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PBL Week 11 > Nerves of upper limb > Flashcards

Nerves of upper limb Flashcards

1
Q

What are the nerves of the upper limb?

A
  1. Musculocutaneous nerve
  2. Axillary nerve
  3. Radial nerve
  4. Median nerve
  5. Ulnar nerve
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2
Q

Dermatome map for upper limb?

A

Very important! learn this!

NOTE: https://www.notion.so/Nerves-of-upper-limb-8216d9e1c8624bfe95137c7a27cbb265

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3
Q

Mytome map for upper limb?

A

Very important! learn this!

NOTE: https://www.notion.so/Nerves-of-upper-limb-8216d9e1c8624bfe95137c7a27cbb265

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4
Q

What is the origin of the musculocutaneous nerve?

A

C5/ C6/ C7

Anterior division of superior & middle trunks > lateral cord

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5
Q

What is the course of the musculocutenous nerve?

A

Pierces coracobrachialis & passed down anterior compartment of arm beneath biceps muscle

then becomes lateral cutaneous nerve of forearm

NOTE: https://www.notion.so/PBL-week-11-92f7a1365c35422b8d2810696c535658

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6
Q

What is the sensory and motor function of muscolcutaneous nerve?

A

Sensory function (skin- touch):
- supplies skin oflateral forearm.

Motor function (movement):
- Biceps brachii -flexes elbow, supinates forearm.
- Brachialis -flexes elbow.
- Coracobrachialis - flexes & adducts the arm at the glenohumeral joint.

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7
Q

What are common injuries to the musculocutaneous nerve?

A

Injuries rare as protected by bulk of bicep muscle

Stab wounds to upper arms

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8
Q

What are the results of the injury to the musculocutaneous nerve?

A

Sensory loss:
- numb lateral forearm

Motor deficit:
- weak elbow flexion
- wear forearm supination
- absent biceps reflex

Deformity:
- wasting of biceps

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9
Q

What is the origin of the axillary nerve?

A

C5/ C6

posterior division of superior trunk > posterior cord

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10
Q

What is the course of the axillary nerve?

A

Passes beneath shoulder joint into posterior compartment of arm

then wraps around surgical neck of humerus

NOTE: know the difference between surgical & actual neck of humerus

NOTE: https://www.notion.so/PBL-week-11-92f7a1365c35422b8d2810696c535658

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11
Q

What is the sensory and motor function of the axillary nerve?

A

Sensory function:
- sergeants patch over lover deltoid

Motor function:
- deltoid
- teres minor

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12
Q

What are the common injuries of the axillary nerve?

A

fracture of the surgical neck of humerus

stab wounds to posterior shoulder

compression by shoulder dislocation or pressure of crutches on armpits

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13
Q

What are the results of the injury to the axillary nerve?

A

Sensory loss:
- numb seargents patch

Motor deficit:
- weak shoulder abduction from 15-90
- weak shoulder flexion
- weak shoulder extension
- weak shoulder external rotation

Deformity:
- wasting of deltoid

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14
Q

What is the origin of the radial nerve?

A

C5/ C6/ C7/ C8/ T1

posterior division of superior, middle & inferior trunks > posterior cord

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15
Q

What is the course of the radial nerve?

A

winds around spinal groove of humerus, passes through ACF into forearm then divides into 2 terminal branches; superficial & deep/ posterior interosseous

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16
Q

What is the sensory and motor function of the radial nerve?

A

Sensory:
- lower posterior arm
- posterior forearm
- lateral 2/3 dorsal of hands
- proximal dorsal aspect of lateral 3 1/2 fingers

Motor function:
- Posterior compartment of arm- tricep brachii
- posterior compartment of forearm- wrist extensors, finger extensors, brachioradialis & supinator

17
Q

What are the common injuries of the radial nerve?

A

fracture of proximal humerus, humeral shaft or proximal radius

stab wound to ACF/ forearm/ wrist

compression by pressure of crutches on armpits, falling asleep on arm, tight pressure cast or prolonged torquiest use

18
Q

What are the results of injury to the radial nerve?

A

Sensory loss:
- numb posterior arm & forearm
- numb radial distribution of hand

Motor deficit:
- weak elbow extension
- absent triceps reflex
- weak wrist extension
- weak finger MCP joint extension
- absent supinator reflex

Deformity:
- wrist drop on attempted wrist extension
- wasting of triceps & posterior compartment of forearm

19
Q

What is the origin of the median nerve?

A

C5/ C6/ C7/ C8/ T1

lateral root from anterior divisions of superior & middle trunks to lateral cord

Medial root from anterior division of inferior trunk to medial cord

20
Q

What is the course of the median nerve?

A

runs down arm w. brachial arm, passed through ACF into forearm & divides into 3 terminal branches; anterior interosseous, deep & superficial/ palmar cutaneous

21
Q

What is the sensory and motor function of the median nerve?

A

Sensory:
- Thenar eminence
- Lateral ⅔ palm of hand
- Palmar aspect lateral 3½ fingers
- Digital dorsal aspect of lateral 3½ fingers

NOTE: view image on notes

Motor function- supplies all muscles ofanterior compartment of forearmexcept flexor carpi ulnaris & medial part of flexor digitorum profundus:
- Flexor carpi radialis
- Palmaris longus
- Pronator teres
- Flexor digitorum superficialis
- Flexor pollicis longus
- Pronator quadratus
- Lateral half of flexor digitorum profundus

LOAF muscles of hand:
- Lateral two lumbricals
- Opponens pollicis
- Abductor pollicis brevis
- Flexor pollicis brevis

22
Q

What are common injuries of the median nerve?

A

supracondylar fracture of humerus

stab wound to ACF/ forearm/ wrist

Wrist lacerations in deliberate self arm

compression at carpal tunnel in wrist

23
Q

What are the results of injury to the median nerve?

A

Sensory loss:
- numb thenar eminence
- numb median distribution of hand

Motore deficit:
- wrist forearm pronation
- weak wrist flexion
- weak wrist abduction
- weak finger flexion- ring & little finger DIP joints preserved
- weak grip strength & opsonisation

Deformity:
- hand of benediction on attempted finger flexion - i.e.cant flex 1st 3 fingers
- wasting of anterior forearm & thenar eminence

NOTE: view image on hand of benediction & claw hand

24
Q

What is the origin of the ulnar nerve?

A

C8/ T1

anterior division of inferior trunk > medial cord

25
Q

What is the course of the ulnar nerve?

A

runs down arm w/ brachial artery, passes behind medial epicondyle into forearm, then travels down anterior compartment w/ ulnar artery to enter palm of hand via guyon’s canal

26
Q

What is the sensory and motor function fo the ulnar nerve?

A

Sensory function:
- Hypothenar eminence
- Medial ⅓ palm of hand
- Palmar aspect medial 1 ½ fingers
- Dorsal aspect of medial 1 ½ fingers
- Medial ⅓ dorsum of hand

NOTE: view image on notes

Motor function:
2 muscles in anterior compartment of forearm
- Flexor carpi ulnaris
- Medial part of flexor digitorum profundus

HILA muscles of hand
- Hypothenar eminence - abductor digiti mini, opponens digiti minimi, flexor digiti minimi brevis and palmaris brevis.
-Interossei
- Lumbricals (medial two)
- Adductor pollicis**

27
Q

What are common injuries of the ulnar nerve?

A

Supracondylar fracture of humerus

medial epicondylar fracture or injury

stab wound to forearm/ wrist

compression at cubital tunnel in elbow

28
Q

What is the result of injury to the ulnar nerve?

A

Sensory loss:
- numb hypothenar eminence
- numb ulnar distribution of hand

Motor deficit:
- weak wrist flexion
- weak wrist adduction
- weak flexion of ring & little finger MCP & DIP joints & weak extension at their IP joints
- weak finger abduction, adduction & opposition

Deformity:
- claw hand- cannot extend 4th & 5th finger

  • wasting of hypothenar eminence & intrinsic muscles of hands

PBL Week 11 (12 decks)

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