Positioning and Nerve Injuries Flashcards
What is the most most upper extremity postop nerve injury?
ulnar
d\t compression between medial epicondyle of humerus and sharp edge of the operating table
The ulnar nerve is stretched when ______ the arm.
pronating
Injury to the ulnar nerve causes the inability to ______ the fifth finger, ultimately leading to “________”.
abduct or oppose; claw hand
What is the second most common postop neurologic injury?
brachial plexus injury
What is the cause of a brachial plexus injury?
stretch injury when the neck is extended and the head is turned away, or the arm is abducted > 90 degrees
*compression injury between the clavicle and first rib with improperly placed shoulder braces or spreading of sternum
This injury occurs if the arm slips off the surgical table or if pressure is applied to the nerve as it traverses the spiral groove of the humerus.
radial nerve injury
What type of nerve injury results in wrist drop, inability to extend the metacarpophalangeal joints, weakness in abduction of the thumb, and decrease in sensation over dorsal surfaces of the lateral three and one half fingers (first, middle, and ring)?
radial
Injury to this nerve is unlikely due to positioning, but can result in inability to oppose the first and fifth digits and decreased sensation on the palmar surface of the lateral three and one half fingers (first, ring, and middle).
medial
What nerve is rarely injured d\t stretching or compression because of how deep it runs in the arm?
musculocutaneous
What will be seen with musculocutaneous nerve injury?
inability to flex the arm and sensation is decreased over the ventral surface of the forearm.
Match the nerve injury: “Ape Hand”
median nerve injury–> unable to oppose thumb
Match the nerve injury: “Claw Hand”
ulnar nerve injury
Match the nerve injury: “Wrist Drop”
radial nerve injury
Match the nerve injury: “inability to flex forearm”
musculocutaneous nerve injury
Match the nerve injury: “inability to abduct arm”
axillary nerve injury
Match the nerve injury: “Foot drop”
sciatic, common peroneal, or anterior tibial
Match the nerve injury: “absent knee jerk and loss of flexion of hip and extension of knee”
femoral
Match the nerve injury: “paresthesias along the medial and anteromedial side of calf”
saphenous
Match the nerve injury: “inability to adduct the leg and diminished sensation over medial side of the thigh”
obturator
Match the nerve injury: “pain and dyesthesia over lateral thigh”
lateral femoral cutaneous
Match the nerve injury: “pain or numbness of lower leg, thigh, or foot”
sciatic
Match the nerve injury: “decreased sensation over superior aspect of thigh and medial and anteromedial side of leg”
femoral
Match the nerve injury: “loss of dorsal extension of toes”
common peroneal
Match the nerve injury: “most frequently damaged nerve of the lower extremity”
common peroneal
Match the nerve injury: “damaged in sitting position with pressure on the ischial tuberosities or in lithotomy position when the nerves and thigh are externally rotated”.
sciatic
*also damaged with improper IM injection–> should be given in the upper, outer quadrant of the buttock
Match the nerve injury: “damaged in lithotomy by extreme abduction of the thighs with external rotation of the hip”
femoral
Match the nerve injury: “damaged during difficult forceps delivery or by excessive flexion of the thigh to the groin”
obturator
Injury to this nerve eventually leads to claw hand.
ulnar
Injury to this nerve prevents abduction and opposition of the fifth finger.
ulnar
Spreading the sternum during heart surgery or abduction of the arm > 90 degrees or turning the head to the left can injury this structure.
brachial plexus
Which nerve is compressed when pressure is applied to the spiral groove of the humerus?
radial
This nerve may be damaged when an IV is started.
musculocuteneous
Injury to this nerve results in decreased sensation over the dorsal surface of the lateral three and one-half fingers.
radial
When this nerve is injured, opposition of the first and fifth digits is precluded (made impossible).
median
The patient has weakened skeletal muscle function below the knee. Which nerve is injured?
sciatic
What is the most frequently damaged nerve in the lower extremity?
common peroneal
Which nerve may be compressed against the pelvic brim by a self-retaining retractor?
femoral
What nerve is a terminal branch of the femoral nerve?
saphenous
