Nerve Palsies of the Limbs

Question 1

Myotone C5

Answer 1

Elbow Flexors

Question 2

Myotone C6

Answer 2

Wrist Extensors

Question 3

Myotone C7

Answer 3

Elbow Extensors

Question 4

Myotone C8

Answer 4

Finger Extensors

Question 5

Myotone T1

Answer 5

Instrinsic Hand muscles

Question 6

Myotone L2

Answer 6

Hip Flexors

Question 7

Myotone L3

Answer 7

Knee Extensors

Question 8

Myotone L4

Answer 8

Ankle Dorsiflexors

Question 9

Myotone L5

Answer 9

Long toe Extensors

Question 10

Myotone S1

Answer 10

Ankle Plantar Flexors

Question 11

Erbs Palsy occurs due to damage of what nerve roots

Answer 11

C5/6

Question 12

What is the usual cause of Erbs Palsy

Answer 12

Stretching of the brachial plexus due to traction of the infants shoulder during childbirth

Question 13

Clinical sign of Erbs Palsy

Answer 13

Waiters Tip Position: The shoulder is adducted and internally rotated. The elbow is extended and pronated and the wrist is flexed.

Question 14

Klumpkes Palsy

Answer 14

This is traction of the C8/T1 nerve root which affects the small muscles of the hand resulting in “claw hand”

Question 15

Hiltons Law

Answer 15

A sensory nerve supplying a joint also supplies the muscles moving the joint and the skin overlying the insertions of these muscles

Question 16

Axillary Nerve Palsy

Answer 16

Occurs due to shoulder dislocation or fracture of the surgical neck of the humerus. The patient presents with deltoid atrophy and loss of sensation over the badge area.

Question 17

Radial Nerve Palsy

Answer 17

Occurs due to entrapment or compression. The symptoms depend on the site of the lesion.

Question 18

Radial nerve palsy axilla

Answer 18

Loss of elbow extension, wrist extension and sensory changes in the forearm and the hand.

Question 19

Radial nerve palsy arm

Answer 19

Loss of wrist extension and sensory loss

Question 20

Radial nerve palsy forearm

Answer 20

Loss of finger extension

Question 21

Radial nerve palsy wrist

Answer 21

Loss of sensation over the handcuff area

Question 22

Carpal Tunnel anatomy

Answer 22

• Floor: carpal bones
• Roof: flexor retinaculum
Contents: FDS x4, FDP x4, FPL and median nerve ie. 9 tendons and a

Question 23

Causes of Carpal Tunnel Syndrome

Answer 23

Developmental
Distal radial fracture
Ganglion, fibroma, lipoma
Rheumatoid arthritis, gout, TB, amyloidosis
Pregnancy, hypothyroidism, mucopolysaccharidosis

Question 24

Presentation of Carpal Tunnel Syndrome

Answer 24

Nocturnal pain and paraesthesia in part or all of the median nerve. Wasting of the thenar muscles.

Tinnels and Phalens Test.

Question 25

Cubital Tunnel

Answer 25

Cubital tunnel is between the medial epicondyle and olecranon, with fascial bands from FCU as roof

Question 26

Presentation of Cubital Tunnel Syndrome

Answer 26

Numbness on the ulnar side of the hands and difficulty with fine tasks. Wasting of muscles in the 1st web space, guttering and hypothenar wasting. Ulnar Claw Hand - hyperextension at MCPJ and flexion at IPJ's

Question 27

Ulnar Paradox

Answer 27

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

Question 28

Signs of common peroneal nerve entraptment

Answer 28

Foot drop (impaired dorsiflexion of the foot)

Question 29

Meralgia Paraesthetica

Answer 29

Altered sensation and pain in the lateral thigh due to compression of the lateral femoral cutaneous nerve of the thigh as it travels under the lateral border of the inguinal ligament