Nerve palsies in the upper Limbs

Question 1

What cord does the axillary nerve come from

Answer 1

posterior

Question 2

What does axillary nerve wrap round

Answer 2

Wraps around surgical neck of humerus

Question 3

What does axillary nerve supply (motor)

Answer 3

Supplies deltoid and teres minor

Question 4

What does axillary nerve supply (sensory)

Answer 4

What does axillary nerve supply

Question 5

What accidents commonly damage axillary nerve

Answer 5

Nerve can be damaged in shoulder dislocation or fracture surgical neck of humerus

Question 6

What should always be done if you suspect axillary nerve damage

Answer 6

Test regimental badge area to see if axillary nerve is damaged .

Important to work this out early so that the patient can be told their prognosis and work on physiotherapy

Question 7

What cord does radial nerve come from

Answer 7

Posterior

Question 8

What can cause radial nerve palsies

Answer 8

-Can be caught, stretched, transected in compound fractures,

Can be due to pressure….SATURDAY NIGHT PALSY

Question 9

What are symptoms if lesion of radial nerve is in the axilla

Answer 9

loss of elbow extnedion and sensory changes forearm and hand

Question 10

What are symptoms if lesion of radial nerve is in the arm

Answer 10

loss of wrsit extension and sensory loss

Question 11

What are symptoms if lesion of radial nerve is in the forearm

Answer 11

loss of finger extension (PIN) – wrist extension preserved

Question 12

What are symptoms if lesion of radial nerve is at the wrist

Answer 12

: loss of sensation (SRN) eg wearing handcuffs

Question 13

What is characteristic of radial nerve damage

Answer 13

Wrist drop

Question 14

Where is there sensory loss after radial nerve damage

Answer 14

1st web space dorsally

Question 15

What cords make up the median nerve

Answer 15

Medial and lateral

Question 16

What does median nerve supply (motor)

Answer 16

Supples flexors of forearm (apart from FCU and medial half of FDP), LOAF muscles

Question 17

What does median nerve supply (sensation)

Answer 17

Supplies sensation to radial 3.5 digits

Question 18

What artery is median artery closely associated to

Answer 18

brachial artery

Question 19

What causes median nerve palsy

Answer 19

Carpal tunnel syndrome

Wrist lacerations

Question 20

What is a motor deficit of median nerve damage

Answer 20

thenar wasting (monkey hand), 
pointing finger

Question 21

What is a sensory deficit of median nerve damage

Answer 21

volar aspect thumb

Question 22

What can cause carpal tunnel syndrome (broad categories)

Answer 22

Developmental problems
Trauma
Swellings
Inflammation
Metabolic

Question 23

Trauma to where can cause carpal tunnel syndrome

Answer 23

Distal radius fracture

Question 24

What swellings can cause carpal tunnel syndrome

Answer 24

Ganglion
Fibroma
Lipoma

Question 25

what inflammatory conditions can cause carpal tunnel syndrome

Answer 25

Rheumatoid Gout TB Amyloid

Question 26

what metabolic conditions can cause carpal tunnel syndrome

Answer 26

Pregnancy Mucopolysaccharidoses Hypothyroidism

Question 27

What is a feature of carpal tunnel syndrome that can make you consider hypothyroidism

Answer 27

Often thought if bilateral carpal tunnel syndrome

Question 28

What are presenting symptoms of carpal tunnel syndrome

Answer 28

Nocturnal pain and parastehdia in past or all of the median nerve distrucbutoin Wasting of the thenar muscles

Question 29

The power of what muscle do you test for carpal tunnel syndrome

Answer 29

Move | - APB (aductor polingus brevis) power

Question 30

What are some special tests for carpal tunnel syndrome

Answer 30

Tinnels | Phalens

Question 31

What is Tinnels test

Answer 31

Patients area over capral tunnel is tapped with middle finger of other hand

Question 32

What is Phalens test

Answer 32

Palmer flexed and put hands on back of each other

Question 33

What cord supplys ulner nerve

Answer 33

medial cord

Question 34

What muscles does ulnar nerve supply (motor)

Answer 34

Supplies medial half (ulner side) of FDP, FCU and all intrinsic muscles in the hand except LOAF

Question 35

What muscles does ulnar nerve supply (sensory)

Answer 35

Sensation to ulnar 1.5 digits (little finger and ulnar half of ring finger)

Question 36

What can cause damage to ulnar nerve

Answer 36

fracture of humeral condyles & wrist lacerations

Question 37

What is motor deficit from ulnar nerve palsy

Answer 37

Claw hand, hypothenar & 1st dorsal interosseous wasting (1st webspace) Guttering (between other metacarpals)

Question 38

What is sensory deficit from ulnar nerve palsy

Answer 38

Loss of sensation of little finger

Question 39

What are symptoms of cubital tunnel syndrome

Answer 39

Patient has numbness on ulnar side of hand and difficulty with fine tasks because it can affect the motor function of intrinsic muscles of hand

Question 40

What is treatment of cubital tunnel syndrome

Answer 40

Steroid or releasing the tunnel (surgical)

Question 41

What tests are used to examine ulnar nerve palsy

Answer 41

Froments test

Question 42

What is froments test

Answer 42

The patient is asked to make a strong pinch between the thumb and index finger and grip a flat object such as a piece of paper between the thumb and index finger. The examiner then attempts to pull the object out of the subject's hands. There is weakness of the adductor pollicus innervated by the ulnar nerve which would keep the IP joint relatively straight; instead, the FPL muscle which is innervated by the median nerve is substituted for the AP and will cause the IP joint to go into a hyperflexed position.