Nerve Palsies in the Limb Flashcards
What is the myotome of C5 responsible for?
Elbow flexors
What is the myotome of C6 responsible for?
Wrist extensors
What is the myotome of C7 responsible for?
Elbow extensors
What is the myotome of C8 responsible for?
Finger extensors
What is the myotome of T1 responsible for?
Intrinsic hand muscles
What is the myotome of L2 responsible for?
Hip flexors
What is the myotome of L3 responsible for?
Knee extensors
What is the myotome of L4 responsible for?
Ankle dorsiflexors
What is the myotome of L5 responsible for?
Long toe extensors
What is the myotome of S1 responsible for?
Ankle plantar flexors
What nerve palsies can occur to the brachial plexus?
Erb’s palsy
Klumpke’s palsy
Total brachial plexus
What nerve is affected by carpal tunnel syndrome?
Median nerve
What nerve is affected by cubital tunnel syndrome?
Ulnar nerve
What roots does Erb’s palsy affect?
Traction of C5, 6 (+/- 7)
What is the clinical signs of Erb’s palsy?
Shoulder is adducted and IR
Elbow is extended and pronated
Wrist is flexed
What roots does Klumpke’s palsy affect?
Traction of C8 and T1
What is the clinical sign of Klumpke’s palsy?
Claw hand
What roots contribute to the musculocutaneous nerve?
C5,6,7
What does the musculocutaneous nerve terminate as?
Lateral cutaneous nerve to the forearm
What is Hilton’s law?
A sensory nerve supplying a joint also supplies the muscles moving the joint and the skin overlying the insertions of these muscles
What roots contribute to the axillary nerve?
C5, 6
What does the axillary nerve innervate?
Deltoid
Teres major
Skin over lateral arm (regimental badge area)
What might cause axillary nerve palsy?
Shoulder dislocation
Fracture surgical neck of humerus
What clinical sign may be present with axillary nerve palsy?
Deltoid atrophy
What roots contribute to the radial nerve?
C5, 6, 7, 8, T1
What are the clinical signs of a radial nerve palsy?
Loss of elbow extension, wrist extension and sensory changes in forearm and hand (Axilla)
Loss of wrist extension and sensory loss (arm)
Loss of finger extension (finger)
Loss of sensation (wrist)
What roots contribute to the median nerve?
C5, 6, 7, 8, T1
What is the contents of the carpal tunnel?
FDS x4
FDP x4
FPL
Median nerve
What is the roof of the carpal tunnel?
Flexor retinaculum
What is the floor of the carpal tunnel?
Carpal bones
What are the causes of carpal tunnel syndrome?
Developmental Distal radius fracture Ganglion Fibroma Lipoma Rheumatoid Gout TB Amyloid Pregnancy Hypothyroidism
What are the symptoms of carpal tunnel syndrome?
Nocturnal pain
Parasthesia in part or all of the median nerve distribution
Thenar muscle wasting
What tests can be used to investigate carpal tunnel syndrome?
APB power
Tinnels
Phalens
What roots contribute to the ulnar nerve?
C8, T1
Where is the cubital tunnel situated?
Between the medial epicondyle and olecranon
What are the symptoms of cubital tunnel syndrome?
Numbness of ulnar side of hand
Hypothenar wasting
1st webspace wasting
Ulnar claw hand
What test can be used to investigate an ulnar nerve palsy?
Froment’s test
What roots contribute to the sciatic nerve?
L4, 5
S1, 2, 3
What is meralgia parasthetica?
Compression of lateral femoral cutaneous nerve of thigh as it travels under lateral border of inguinal ligament
