Nerves Of UL

Question 1

brachial plexus is formed by the

Answer 1

anterior root of C5, C6, C7, C8 and T1

Question 2

end nerves from brachial plexus

Answer 2

musculocutaneous, axillary, radial, median and ulnar

Question 3

During axillary nodes dissection
(next slide)
two nerves are at the risk of injury.

Answer 3

1- long thoracic nerve to the
serratus anterior,

2- thoracodorsal nerve to the
latissimus dorsi,

Question 4

When there is breast cancer and surgery is done to remove the cancer, they need to remove with it the lymph nodes because they might be involved
* The lymph nodes are in close association with

Answer 4

long thoracic nerve

Question 5

serratous anterior function

Answer 5

fixer of scapula, medial aspect

Question 6

thoracodorsal which supplies

Answer 6

latissimus dorsi

Question 7

latissimus dorsi function

Answer 7

adduction and medial rotation

Question 8

Function of deltoid

Answer 8

Abduct

Question 9

FRACTURES OF THE HUMERUS

Can be

Answer 9

1. Transverse.
2. Spiral.
3. Comminuted.

Question 10

Axillary nerve

Terminal branch of the posterior cord, receiving fibers from

Answer 10

C5

C6

Question 11

AXILLARY NERVE
Pass posteriorly through ————- with posterior circumflex humeral artery, then winds
around surgical neck of humerus.

Answer 11

quadrangular space

Question 12

Axillary nerve supply

Answer 12

-shoulder joint(axilla)
-scapular region;
1)anterior=skin over lower half of deltoid
2)posterior=teres minor
=deltoid
=upper lateral cutaneous nerve of arm to skin over lower half of deltoid

Question 13

SHOULDER QUADRILATERAL SPACE SYNDROME
Happens when ?
Causes?

Answer 13

-Axillary nerve compressed/injured in the back of the shoulder
From overuse,+hypertrophy(carrying a lot of weight)
especially with overhead sports like
throwing and swimming. (anything that comprimises or pressures this space)
-injury, like a shoulder dislocation.

Question 14

SHOULDER QUADRILATERAL SPACE SYNDROME

Symptoms sometimes can be caused by

Answer 14

compression of an artery in the same

area

Question 15

MUSCULOCUTANEOUS NERVE

One of the terminal branches of the
—— cord.

Receiving fibers from?

Answer 15

lateral

C5,6,C7.

Question 16

MUSCULOCUTANEOUS NERVE

Supplies muscle

Answer 16

Muscles of anterior compartment (**flexor)

Question 17

MUSCULOCUTANEOUS NERVE

Becomes ————

Answer 17

lateral cutaneous nerve
of the forearm.
*so if injured *loss sensation of lateral aspect of forearm)

Question 18

MUSCULOCUTANEOUS NERVE
Supplies muscles?
And

Answer 18

• coracobrachialis(axilla)
• biceps(upper arm)
• brachial (upper arm)
• elbow joint(upper arm)
• lateral cutaneous nerve(forearm)
• Sensation of forearm from elbow to wrist

Question 19

Biceps function

Answer 19

Supination

*so in musculotaneous nerve injury =loss of biceps=lweakend not loss of supination

Question 20

lweakend not loss of supination in MUSCULOCUTANEOUS NERVE

Injury

Answer 20

BRACHIORADIALIS

Question 21

MUSCULOCUTANEOUS NERVE

If it happen after supplying the muscle then

Answer 21

the function muscle normal but there is loss of sensation in lateral aspect)

Question 22

RADIAL NERVE

Continuation of the ——— cord.

Receiving fibers from——-

Answer 22

posterior

C5-C8 & T1.

Question 23

Radial nerve supplies

Answer 23

Deep branch supplies muscle of the posterior (extensor) compartment.
1)axilla=post. Cutaneous nerve of arm
2)upper arm=
Triceps(long,medial,lateral head)
Brachial is
BRACHIORADIALIS *****exception bcz it’s ant muscle(flexor)
Extensor carpi
Elbow joint
3)forearm =
-Superficial branch: skin of lateral side of dorsum of hand and lateral 31/2 fingers
-Deep branch:

Question 24

Radial nerve injured at spinal groove will affect

Answer 24

Triceps
Patient cannot extend his arm
Loss sensation ot back of ar,

Question 25

• The deep branch of the radial nerve passes between the —————le as it leaves the cubital fossa

Answer 25

two heads of the supinator muscle

Question 26

Median nerve originate from the terminal branch of

Answer 26

lateral (C6,

C7) and medial cord (C8, T1).

Question 27

Hand of Benedict seen when ask patient with median nerve injury to ——— and the result

Answer 27

Make a fist

Question 28

What causes hand of Benedict

Answer 28

Median nerve injury =loss of flexor digitorum profundus

Question 29

Hand of benediction

Answer 29

1) Flexion of the
proximal interphalangeal joint of the 1st-3rd
digits is lost (FDS)
1*)4th &5th weakened.

(Flex 2nd and 3rd metacarpophalangeal joint lost (1st and 2nd lumbricals)

2) Flexion of the distal interphalangeal joint of
the 2nd &3rd is lost (FDP)
2*)flexion of the distal interphalangeal joint of the 4th and 5th is not affected (unar nerve=FDP)

Question 30

Ape hand

Answer 30

median nerve injury at
the wrist joint.
Function of thenar muscle is affected

Question 31

CARPAL TUNEL SYNDROME

Answer 31

median nerve compromise

-thenar muscle atrophied (no flex no opposition)

Question 32

Pronator syndrome

Answer 32

Compression by pronator teres

Ask patenit to pronator against resistance

Question 33

Ulnar nerve injuries usually occur in 4 places:

Answer 33

1. Posterior to the medial epichondyle of humerus
2. In the cubital tunnel formed by the tendinous arch connecting the humeral and ulnar heads
   of FCU. flexor carpi ulnaris
3. At the wrist.
4. In the hand.between pisiform and hook of hamate (4) to supply hypothenar muscles

Question 34

Claw hands

Answer 34

1) hyperextension posteriorly
2) loss of function of lumbricals
3) flexor carpi ulnaris lost its function (adduct the hand) so slightly abducted hand

Question 35

SUPERIOR TRUNK INJURIES

Answer 35

Re sults in paralysis of the muscle of the shoulder and arm supplied by the C5and C6 spinal
nerve (deltoid, Biceps, brachialis, and brachioradialis).

Question 36

Wh at type of accident may lead to superior trunk injuries?

And most affected nerve ?

Answer 36

1) when head of the baby is pulled and angle increased
2) falling, head is pulled away from shoulder

Axillary

Question 37

Nerves affected in brachial plexus injuries

Answer 37

1) axillary lost ;
- supplies teres minor (lateral rotation) and deltoid (abduction) these two lost
2) musculocutaneous is defected
3) suprascapular nerve (supplies supraspinatous and infraspinatous which cause abduction and lateral rotation) lost completely

4) little bit of radial function;
- extension cant fully happen, hand is slightly flexed (Waiter’s tip)

Question 38

Erb-Duchenne (Waiter’s tip)

Answer 38

Paralysis of the muscles of the
shoulder and arm supplied by
the C5 & C6 spinal nerve occurs:
deltoid, biceps, and brachialis.

Question 39

Erb-Duchenne (Waiter’s tip)

Clinical appearance

Answer 39

-upper limb with adducted shoulder
-medially rotated arm
-extended elbow
-lateral aspect of the forearm
experience some loss of
sensation.

Question 40

INFERIOR TRUNK INJURIES

Result in

Answer 40

paralysis of the muscle of the forearm and hand supplied by the C8and T1 spinal
nerve.

Question 41

What type of accident may lead to inferior trunk injuries?

Answer 41

falls down hanging

Question 42

nerve that is mainly affected in lower brachial injuries

Answer 42

Ulnar

Question 43

cords are impinged or

compressed between

Answer 43

coracoid process of the
scapula and the pectoralis
minor tendon.

Question 44

COMPRESSIONS OF THE CORDS OF THE BRACHIAL PLEXUS

Result in

Answer 44

prolonged
hyperabduction of the arm
during performance of
manual task.

Question 45

examine C8

Answer 45

flexion of digit

Question 46

examining T1

Answer 46

abduction and adduction of digit

Question 47

Flexion of elbow

Extension of elbow

Answer 47

C5,6

C6,7,8