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Musculoskeletal > Nerve palsies in the upper Limbs > Flashcards

Nerve palsies in the upper Limbs Flashcards

1
Q

What cord does the axillary nerve come from

A

posterior

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2
Q

What does axillary nerve wrap round

A

Wraps around surgical neck of humerus

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3
Q

What does axillary nerve supply (motor)

A

Supplies deltoid and teres minor

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4
Q

What does axillary nerve supply (sensory)

A

What does axillary nerve supply

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5
Q

What accidents commonly damage axillary nerve

A

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

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6
Q

What should always be done if you suspect axillary nerve damage

A

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

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7
Q

What cord does radial nerve come from

A

Posterior

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8
Q

What can cause radial nerve palsies

A

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

Can be due to pressure….SATURDAY NIGHT PALSY

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9
Q

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

A

loss of elbow extnedion and sensory changes forearm and hand

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10
Q

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

A

loss of wrsit extension and sensory loss

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11
Q

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

A

loss of finger extension (PIN) – wrist extension preserved

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12
Q

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

A

: loss of sensation (SRN) eg wearing handcuffs

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13
Q

What is characteristic of radial nerve damage

A

Wrist drop

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14
Q

Where is there sensory loss after radial nerve damage

A

1st web space dorsally

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15
Q

What cords make up the median nerve

A

Medial and lateral

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16
Q

What does median nerve supply (motor)

A

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

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17
Q

What does median nerve supply (sensation)

A

Supplies sensation to radial 3.5 digits

18
Q

What artery is median artery closely associated to

A

brachial artery

19
Q

What causes median nerve palsy

A

Carpal tunnel syndrome

Wrist lacerations

20
Q

What is a motor deficit of median nerve damage

A 
thenar wasting (monkey hand), 
pointing finger
21
Q

What is a sensory deficit of median nerve damage

A

volar aspect thumb

22
Q

What can cause carpal tunnel syndrome (broad categories)

A 
Developmental problems
Trauma
Swellings
Inflammation
Metabolic
23
Q

Trauma to where can cause carpal tunnel syndrome

A

Distal radius fracture

24
Q

What swellings can cause carpal tunnel syndrome

A

Ganglion
Fibroma
Lipoma

25
Q

what inflammatory conditions can cause carpal tunnel syndrome

A

Rheumatoid
Gout
TB
Amyloid

26
Q

what metabolic conditions can cause carpal tunnel syndrome

A

Pregnancy
Mucopolysaccharidoses
Hypothyroidism

27
Q

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

A

Often thought if bilateral carpal tunnel syndrome

28
Q

What are presenting symptoms of carpal tunnel syndrome

A

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

29
Q

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

A

Move

- APB (aductor polingus brevis) power

30
Q

What are some special tests for carpal tunnel syndrome

A

Tinnels

Phalens

31
Q

What is Tinnels test

A

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

32
Q

What is Phalens test

A

Palmer flexed and put hands on back of each other

33
Q

What cord supplys ulner nerve

A

medial cord

34
Q

What muscles does ulnar nerve supply (motor)

A

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

35
Q

What muscles does ulnar nerve supply (sensory)

A

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

36
Q

What can cause damage to ulnar nerve

A

fracture of humeral condyles & wrist lacerations

37
Q

What is motor deficit from ulnar nerve palsy

A

Claw hand,

hypothenar & 1st dorsal interosseous wasting (1st webspace)

Guttering (between other metacarpals)

38
Q

What is sensory deficit from ulnar nerve palsy

A

Loss of sensation of little finger

39
Q

What are symptoms of cubital tunnel syndrome

A

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

40
Q

What is treatment of cubital tunnel syndrome

A

Steroid or releasing the tunnel (surgical)

41
Q

What tests are used to examine ulnar nerve palsy

A

Froments test

42
Q

What is froments test

A

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.

Musculoskeletal (22 decks)

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