Peripheral Nerve Lesions

Question 1

Which nerves are damaged in Erb’s Palsy

Answer 1

C5- C6 Nerve Root Damage

Question 2

Causes of Erb’s Palsy

Answer 2

Neck stretching during delivery

Fall on head/shoulder with them apart

Question 3

Signs of Erb’s Palsy

Answer 3

Limp Arm
Adducted shoulder
Medially Rotated Arm
Extended Elbow
Pronated forearm
Sensory deficit of arm and forearm (mainly elbow)

Question 4

Muscles affected by Erb’s Palsy?

Answer 4

Shoulder Abductors (Axillary Nerve C5-C6)

Lateral Rotators (Infraspinatus and Teres Minor)

Flexion and Supination (Biceps Brachii, Brachialis)

Question 5

Which nerves are affected in Klumpke’s Palsy?

Answer 5

Inferior Trunk of Brachial Plexus (C8-T1)

Ulnar Nerve is Damaged

Question 6

Causes of Klumpke’s Palsy

Answer 6

Pulling of upper limb during delivery

Pulling upper limb superiorly in adults

Question 7

Signs of Klumpke’s Palsy

Answer 7

Hand Deformity

e.g. Claw Hand due to Ulnar Nerve Damage

(Lumbricals 4 and 5 are paralysed, extensors are unopposed)

Question 8

Why may Klumpke’s Palsy be associated with Horner’s Syndrome?

Answer 8

Sympathetic nerves supply the Eyes and Face originate from T1

Question 9

What is Cubital Tunnel Syndrome?

Answer 9

Entrapment of the Ulnar nerve in the Cubital Tunnel

between heads of FC Ulnaris

Question 10

Causes of Cubital Tunnel Syndrome?

Answer 10

Constricting Fascial bands
Direct Compression
Swelling
Repetitive Elbow Flexion/Extension

Question 11

Symptoms of Cubital Tunnel Syndrome?

Answer 11

Same as Klumpke’s Palsy

• Claw Hand
• Elbow Pain

Question 12

What is Radial Nerve Palsy

Answer 12

Injury to the Radial Nerve in the Radial Groove

Question 13

Causes of Radial Nerve Palsy

Answer 13

Humeral Fracture- normally mid shaft

Question 14

Signs/Symptoms of Radial Nerve Palsy

Answer 14

Wrist Drop (can’t extend wrist or MCP joints)

Paralysis of forearm extensors

Question 15

Why is triceps normally not affected in Radial nerve palsy?

Answer 15

Has different branches going to each head

Question 16

What is Median Nerve Palsy?

Answer 16

Injury to the Median nerve, normally at the elbow

Question 17

Causes of Median Nerve palsy?

Answer 17

Supracondylar Fracture

Pronator Teres Syndrome

Question 18

Muscles affected in Median Nerve Palsy?

Answer 18

Forearm Flexors except FC Ulnaris and Medial 1/2 FD Profundus

Thenar Eminence

Lumbricals 1&2

Question 19

Signs/ Symptoms of Median Nerve Palsy

Answer 19

HAND OF BENEDICTION

Can’t Flex Digits 1-3
Weak Flexion of Digits 4 and 5

Appears like the Hand of Benediction when trying to make a fist.

Question 20

Nerve affected in Winged Scapula?

Answer 20

Long Thoracic Nerve

Question 21

Causes of Winged Scapula

Answer 21

Penetrating Injuries
Iatrogenic
Neuritis

Question 22

Causes of Axillary Nerve Damage

Answer 22

Antero-inferior Shoulder Dislocation

Quadrangular Space Syndrome

Question 23

Signs of Axillary Nerve Damage

Answer 23

Deltoid Atrophy
Parasthesia in Regimental Badge area
Prominent Acromion and Humeral Head

Question 24

Causes of Ulnar Nerve Damage at elbow

Answer 24

Posterior Elbow Dislocation

Cubital Tunnel Syndrome

Question 25

Cause of Median Nerve damage at wrist

Answer 25

Carpal Tunnel Syndrome