Nerve Palsies in the Limbs Flashcards

1
Q

What is erb’s palsy - CF and RF

A

Downward traction of C5/6
Waiters’ tip - shoulder adduction and internal rotation, elbow extension, forearm pronation and wrist flexion

Common in neonates during birth as head is pulled out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is klumpke’s palsy - causes and features

A

Traction C8-T1
Falling out tree or pulled out hand first in birth
Claw hand - intrinsic muscles of hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of axillary nerve palsy

A

Shoulder dislocation

Fracture of surgical neck of humerus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Clinical features of axillary nerve palsy

A

Loss of shoulder abduction

Deltoid atrophy and regimental badge area numbness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Radial nerve palsy causes

A

Secondary to compression (i.e. Saturday night palsy) and entrapment (humerus fracture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Symptoms of radial nerve palsy

A

Depend on site of lesion

  • axilla –> loss of elbow and wrist extension and sensory changes in the forearm and hand
  • arm –> loss of wrist extension (wrist drop) and sensory loss
  • Forearm –> loss of finger extension n
  • Wrist –> loss of sensation in 1st web space dorsally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of median nerve palsy

A

Carpal tunnel syndrome
Wrist lacerations
Supracondylar #s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of carpal tunnel syndrome

A
Idiopathic 
Trauma - distal radial #
Swellings - ganglion, fibroma, lipoma
Inflammatory - RA, gout, TB, amyloid 
Metabolic - pregnancy (fluid overload), mucopolysaccharides, hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Symptoms / signs of carpal tunnel

A

Nocturnal pain and paraesthesia in median nerve distribution
Wasting of thenar muscles (monkey hand)
Pointing finger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Examination for suspected carpal tunnel

A

Look - thenar wasting, previous scars, deformity
Feel - loss of sensation on volar aspect of thumb
Move - APB power
Tinnels - tap over carpal tunnel
Phalens - reverse prayer 1m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment of carpal tunnel

A

Splint
Steroid injection
Carpal tunnel release surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of ulnar nerve palsy

A
# humeral condyles 
Wrist lacteration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical features of ulnar nerve palsy (cubital tunnel)

A
Numbness of ulnar side of hand
Difficulty with fine tasks
Wasting of 1st web space (dorsal interosseous), guttering, hypothenars
Ulnar claw hand 
- hyperextension at MCPJ
- Flexion at IPJs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the ulnar paradox

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Test for cubital tunnel syndrome

A

Froment’s test
- ask patient to grip paper between fist and thumb, if the ulnar nerve is not working, the patient will cheat and use flexor policies Longus instead of adductor pollicis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Causes of sciatic nerve palsy

A

Posterior dislocation of hip
IM injections
Surgical procedures of leg

17
Q

What does palsy of the common peroneal (fibular) nerve cause

A

Foot drop and slapping gait

18
Q

What does compression of the lateral femoral cutaneous nerve cause

A

Lies on the surface of the iliac muscle and exits pelvis under lateral end of inguinal ligament
If compressed as it travels under IL causes MERALGIA PARASTHETICA - altered sensation in lateral thigh