Nerve Palsies in the Limbs Flashcards
What are the clinical features involved in axillary nerve lesions?
- Deltoid atrophy
- Loss of sensation over regimental badge area
What are the clinical features of radial nerve lesions?
Lesion in Axilla - Loss of elbow extension, wrist extension and sensory changes in forearm and hand
Lesion in arm - Loss of wrist extension and sensory loss
Lesion in forearm - Loss of finger extension
What are the clinical features of median nerve palsies (carpal tunnel syndrome)?
Carpal tunnel syndrome
- Nocturnal pain and parastheisa
- Pain worst in morning
- Wasting of Thenar muscles
What are the clinical features of ulnar nerve lesions?
Cubital tunnel syndrome
- Ulnar claw hand
- Muscle wasting in 1st webspace
- Hypothenar wasting
What are the clinical features of brachial plexus palsies?
Upper brachial plexus - Erb’s palsy (waiters tip position)
Lower brachial plexus - Klumpke’s palsy (claw hand)
What is the innervation of the lower limb?
Sacral Plexus:
- Sciatic L4, 5, S1, 2, 3 (Common Peroneal nerve & Tibial nerve)
Lumbar Plexus:
- Femoral nerve L2, 3, 4
What are the clinical features of a lesion to the common peroneal nerve?
- Foot drop (unable to dorsiflex the foot)
Through which foramen of the vertebral column do spinal nerves exit?
Intervertebral foramen
What are the myotome patterns of the upper limb? I.e. what muscle do they innervate?
C5 - Flexors of elbow
C6 - Extensors of wrist
C7 - Extensors of elbow
C8 - Extensors of fingers
T1 - Intrinsic hand muscles
What are the myotome patterns of the lower limb? I.e. what muscle do they innervate?
L2 - Hip flexors
L3 - Knee extensors
L4 - Extensors of the ankle
L5 - Extension of the big toe
S1 - Flexors of the ankle
Which nerve roots are affected in Erb’s palsy?
C5
C6
Which nerve roots are affected in Klumpke’s palsy?
C8
T1
Which muscles are affected in Klumpke’s palsy?
Small muscle of hand
What is Hilton’s law?
A sensory nerve supplying a joint also supplies the muscles moving that joint and also innervates the skin overlying the insertions of these muscles
What can cause axillary nerve palsy?
1 - Shoulder dislocation
2 - Fracture of surgical neck of humerus