overview of upper limb

Question 1

what allows the upper limb to move

Answer 1

shoulder, large range of movement, wide area

Question 2

what do the muscles of the shoulder do for the upper limb

Answer 2

allow it to move and can anchor it to trunk

Question 3

where do the muscles that move the fingers originate?

Answer 3

intrinsic muscles in the hand for fine fine movement

extrinsic in forearm for power

Question 4

What are the two main types of grip

Answer 4

power grips and precision grips

Question 5

which grips are most primitive?

Answer 5

power grips and present in new born babies

Question 6

What do hypothenar muscles do in power grips

Answer 6

stabilise medial side of palm against handle

Question 7

What do wrist extensors do in power grips

Answer 7

provide a stable base

Question 8

What types of grips are examples of power grips

Answer 8

cylindrical, spherical, hook, lateral prehension

Question 9

What muscles are used in precision grips

Answer 9

intrinsic muscles cooperate with long flexor and extensor muscles (extrinsic) to give a more complex movement holding objecting between tip of thumb and finger(s)

Question 10

When will precision grip develop?

Answer 10

9 months of age

Question 11

what types of grips are precision?

Answer 11

plate pinch key or pincer

Question 12

what are the subgroups of power grips and what is the difference between them

Answer 12

prehensile where thumb is involved or non prehensile where thumb isn’t involved

Question 13

what is an example of a non prehensile grip

Answer 13

hook

Question 14

What will cause damage to the radial nerve

Answer 14

fracture to mid shaft of humerus

Question 15

What groove does the radial groove run in

Answer 15

spiral groove, or radial groove

Question 16

what is the main symptom of radial nerve injury and why

Answer 16

wrist drop as no extension of wrist and digits as no action of FDS and FDP

Question 17

what is Saturday night palsy caused by

Answer 17

radial nerve in armpit or upper arm compressed or stretched due to falling asleep with arm hanging

Question 18

what happens after radial nerve injury

Answer 18

nerves will regrow and repair

Question 19

what is the only area which is purely radial nerve

Answer 19

thumb and first finger web of skin so if damaged get loss of sensory feeling here

Question 20

What is the cause of radial nerve palsy in newborns and symptoms

Answer 20

prolonged pressure of inferior arm through labour stretching nerve in armpit
wrist drop
unable to extend thumb and MCP of all digits
weak elbow extension

Question 21

Where is the median nerve at risk of damage

Answer 21

as it comes into cubital fossa - supra condular humerus fracture, oeverything below loses innervation

Question 22

what happens when you ask a high median nerve injury patient to make a fist

Answer 22

hand of benediction
index and middle won’t flex and thumb doesn’t move
4th and 5th DIP can flex as ulnar nerve inner area medial FDP and FCU

Question 23

what is low median nerve injury example

Answer 23

carpal tunnel syndrome
reduces size of carpal tunnel can compress median nerve
progressive loss of coordination and strength in thumb

Question 24

if you ask a low median nerve injury patient to close their fist what happens

Answer 24

they can weakly close fingers and thumb as FPL works but thenar muscles to thumb are not working as not innervated

Question 25

Where is the most likely place where the ulnar nerve will be injured?

Answer 25

medial epicondyle if humerus

Question 26

What does ulnar nerve lead to? symptoms?

Answer 26

clawhand

Question 27

Why is there an ulnar paradox

Answer 27

in high nerve injury, clawing of the hand looks more subtle whereas high nerve injury indicates worse muscle damage

Question 28

What is the difference between high and low ulnar nerve palsy?

Answer 28

high - all muscles lost and get cubital tunnel syndrome

low - FDP pulls digits 4 and 5 into flexion, Guyon’s canal syndrome