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anatomy - physio > peripheral nerve injuries > Flashcards

peripheral nerve injuries Flashcards

1
Q

what nerve roots are damaged in erbs palsy (upper brachial plexus injury)?

A

C5 and C6

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2
Q

what nerve roots are damaged in klumpke’s paralysis (lower brachial pleus injury)?

A
  • C8 & T1
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3
Q

what roots does the long thoracic nerve come off?

A

C5, C6, C7

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4
Q

what can cause erbs palsy?

A

widening of the angle between the neck and shoulder

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5
Q

what is the deformity seen with erbs palsy & why?

A
  • waiters tip
  • C5 & C6 damaged - lateral cord damaged - musculocutaneous and median nerve damaged - unable to flex arm and forarm and wrist - so arm 7 wrsit stays in an extended position
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6
Q

what can cause klumpke’s paralysis?

A

an increased angle between the trunk and arm

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7
Q

what deformity is seen with klumpke’s paralysis?

A

a claw hand

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8
Q

what structures does the median nerve provide motor innervation/ function to?

A
  • flexor muscles in forearm EXCEPT FCU and 1/2 of FDP
  • first & second lumbricals
  • muscles of thenar eminence (thumb) - OAF
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9
Q

what would a disability of the median nerve look like - what symptoms might the patient have?

A
  • wasting of thenar eminence
  • ape like hand
  • loss of opponens muscle
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10
Q

what is a good test to test for median nerve injury?

A
  • ask the patient to oppose their thumb - they should be unable to with a median nerve injury
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11
Q

what are examples of situations that could cause a median nerve injury?

A
  • laceration (cut) at elbow
  • fractures at elbow
  • laceration at the wrist
  • carpel tunnel syndrome (compression of the median nerve)
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12
Q

what kind of symptoms can be seen with carpal tunnel syndrome?

A
  • pins and needles
  • burning pain
  • possible wasting of thenar eminence over time
  • most patients with this syndrome have normal power and may have symptoms but no signs
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13
Q

what muscles does the ulnar nerve provide motor innervation to?

A
  • flexor carpi ulnaris and 1/2 of FDP
  • hypothenar eminence
  • interossei muscles
  • adductor pollicis
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14
Q

what are examples of ulnar nerve motor disability symptoms?

A
  • partial claw hand
  • wasting of the hypothenar eminence
  • wasting of the interossei
  • loss of DAB & PAD
  • loss of adduction of thumb
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15
Q

what is a partial claw hand?

A

partial clawing of the litte and ring finger

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16
Q

how can the adductor pollicus muscle be tested?

A
  • froments test
  • ask the patient to pinch a piece of paper between the thumb and index finger
  • if an ulnar nerve injury is present, the patient will flex their thumb - showing weakness of adductor pollicis
17
Q

what is the ulnar nerve paradox?

A
  • this refers to the difference in severity of ulnar nerve injury between a lesion at the elbow compared to the wrist
  • lesion at or above the elbow - causes loss of flexor digitorum profundus - therefore loss of flexion at the IP joints
  • a lesion at the wrist would cause weakness of the hand muscles
18
Q

what are examples of situations that could cause axillary nerve lesions?

A
  • dislocated shoulder
  • fracture of the surgical neck of the humerus
  • deltoid injections - paralysis of deltoid or loss of sensation over the regimental patch
19
Q

what is the regimental patch?

A

a patch of skin at the top of the upper arm

20
Q

what are examples of situations and conditions that could cause radial nerve injuries?

A
  • fracture of the midshaft of the humerus
  • crutch palsy (compression of the nerve caused by crutches)
  • saturday night palsy - prolonged direct pressure on the axillary region
21
Q

what are examples of disabilities that are seen with radial nerve injuries?

A
  • wrist drop - due to the loss of the wrist extensors
  • if lesion is high in humerus then also loss of elbow extension
  • poor grip
22
Q

what is the sensory distribution of the median and ulnar nerve on the palmar surface of the hand?

A
  • median - palmar surface of thumb, index and middle finger, half of ring finger
  • ulnar - half of the ring finger and little finger
23
Q

Describe the sensory innervation of the dorsal surface of the hand

A
  • radial nerve - supplies the dorsal surface of the thumb, index, middle and half of the ring finger
  • the ulnar nerve supplies the dorsal surface of the little finger and half the ring finger

anatomy - physio (17 decks)

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