nerve palsies

Question 1

nerve roots myotone patterns

Answer 1

C5- elbow flexors
C6- wrist extensors
C7 elbow extensors
C8- Finger extensors
T1- Intrinsic hand muscles

L2- Hip flexors
L3- Knee extensors
L4- Ankle dorsiflexors
L5- Long toe extensors
S1- Ankle Plantar Flexors

Question 2

Brachial plexus palsies

Answer 2

Erb’s palsy
Klumpke’s palsy
total brachial plexus

Question 3

peripheral nerves

Answer 3

-axillary
Secondary to trauma
-Radial
secondary to compression or entrapment
-Median
Carpal tunnel syndrome
- Ulnar
Cubital tunnel syndrome

Question 4

Upper brachial plexus (C5,6)

Answer 4

Erb’s palsy

Question 5

Lower Brachial plexus (C8,T1)

Answer 5

Klumpke’s (very rare)

Question 6

Total brachial plexus

Answer 6

C5 to T1

Question 7

Erb’s palsy

Answer 7

traction (during delivery)
waiter's tip position
shoulder is adducted and IR
elbow extended
wrist is flexed

Question 8

klumpke

Answer 8

traction (C8,T1)

affects small muslces of hand-claw hand

Question 9

hilton’s law

Answer 9

a sensory nerve supplying a joint also supplies the muscles moving the joint and skin overlying the insertions of these muscles

Question 10

axillary nerve

Answer 10

wraps around surgical nexk of humerus
supplies deltoid and teres minor
supplies skin over lateral arm ( regimental badge area)

Question 11

axillary nerve palsy

Answer 11

shoulder dislocation
fracture surgical neck of humerus
deltoid atrophy

Question 12

radial nerve

Answer 12

posterior cord
supplies triceps
runs in radial groove
supplies BCR, ECRL,ECRB

Question 13

Radial nerve palsy

Answer 13

radial nerve entrapment
saturday night palsy
honeymoon palsy
crutch palsy

Question 14

median nerve

Answer 14

medial and lateral cords
C5679T1)
supplies flexors of forearm ( Bar FCU and medial half of FDP), LOF muscles

Question 15

carpal tunnel

Answer 15

floor: carpal bones
roof: flexor retinaculum
contents: FDS,FDP, FPL and median nerve

Question 16

causes of carpal tunnel

Answer 16

developmental
trauma- distal radius fracture
swellings- ganglion
inflammatory
metabolic- pregnancy
-mucopolysaccharidoses
-hypothyroidism

Question 17

syndrome

Answer 17

noctural pain and parasthesia

wasting of thenar muscles

Question 18

test

Answer 18

Look
previous scars, deformity
feel
sensation
Move APB power
special tests tinels, phalens

Question 19

ulnar

Answer 19

medial cord
enters forearm between two heads of FCU
supplies medial half of FDP, FCU and all intrinsic muscles in hand

Question 20

cubital tunnel syndrome

Answer 20

second most common nerve entrapment
cubital tunnel between medial epicondyle and olecranon with fascial bands from FCU
numbness on ulnar side
difficulty fine tasks

Question 21

ulnar nerve palsy

Answer 21

wasting of muscles
1st webspace
guttering
hypothenar wasting
ulnar claw hand- hyper ext MCPJ and flex at IPJ

Question 22

ulnar paradox

Answer 22

distal lesion has worse clawing than a proximal lesion due to intact long flexors with a distal lesion

Question 23

froment’s test

Answer 23

key muscles Adductor pollicis (ulnar)
Flexor Pollicis longus (median)
if ulnar not working patient will try to use FPL

Question 24

sacral plexus

Answer 24

sciatic
common peroneal nerve,
tibial nerve
-ventral rami of L4 to S4
superior gluteal
Gluteus medius/minimus and TFL
inferior gluteal maximus
main branch sciatic supplies posterior thigh, leg and foot muscles

Question 25

lumbar plexus

Answer 25

femoral nerve

Question 26

sciatic nerve

Answer 26

made up of tibial nerve and common peroneal nerve

suplies hamstring muscles in posterior compartment

Question 27

common peroneal/fibular nerve

Answer 27

wraps around neck of fibula

divides into deep supplying anterior comparrment and superficial supplying lateral

Question 28

palsy

Answer 28

footdrop

Question 29

lumbar plexus

Answer 29

L1-L5
main branches
LFCN
femoral obturator

Question 30

meralgia paraesthetica

Answer 30

altered sensation and pain lateral thigh

compression of lateral femoral cutaenous nerve of thigh as it travels under lateral border of inguinal ligament