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MSK - ABDN > Nerve palsies in the limbs > Flashcards

Nerve palsies in the limbs Flashcards

1
Q

What is found in the dorsal root ganglia

A

the cell bodies of sensory nerves

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2
Q

what dermatome gives sensory innervation to the thumb

A

C6

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3
Q

what dermatome gives sensory innervation to the middle finger

A

C7

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4
Q

what dermatome gives sensory innervation of the little finger

A

C8

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5
Q

what dermatome gives sensory innervation for the big tow

A

L4

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6
Q

what dermatome gives sensory innervation for the little toe

A

S1

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7
Q

what dermatome gives sensory innervation for the middle 3 toes

A

L5

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8
Q

what myotome extends the wrists

A

C6

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9
Q

what myotome flexes the elbows

A

C5

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10
Q

what myotome extends the elbow

A

C7

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11
Q

what myotomes innervates the intrinsic muscles of the hand

A

T1

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12
Q

what myotome innervates the muscles that flex the hip

A

L2

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13
Q

what myotome is responsible for extending the knee joint

A

L3

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14
Q

what myotome extends the toes

A

L5

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15
Q

what myotome is responsible for plantar flexing the ankle joints

A

S1

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16
Q

what myotome is responsible for dorsiflexing the ankle

A

L4

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17
Q

Name 5 upper limb nerve palsies

A
  • Erb’s
  • Klumpke’s
  • Total brachial nerve palsy
  • Axillary nerve palsy
  • Carpal Tunnel
  • Cubital Tunnel
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18
Q

what is Erb’s palsy

A

a palsy that arises as a result of damage to the upper trunk of the brachial plexus.

It results in a waiter’s tip position (the elbow is extended and pronated) and the wrist is flexed

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19
Q

what is Klumpke’s palsy

A

damage to the lower trunk of the brachial plexus that results in claw hand

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20
Q

what cord does the musculocutaneous nerve come off of

A

the lateral cord

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21
Q

what does the musculocutaneous nerve supplies

A

the bicep muscles in the arm

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22
Q

what muscle does the musculocutanous nerve pierce through

A

the coracobrachialis

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23
Q

what is meant by Hilton’s law

A

a sensory nerve supplying a joint also supplies the muscles that move that joint and the skin overlying that joint

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24
Q

name two muscles that are innervated by the axillary nerve

A

the deltoid and the trees minor

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25
Q

what area of skin does the axillary nerve supply

A

the area of skin over the badge area on the arm

26
Q

what can result in damage to the axillary nerve

A

a fracture in the surgical neck of the humerus or a dislocated shoulder

27
Q

name some clinical signs of an axillary nerve palsy

A
  • deltoid atrophy
  • loss of sensation over the badge area of the arm
  • unable to raise the arm at the shoulder
  • weakness of the deltoid muscle
28
Q

what does the radial nerve innervates

A

the triceps of the arm

29
Q

what cord of the brachial plexus does the radial nerve branch from

A

the posterior cord

30
Q

what does the radial nerve supply in the hand

A

the majority of the skin overs the dorsal of the hand and the area of skin over the thenar muscles

31
Q

what is a term used to describe compression of the radial nerve

A

Saturday night palsy

32
Q

what does the median nerve innervate

A

all of the flexors of the forearm (except the flexor carpi ulnas and the medial half of the FDP)
it provides sensory innervation to the majority of the palm of the hand and the tips of the first 3 fingers

33
Q

what is compression of the median nerve known as

A

carpal tunnel syndrome

34
Q

what are the contents of the carpal tunnel

A

9 tendons and one nerve

35
Q

what forms the roof of the carpal tunnel

A

the flexor retinaculum

36
Q

what forms the floor of the carpal tunnel

A

the carpal bones

37
Q

name some causes of carpal tunnel

A

trauma, pregnancy, swellings (e.g. lipoma), hypothyroidism, TB, gout

38
Q

what are some of the clinical signs of carpal tunnel

A

nocturnal pain, parasthesia is the area of median nerve distribution and wasting of the thenar muscles

there may be a deformity from a previous fracture, scars from previous carpal tunnel release

a positive Tinel’s and Phalens test

39
Q

describe the Tinel’s test

A

this is when you tap over the nerve to elicit a sensation of pins and needles

40
Q

describe the Phalen’s test

A

this is when you place the dorsal aspect of both hands together for at least 60 seconds. If there is numbness, pain or tingling, the patient could have carpal tunnel

41
Q

what nerve fibres are found in the median nerve

A

the median nerve contains fibres from C5-T1 as it is a branch of the posterior cord of the brachial plexus

42
Q

what cord does the ulnar nerve come from

A

the medial cord of the brachial plexus

43
Q

what is the role of the ulnar nerve

A

the ulnar nerve has no branches in the arm and it is responsible for innervating the flexor carpi ulnaris and the medial half of the FDP

the ulnar nerve also innervates all of the intrinsic muscles of the hand and sensation to the medial 1.5 digits

44
Q

where is the cubital tunnel located

A

between the olecranon process and the medial epicondyle - if this space narrows, this is when you get compression of the ulnar nerve/cubital tunnel syndrome

45
Q

name some clinical signs of cubital tunnel syndrome

A

pain, disordered sensation over the ulnar aspect of the hand, wasting of the hypothenar muscles, guttering of the fingers and wasting of the first web space (this is usually one of the most marked signs)

46
Q

what shape will the hand take in an ulnar nerve lesion

A

you may get claw hand there will be hyperextension at the metacarpal-phalangeal joint and flexion at the inter-phalangeal joints

47
Q

what test is used to assess ulnar nerve palsy

A

Froment’s test - pulling on a sheet of paper - if they cannot do it with a flat thumb they have ulnar nerve palsy

48
Q

what test is used to assess median nerve palsy

A

Phalen’s and Tinnel’s test

49
Q

name the two main nerve plexuses int he lower limb

A

the sacral and the lumbar plexus

50
Q

what is the sacral plexus made up of

A

the ventral rami of spinal nerves L4-S4

51
Q

what are the main branches of the sacral plexus

A

the sciatic nerve, the superior gluteal nerve and the inferior gluteal nerve

52
Q

what is the role of the sciatic nerve

A

innervates the posterior thigh muscle, the muscles of the leg and the foot

53
Q

what makes up the sciatic nerve

A

L4-S3 ventral rami of spinal nerves

54
Q

what is the role of the superior gluteal nerve

A

to innervate the gluteus medius and minimus

55
Q

what is the role of the inferior gluteal nerve

A

to innervate the gluteus Maximus muscle

56
Q

what is the main branch of the sacral plexus

A

the sciatic nerve

57
Q

what are the main branches of the sciatic nerve

A

the tibial nerve and the common fibular/peroneal nerve

58
Q

what are the branches of the common peroneal nerve and what is the role of each

A

the main branches are the superficial and deep peroneal nerves

the superficial nerve supplies the lateral compartment of the leg and the deep peroneal nerve supplies the anterior compartment of the leg

59
Q

what could cause a common peroneal nerve palsy

A

a fracture in the head of the fibula

60
Q

what is the main branch of the lumbar plexus

A

the femoral nerve

61
Q

what are the branches of the lumbar plexus

A

the femoral nerve, the obturator and the lateral cutaneous nerve

62
Q

what is neuralgia parasthetica

A

this I the compression of the lateral cutaneous nerve of the lumbar plexus. the compression occurs at the lateral border of the inguinal ligament where the nerve passes under it

MSK - ABDN (33 decks)

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