Nerve Palsies in the Limbs Flashcards

Question

What is Saturday night palsy?

Answer 1

Compression of the radial nerve by falling asleep with your arm hung over the back of a chair.

Answer 2

Compression of the radial nerve by someone else falling asleep on your arm.

Answer 3

Paralysis of the arm/hand due to constant compression of the radial nerve, for example when using a crutch.

Answer 4

Depend on site of lesion: Axilla - loss of elbow extension, wrist extension and sensory changes in forearm and hand. Arm - loss of wrist extension and sensory loss. Forearm - loss of finger extension Wrist - loss of sensation

Answer 5

Median and lateral cords Supplies the flexors for forearm bar flexor carper ulnas and medial half of flexor digitorum profundus, and LOAF muscles. Supplies sensation to radial 3.5 digits.

Answer 6

Lateral two lumbricals Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis

Answer 7

4 tendons of Flexor Digitorum Superficialis. 4 tendons of Flexor Digitorum Profundus. 1 tendon of Flexor Pollicis Longus Median nerve

Answer 8

``` Floor = Carpal bones Roof = Flexor retinaculum ```

Answer 9

Developmental Trauma - distal radius fracture. Swellings - ganglion, fibroma, lipoma. Inflammatory - rheumatoid, gout, tuberculosis, amyloid. Metabolic - pregnancy, mucopolysaccharidoses, hypothyroidism.

Answer 10

Nocturnal pain and parasthesia in part or all of median nerve distribution. Wasting of the thenar muscles. Due to compression of the median nerve as it passes into wrist.

Answer 11

Look - thenar wasting, previous scars, deformity (previous fracture). Feel - sensation lost Move - APB power reduced Special tests - tinnels and phalens

Answer 12

Medial cord NO branches in the forearm. Enters forearm between 2 heads of flexor carpi ulnaris. Supplies medial half of Flexor digitorum profundus, flexor carpi ulnas and all intrinsic muscles in hand bar LOAF muscles. Sensation to ulnar to 1.5 digits.

Answer 13

2nd most common nerve emtrapment. Entraped ulnar nerve. Cubital tunnel lies between medial epicondyle and olecranon, with fascial bands from flexor carpi ulnaris as the roof. Patient has numbness on ulnar side of hand and difficulty with fine tasks.

Answer 14

1st webspace Guttering (wasting of interossei) Hypothenar wasting

Answer 15

Hyperextension at the MCPJ and flexion at interpharyngeal joints.

Answer 16

When a distal lesion has worse clawing than a proximal lesion due to intact long flexors with a distal lesion.

Answer 17

Tests the strength of adductor pollicis supplied by ulnar nerve. Patient is asked to pinch grip something e.g a newspaper. Test is Froment's positive if the patient uses the FPL instead of adductor pollicis.

Answer 18

Ventral rami of L4 to S4. Superior gluteal nerve supplies gluteus Medius and tensor fascia latae. Inferior gluteal nerve supplies gluteus maximus. Main branch is Sciatic nerve which supplies posterior thigh, leg and foot muscles.

Answer 19

Main branch of sacral plexus. Made up of tibial nerve and common peroneal nerve. Supplies the hamstring muscles in posterior compartment of thigh.

Answer 20

Wraps around neck of fibula. Divides into deep peroneal nerve which supplies anterior compartment of leg, and superficial peroneal nerve which supplies later compartment of leg.

Answer 21

Foot drop - damage to peroneal nerve impairs dorsiflexion of the foot. Ability to raise foot is lost.

Answer 22

Femoral Obturator Lateral femoral cutaneous nerve.

Answer 23

Compression of Lateral Femoral Cutaneous nerve of thigh as it travels under lateral border of inguinal ligament. Results in altered sensation and pain in lateral thigh.