Peripheral Nerve Lesions - upper limb - movement Symposium

Question 1

Nerve roots of musculocutaneous

Answer 1

Musculocutaneous is from the lateral cord.

C5-C7

Question 2

Nerve roots of Median nerve

Answer 2

Median has both lateral and medial cord contributions.

C6-T1

Question 3

Ulnar nerve roots

Answer 3

Ulnar is from medial cord.

C8-T1

Question 4

Radial nerve roots

Answer 4

radial is from posterior cord which has contribution from all trunks.

C5-T1

Question 5

Axillary nerve roots

Answer 5

Axillary comes off the posterior cord.

C5-C6

Question 6

Long thoracic nerve roots

Answer 6

C5-C7

Question 7

What is Erb’s Palsy?

Answer 7

Paralysis of muscles in shoulder and arm supplied by C5, C6.

excessive stretching of neck during delivery

Question 8

What condition is characterised by a “waiter’s tip” positioned arm

Answer 8

Erb’s Palsy

paralysis of muscles supplied by C5,C6

Question 9

What muscles are affected in Erb’s Palsy?

Answer 9

Abductors e.g.
Deltoid (Axillary C5,C6)

Lateral rotators e.g.

• infraspinatus (suprascapular C5,C6)
• Teres minor (Axillary C5, C6)

Flexion / supination by biceps
(musculocutaneous C5-C7)

Flexion by brachialis
(musculocutaneous C5-C7)

Question 10

What is Klumpke’s Palsy?

Answer 10

Damage to C8, T1 (ulnar nerve)
**Causes : paralysis of most of intrinsic hand muscles - ulnar flexors of wrist and digits)

*occurs in delvery when upper limb is ppulled excessively during delivery.

Question 11

What does damge to C8, T1 during delivery cause?

Answer 11

Klumpke’s Palsy.

-paralysis of most intrinsic muscles of the the hand (ulnar flexors of wrist and digits)

Question 12

What is claw hand?

Answer 12

Claw hand is due to paralysed lumbricals of digits 4 and 5.

Results in hyperextension at the metacarpophalangeal joints and flexion at the interphalangeal joints.

Question 13

What is cubital tunnel syndrome?

Answer 13

The cubital tunnel is between the heads of flexor carpi ulnaris (medial side of elbow)

Through which runs the ulnar nerve.

*Compression of the ulnar nerve causes paralysis of most of the muscles of the hand and elbow pain.

(same as Klumpke’s palsy + elbow pain)

Question 14

What upper limb nerve problem is associated with horner’s syndrome?

Answer 14

Klumpke’s Palsy

Question 15

Radial nerve palsy

Answer 15

• Injury to radial nerve
• caused by fracture of humerus shaft
• causes WRIST DROP

Question 16

Wrist drop

Answer 16

caused by injury to the radial nerve (fracture of shaft of humerus)

-paralysis of extensor muscles of forearm causes wrist drop

Question 17

Hand of Benediction

Answer 17

Inability to flex digits 1-3 caused by median nerve injury

Question 18

Thenar atrophy

Answer 18

Recurrent branch of median nerve

Question 19

Hypothenar atrophy

Answer 19

Deep branch of ulnar nerve

Question 20

First dorsal interosseous atrophy

Answer 20

Deep branch of Ulnar Nerve

Question 21

Wrist Drop

Answer 21

Radial nerve

Question 22

Paraesthesia over lateral deltoid

Answer 22

Axillary nerve

Question 23

Weakened finger adduction

Answer 23

Deep branch of ulnar nerve

Question 24

Winging of scapula

Answer 24

Long thoracic nerve