Nerve palsies in the limbs

Question 1

what are the clinical signs of axillary nerve damage?

Answer 1

unable to flex, extend and abduct the arm fully
deltoid muscle wasting
loss of sensation to the lateral side of shoulder

Question 2

what are the clinical signs of radial nerve damage ?

Answer 2

wrist drop as it innervates the extensor muscles of the arm, wrist and hand
but the presentation varies if it is damaged more distally

Question 3

what are the clinical signs of ulnar nerve damage?

Answer 3

paraesthesia of the little and wring fingers
wasting of the 1st web space - hypothenar wasting
ulnar claw hand - flexion at the IPJ of wring and little finger with hyperextension at MCPJ of long and index fingers

Question 4

what are the clinical signs of damage to the median nerve?

Answer 4

nocturnal pain and paraesthesia to the long and index fingers

wasting of the thenar muscles

Question 5

what is erbs palsy?

Answer 5

damage to the superior trunk of brachial plexus - C5,C6 roots
shoulder is adducted and medially rotated
elbow is extended and pronated
wrist flexed

Question 6

what is klumpkes palsy?

Answer 6

damage to the inferior trunk of the brachial plexus (C8, T1)
affects small muscles of the hand creating a clawed appearance
(cannot extend fingers)

Question 7

what nerve supplies the elbow joint?

Answer 7

musculocutaneous nerve

Question 8

what muscles does the axillary nerve supply?

Answer 8

teres minor
deltoid
skin overlying the lateral side of arm

Question 9

what nerve supplies the extensors of the arm?

Answer 9

radial nerve

Question 10

how can you get radial nerve palsy?

Answer 10

entrapment with a mid shaft fracture of the humerus

compression i.e. falling a sleeping with arm hanging over a chair

Question 11

what are the clinical signs if the radial nerve is damaged at the….

a) Axilla ?
b) Arm ?
c) Forearm ?
d) Wrist ?

Answer 11

a) lack of elbow and wrist extension, sensory loss of parts of the hand
b) loss of wrist extension and sensory loss
c) loss of sensation

Question 12

what muscles does the median nerve supply?

Answer 12

flexors of forearm

Question 13

what are the contents of the carpal tunnel?

Answer 13

9 tendons + median nerve
flexor digitorum superficialis tendons (x4)
flexor digitorum profundus tendons (x4)
flexor pollicis longus tendon (x1)

Question 14

what are the causes of carpal tunnel syndrome?

Answer 14

idiopathic 
inflammatory 
- rheumatoid
- gout
- amyloid
metabolic 
- pregnancy
- hypothyroidism
- mucopolysacharidosis
swellings
- ganglion
- lipoma
- fibroma 
trauma
- distal radius fracture

Question 15

what tests can you carry out to confirm carpal tunnel syndrome?

Answer 15

tinnels

phalens

Question 16

what test can be carried out to confirm ulnar nerve damage?

Answer 16

froment’s test

Question 17

what are the roots of the sacral plexus?

Answer 17

L4 - S4

Question 18

what muscles does the superior and inferior gluteal nerve supply?

Answer 18

superior supplies gluteus medius, minimus and TFL

inferior nerve supplies gluteus maximus

Question 19

what nerves make up the sciatic nerve?

Answer 19

tibial nerve

common peroneal nerve

Question 20

what nerves supply the anterior, posterior and lateral compartments of the leg?

Answer 20

anterior - deep peroneal nerve
posterior - sciatic nerve
lateral - superficial peroneal nerve

Question 21

what nerve is prone to injury if there is a fracture at the proximal part of the fibula?

Answer 21

common peroneal nerve

Question 22

if there is damage to the common peroneal nerve what clinical sign would be present?

Answer 22

foot drop

impairs dorsiflexion

Question 23

what is meralgia parasthetica?

Answer 23

altered sensation and pain in the lateral compartment of the thigh
compression of the lateral femoral cutaneous nerve of the thigh as it travels under the border of the inguinal ligament

Question 24

a patient presents with numbness of the lateral aspect of her thigh.
what is the diagnosis ?

Answer 24

neuralgia paresthetica

entrapment of the lateral femoral cutaneous nerve