Nerve Palsies in the Limbs Flashcards

1
Q

What are the clinical features involved in axillary nerve lesions?

A
  • Deltoid atrophy
  • Loss of sensation over regimental badge area
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2
Q

What are the clinical features of radial nerve lesions?

A

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

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3
Q

What are the clinical features of median nerve palsies (carpal tunnel syndrome)?

A

Carpal tunnel syndrome

  • Nocturnal pain and parastheisa
  • Pain worst in morning
  • Wasting of Thenar muscles
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4
Q

What are the clinical features of ulnar nerve lesions?

A

Cubital tunnel syndrome

  • Ulnar claw hand
  • Muscle wasting in 1st webspace
  • Hypothenar wasting
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5
Q

What are the clinical features of brachial plexus palsies?

A

Upper brachial plexus - Erb’s palsy (waiters tip position)

Lower brachial plexus - Klumpke’s palsy (claw hand)

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6
Q

What is the innervation of the lower limb?

A

Sacral Plexus:

  • Sciatic L4, 5, S1, 2, 3 (Common Peroneal nerve & Tibial nerve)

Lumbar Plexus:

  • Femoral nerve L2, 3, 4
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7
Q

What are the clinical features of a lesion to the common peroneal nerve?

A
  • Foot drop (unable to dorsiflex the foot)
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8
Q

Through which foramen of the vertebral column do spinal nerves exit?

A

Intervertebral foramen

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9
Q

What are the myotome patterns of the upper limb? I.e. what muscle do they innervate?

A

C5 - Flexors of elbow

C6 - Extensors of wrist

C7 - Extensors of elbow

C8 - Extensors of fingers

T1 - Intrinsic hand muscles

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10
Q

What are the myotome patterns of the lower limb? I.e. what muscle do they innervate?

A

L2 - Hip flexors

L3 - Knee extensors

L4 - Extensors of the ankle

L5 - Extension of the big toe

S1 - Flexors of the ankle

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11
Q

Which nerve roots are affected in Erb’s palsy?

A

C5

C6

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12
Q

Which nerve roots are affected in Klumpke’s palsy?

A

C8

T1

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13
Q

Which muscles are affected in Klumpke’s palsy?

A

Small muscle of hand

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14
Q

What is Hilton’s law?

A

A sensory nerve supplying a joint also supplies the muscles moving that joint and also innervates the skin overlying the insertions of these muscles

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15
Q

What can cause axillary nerve palsy?

A

1 - Shoulder dislocation

2 - Fracture of surgical neck of humerus

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16
Q

Which muscle becomes atrophied as a result of an axillary nerve palsy?

A

Deltoid

17
Q

What are the contents of the carpal tunnel?

A

Flexor digitorum superficialis x 4 tendons

Flexor digitorum profundus x 4 tendons

Flexor pollicus longus x 1 tendon

Median nerve

18
Q

What are some of the causes of carpal tunnel syndrome?

A

Gout

Rheumatoid

Distal radius fracture

Ganglion

19
Q

What tests can be performed to check for carpal tunnel syndrome?

A

Tinnels (tapping)

Phalens (reverse prayer)

20
Q

What test can be used to check for Ulnar nerve palsies?

A

Froment’s test (grabbing paper)

21
Q

What is the main nerve of the sacral plexus?

A

Sciatic nerve

22
Q

What are the main nerves of the lumbar plexus?

A

Femoral nerve

Obturator nerve

23
Q

Which two nerves does the sciatic nerve split into?

A

1 - Tibial nerve

2 - Common fibular nerve