Peripheral Nerves clinical

Question 1

what are the important functions of peripheral nerves?

Answer 1

reception, execution, social interaction, cosmetic, thermoregulation

Question 2

what is the grading system for assessment of nerve function?

Answer 2

nerve function is assessed based on the MRC scale

Question 3

what is the motor and sensory branch of the radial nerve comprising?

Answer 3

the motor makes the posterior interosseous nerve which goes to the wrist, finger and thumb extensors and the sensory makes the radial sensory nerve which goes to the dorsum 1st web space

Question 4

what is the difference between high and low lesions?

Answer 4

in high there will be both loss of active sensation and altered sensation whereas there is only altered sensation in low lesions

Question 5

what does the recurrent motor branch of the median nerve supply?

Answer 5

thenar, FPL and FDP (IF and MF)

Question 6

what are the clinical presentations of high lesions of the median nerve?

Answer 6

loss of wrist flexion, altered sensation, loss of ‘circle sign’, thumb weakness and loss of opposition

Question 7

which nerve would be damaged if the presentations were thumb weakness, loss of opposition, altered sensation and normal thenar sensation?

Answer 7

lower lesion of the median nerve

Question 8

which nerve supplies the hypothenar muscles, interossei, 2 lumbricals and the AP?

Answer 8

motor branch of the ulnar nerve - deep branch

Question 9

what does the sensory superficial branch of the ulnar nerve supply?

Answer 9

ulnar half of palm and back of hand

Question 10

how would you test for ulnar weakness?

Answer 10

Froment’s test - interosseous weakness, FDIO weakness, Tinel’s

Question 11

describe neural control of the thumb?

Answer 11

radial - extension
median - opposition and flexion
ulnar - adduction