Nerve palsies in the limbs Flashcards
what are the clinical signs of axillary nerve damage?
unable to flex, extend and abduct the arm fully
deltoid muscle wasting
loss of sensation to the lateral side of shoulder
what are the clinical signs of radial nerve damage ?
wrist drop as it innervates the extensor muscles of the arm, wrist and hand
but the presentation varies if it is damaged more distally
what are the clinical signs of ulnar nerve damage?
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
what are the clinical signs of damage to the median nerve?
nocturnal pain and paraesthesia to the long and index fingers
wasting of the thenar muscles
what is erbs palsy?
damage to the superior trunk of brachial plexus - C5,C6 roots
shoulder is adducted and medially rotated
elbow is extended and pronated
wrist flexed
what is klumpkes palsy?
damage to the inferior trunk of the brachial plexus (C8, T1)
affects small muscles of the hand creating a clawed appearance
(cannot extend fingers)
what nerve supplies the elbow joint?
musculocutaneous nerve
what muscles does the axillary nerve supply?
teres minor
deltoid
skin overlying the lateral side of arm
what nerve supplies the extensors of the arm?
radial nerve
how can you get radial nerve palsy?
entrapment with a mid shaft fracture of the humerus
compression i.e. falling a sleeping with arm hanging over a chair
what are the clinical signs if the radial nerve is damaged at the….
a) Axilla ?
b) Arm ?
c) Forearm ?
d) Wrist ?
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
what muscles does the median nerve supply?
flexors of forearm
what are the contents of the carpal tunnel?
9 tendons + median nerve
flexor digitorum superficialis tendons (x4)
flexor digitorum profundus tendons (x4)
flexor pollicis longus tendon (x1)
what are the causes of carpal tunnel syndrome?
idiopathic inflammatory - rheumatoid - gout - amyloid metabolic - pregnancy - hypothyroidism - mucopolysacharidosis swellings - ganglion - lipoma - fibroma trauma - distal radius fracture
what tests can you carry out to confirm carpal tunnel syndrome?
tinnels
phalens
what test can be carried out to confirm ulnar nerve damage?
froment’s test
what are the roots of the sacral plexus?
L4 - S4
what muscles does the superior and inferior gluteal nerve supply?
superior supplies gluteus medius, minimus and TFL
inferior nerve supplies gluteus maximus
what nerves make up the sciatic nerve?
tibial nerve
common peroneal nerve
what nerves supply the anterior, posterior and lateral compartments of the leg?
anterior - deep peroneal nerve
posterior - sciatic nerve
lateral - superficial peroneal nerve
what nerve is prone to injury if there is a fracture at the proximal part of the fibula?
common peroneal nerve
if there is damage to the common peroneal nerve what clinical sign would be present?
foot drop
impairs dorsiflexion
what is meralgia parasthetica?
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
a patient presents with numbness of the lateral aspect of her thigh.
what is the diagnosis ?
neuralgia paresthetica
entrapment of the lateral femoral cutaneous nerve
