Neuropathies Flashcards
Lesions of the upper trunk of brachial plexus
Erb-Duchenne Palsy “Waiters tip”
common in MVA
Nerves affected:
1. suprascapular nerve (supra, infra with shoulder abd and ER affected)
- subclavuis nerve (subclavius with clavice depression affected)
- musculocutaneous nerve (coracobrachialis, brachialis, and biceps brachii with shoulder flexion, elbow flexion, and supination affected. Also sensory loss on lateral forearm)
- axillary nerve (deltoid and teres minor mm, shoulder abductio and ER affected. Sensory loss on lateral arm over lower deltoid)
Lesions of the lower trunk of brachial plexus
Klumpke Palsy “claw hand”
common from stopping a fall by grabbing something and fro cervical rib
Nerves affected:
1. Ulnar (small muscles of hand except 1 & 2 lumbricals and thenar. Finger flexion, abduction, adduction, opposition affected. Also sensory loss over medial palm)
- Median (thenar muscles and lumbricals 1 & 2. Finger flexion, adduction, abduction, and opposition. Sensory loss over lateral palm)
Axillary nerve injury
Causes include pressure in shoulder joint and dislocation of shoulder joint
Deltoid and teres minor affected-shoudler abduction.
Sensory loss over lateral lower deltoid
Long thoracic nerve injury
Causes include penetrating wound of the neck and complication of radial masectomy
“winged scapula”
Serratus anterior affected- rotation of scapula
Median nerve injury at the elbow
Cause includes supracondylar fracture
“hand of benediction”
Muscles affeced- pronators, long flexors and thenaer muscles and lumbricals 1 and 2
Sensory loss over lateral palm
Median nerve injury at the wrist
Caused by penetrating wounds of the wrist
“ape hand”
Muscles affected- thenar muscles and 1 & 2 lumbricals
Sensory loss over lateral palm
Median nerve injury at the carpal tunnel
Caused by repetitive motion
“Carpal tunnel syndrome”
Muscles affected- thenar muscles and lumbricals 1 & 2
Radial nerve injury at the axilla
Causes by pressure in the axilla
“wrist drop”
Muscles affected- wrist extensors
Sensory loss- variable on posterior arm and forearm, and dorsal hand
Ulnar nerve injury at the elbow
Causes by fracture of the medial epicondyle
“claw hand”
muscles affected- FCU, 1/2 FDP (reduced flx of finger and little finger) and all small muscles of the hand except thenar and 1 &2 lumbricals (inability to abduct and adduct fingers and adduct thumb)
Sensory loss over medial hand (palmar and dorsal)
Distal (peripheral nerve)
numbness > paresthesia (pins and needles) > pain
Nerve trunk
paresthesia > numbness > pain
Nerve root
pain > paresthesia> numbess
spinal cord
completely painless (sometimes dural pain)
extrasegmentally and bilaterally distributed paresthesia
myotomes
group of muscles that a single nerve root innervates. However, each muscle is innervate b more than one nerve root.
