerve Palsies Flashcards
What is Erbs palsy
Palsy by traction of the upper brachial trunk
Risk factors for Erb’s palsy
Use of instrumental delivery Large infant size Small maternal size Prolonged second stage labour Maternal DM Malposition
Which palsy is Waters tip associated with
Erbs
Clinical features of Erbs palsy
Shoulder is adducted Internally rotated Elbow is extended and pronated Wrist is flexed Waiters tip
Ddx for Erbs palsy
Clavicle or humeral fracture
Septic arthritic shoulder
Osteomyelitis
What is Klumpkes palsy
Tractin of C8/T1 (lower brachial trunk)
Which is more common Klumpkes palsy or Erbs palsy
Erbs
Klumpkes is very rare
What can involvement of T1 in Klumpkes palsy result in
Horners Syndrome
What sign in the hand can Klumpkes palsy give
Claw hand
From which cord of the brachial plexus does the axillary nerve arise from
Posterior cord
What sensational deficit can axillary nerve palsy lead to
Loss of sensation over the regimental badge area
What motor deficit can axillary nerve palsy lead to
Deltoid weakness
Deltoid atrophy
Which 2 injuries are likely to injury the axillary nerve
Fracture of the surgical neck of the humerus
Shoulder dislocation
Rx axillary nerve palsy
Most recover spontaneously with no treatment required
Surgery in very sever cases
What is the main prognosis of axillary nerve palsy
Spontaneous resolution without the need for Rx
What characteristic sign does Radial nerve palsy give
Wrist drop
From which cord of the brachial plexus does the radial nerve arise from
Posterior cord
In which compartment of the arm does the radial nerve run in
Posterior compartment
What does radial nerve palsy in the axilla result in
Loss of elbow extension
Loss of wrist extension
Sensory changes of forearm and hand
What does radial nerve palsy in the arm result in
Loss of wrist extension
Sensory loss
What does radial nerve palsy in the forearm result in
Loss of finger extension
What does radial nerve palsy in the wrist result in
Loss of sensation e.g handcuff
From which cord of the brachial plexus does the ulnar nerve arise from?
Medial cord
Which roots does the ulnar nerve arise from
C8 and T1
Where would the ulna nerve be susceptible to an injury from
Elbow
What characteristic sign does an ulnar nerve palsy give
Claw hand
What test can be used to clinically examine for an ulnar nerve palsy
Froments Test
Describe the ulnar paradox
A distal lesion has worse clawing than a proximal lesion of the ulnar nerve
What causes winging of the scapula
Palsy of long thoracic nerve
In which procedure is the long thoracic nerve most commonly damaged
Axillary LN clearance in breast cancer surgery
Clinical appearance of scapula wining
Shoulder blade protrudes from back in abnormal position
What muscle is commonly affected to cause winging of scapula
Serratus anterior
Which nerve can surgical neck of humerus fracture damage
Axillary nerve
What artery can surgical neck of humerus fracture damage
Posterior circumflex artery
Is rupture of biceps tendon common or uncommon
Uncommon
Cause of biceps tendon rupture
Typically sudden injury
Clinical sign of biceps tendon rupture
Pop-eye muscle
Ball of muscle during flexion
Rx for biceps tendon rupture
Repair generally required as function remains
Surgery if indicated
