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Systems: MSK AB > Nerve Palsies in Limbs > Flashcards

Nerve Palsies in Limbs Flashcards

1
Q

Where does each peripheral nerve start from?

A

Spinal cord

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2
Q

Dermatome

A

Sensory area of the skin supplied by a single spinal nerve

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3
Q

How do dermatomes develop?

A
  • Adjacent dermatomes overlap considerably
  • Embryological development of limb buds growing out from body wall results in axial lines (anterior and posterior) - there is no overlap between adjacent pre- and post-axial dermatomes
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4
Q

What are the dermatomes of the lower limb?

A
  • STAND on S1
  • SLEEP on S2
  • SIT on S3
  • ** on S4
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5
Q

Why are the dermatomes of the lower limb distorted?

A

Lower limb dermatomes distorted by rotation and extension, and “borrowing” of skin from trunk

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6
Q

What is Hilton’s law?

A

The nerve crossing a joint supply the muscles acting on it and joint itself

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7
Q

What are the implications of Hilton’s Law?

A

-May supply 2 joints, eg. hip and knee supplied by femoral, sciatic and obturator nerves
Therefore, HIP DISEASE MAY GIVE RISE TO KNEE PAIN

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8
Q

What is the hip joint supplied by?

A
  • Obturator nerve (predominantly)
  • Femoral nerve
  • Lateral femoral cutaneous nerve
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9
Q

Myotome

A

Group of muscles supplied by one segment of the spinal cord

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10
Q

What is the brachial plexus?

A

Large network of nerves supplying the upper limb, extending from the cervical spine to the axilla

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11
Q

How is the brachial plexus divided?

A
  • Roots
  • Trunks
  • Divisions
  • Cords
  • Branches
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12
Q

How does Erb’s palsy occur?

A

Downward traction such as a fall on the side of the neck

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13
Q

What happens if C5 and C6 are damaged?

A

Erbs palsy

-Deltoid and shoulder muscles, brachialis and biceps all affected

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14
Q

How does Klumpke’s paralysis occur?

A

Upward traction for example in a breech delivery

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15
Q

What happens if T1 is damaged?

A

Klumpke’s paralysis

  • Intrinsic muscles are damaged
  • Hand clawed
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16
Q

Give examples of brachial plexus injuries?

A
  • Erb’s palsy

- Klumpke’s paralysis

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17
Q

Where is the axillary nerve at most risk of injury?

A

Surgical neck of the humerus

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18
Q

What is Saturday night palsy?

A
  • Complication of humeral neck fracture, and shoulder dislocation
  • Caused by pressure on the posterior cord of the brachial plexus
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19
Q

What does axillary nerve injury result in?

A
  • Motor deficit: loss of shoulder abduction (deltoid)

- Sensory deficit over the badge area

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20
Q

What are the roots of the radial nerve?

A

C5-T1

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21
Q

What is the radial nerve closely associated with in the arm?

A

Profunda brachii artery

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22
Q

How does the radial nerve enter the forearm?

A

Enters forearm by passing between - brachioradialis & brachialis (and posterior interosseous branch of radial nerve passes between 2 planes of supinator)

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23
Q

Where is the radial nerve most at risk?

A

Spiral groove of humerus and lateral intermuscular septum (and posterior interosseous branch at radial neck)

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24
Q

How does radial nerve injury present?

A
  • Motor deficit: wrist drop (extensors)

- Sensory deficit in the 1st web space dorsally

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25
What are the roots of the median nerve?
C7-T1
26
What is the median nerve closely associated with in the arm?
Brachial artery
27
How does the median nerve enter the forearm?
Enters forearm by passing between - two heads of pronator teres
28
Where is the median nerve most at risk?
Volar aspect of wrsit (and cubital fossa)
29
What can median nerve injury occur as a result of?
- Carpal tunnel syndrome | - Wrist lacerations (and supracondylar fractures, Struther;s ligament)
30
What does median nerve injury result in?
- Motor deficit: thenar wasting (monkey's hand) and pointing fingers - Sensory deficit of the volar aspect of the thumb
31
What are the roots of the ulnar nerve?
C7-T1
32
What is the ulnar nerve closely associated with in the arm?
Superior ulnar collateral artery ( and ulnar artery and nerve very closely interwoven at wrist)
33
How does the ulnar nerve enter the forearm?
By passing between 2 heads of flexor carpi ulnaris
34
Where is the ulnar nerve most at risk?
Behind medial epicondyle of humerus (and wrist, canal of GUyon)
35
What can ulnar nerve injury occur as a result of?
Fracture of humeral condyles (and wrist lacerations)
36
What does ulnar nerve injury result in?
- Motor deficit: claw hand, hypothenar and 1st dorsal interosseous wasting - Sensory deficit in the little finger
37
Where is the lumbar plexus found?
Lies on surface of quadratus lumborum and within body of psoas muscle
38
How do the major nerve around the hip exit into the leg?
Most major nerves about the hip exit the pelvis by the sciatic foramen, except genitofemoral & ilioinguinal, femoral, lateral femoral cutaneous and obturator nerves
39
What are the roots of the femoral nerve?
L2-L4
40
What is the largest branch of the lumbar plexus?
;Femoral nerve
41
How does the femoral nerve enter the leg?
- Passes through psoas muscle - Exits pelvis under inguinal ligament, lateral to femoral artery, vein and lymphatic channels in femoral triangle (VAN with Vein next to “V” of legs)
42
What does the femoral nerve supply?
Quadricep muscles in the anterior thigh
43
What does the femoral nerve terminate as?
Terminates in long fine sensory branch (Saphenous Nerve - accompanies femoral artery in subsartorial canal of thigh, and long saphenous vein in lower leg and in front of medial malleolus at ankle to supply great toe)
44
What are the roots of the lateral femoral cutaneous nerve?
L2,L3
45
Where is the lateral femoral cutaneous nerve located?
Lies on the surface of the iliacus muscle, usually exits the pelvis under the lateral end of the inguinal ligament, but variable
46
What does the lateral femoral cutaneous nerve supply?
Purely sensory to the lateral aspect of the thigh
47
What does compression of the lateral femoral cutaneous nerve cause?
Meralgia paraesthetica
48
What are the roots of the sciatic nerve?
L4-S3
49
What is the largest nerve in the body?
Sciatic nerve
50
What is the main branch of the sacral plexus?
Sciatic nerve
51
What is the structure of the sciatic nerve?
Broad and flat with accompanying artery
52
How does the sciatic nerve enter the leg?
Exits pelvis through sciatic foramen below piriformis muscle
53
Where is the sciatic nerve located in the buttocks?
Deep to gluteus maximus
54
What does the sciatic nerve supply?
- Hamstring muscles in posterior thigh - Part of adductor magnus - All lower leg and foot muscles through terminal branches (tibial and commob fibular nerves), height of division is variable
55
When is the sciatic nerve at risk of injury?
- Posterior dislocation of the hip - Intra-muscular injections - During surgery
56
What are the roots of the common fibular nerve?
L4-S2
57
What are other names for the common fibular nerve?
- Lateral popliteal nerve | - Common peroneal nerve
58
What is the common fibular nerve a branch of?
Smaller and lateral branch of the sciatic nerve
59
Where is the common fibular nerve at risk of injury?
As it passes around the lateral aspect of the neck of the fibula (deficit causes foot drop and slapping gait,)
60
What is the most commonly injured nerve of the lower limb?
Common fibular nerve
61
What does the common fibular nerve divide into?
Superficial and deep fibular nerves

Systems: MSK AB (43 decks)

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