Robertson Putting It All Together Flashcards
If you have absence of shoulder abduction and external rotation, and elbow flexion what part of your brachial plexus is damaged?
C5,6 Palsy
If you have lack of wrist and finger extension what part of your brachial plexus is damaged?
C5,6,7
If you have a traction mechanism (ie. stretch injury) with intrinsic wasting of the muscles innervated by the ulnar nerve, what part of the brachial plexus i affected?
C8T1
What happens when you get a preganglionic lesion?
you get a spinal avulsion and therefore Horners, elevated hemi diaphragm, winged scapula, absence of rhomboid
So why do you get Horners when you have a spinal avulsion (preganglionic lesion)?
because you screwed up the sympathetic chain (due to ripping out T1)
Why do you get an elevated hemi-diaphragm when you have a spinal avulsion?
because you screwed up your phrenic nerve
Why do you get a winged scapula when you have a spinal avulsion?
because you damage the long thoracic nerve
Why do you get absence of motor function of rhomboids when you have a spinal avulsion?
because you lose the dorsal scapular nerve
How do you treat a spinal avulsion?
the nerve will not recover or regenerate so therefore you will have to have a nerve/tendon transfer
What will you get if you have radial nerve palsy?
you will get wrist drop
What is another name for the posterior interossesus nerve (PIN)?
the deep radial nerve
If you have a damaged radial nerve at the elbow, and it is undergoing recovery, what is the first sign that this is occuring?
your brachioradialis will begin to function
Where does the anterior interosseus come from and what does it do?
it comes off the median nerve and innervates deep forearm muscles (pronator quadratus, flexor digitorum profundus, flexor pollicis longus)
How do you get saturday night palsy and what is it?
when you arm is extended on the table and you sleep on it which makes you compress the radial nerve and you get wrist drop
How long does it take to improve your radial nerve compression injury from saturday night palsy?
three months
What does palsy mean?
paralysis
What does ulnar nerve damage cause key pinch?
cuz you lose adductor pollicis!!!!!!!!!!!
What am I describing: MP hyperextension lack of finger abduction/adduction weak grip lack of key pinch
AND why does this happen
Ulnar damage
you get ulnar claw hand deformity which happens cuz you lose all interosseus and you lose you medial two head of your flexor digitorum profundus and the last two lumbricals. You get key pinch cuz you cant adduct thumb so you flex it hard to compensate And you lose flexor carpi ulnaris
What is fromonts sign?
when people use hyperflexion of their thumb to compensate for loss of adductor pollicis due to ulnar nerve damage
(blank) nerve is necessary for power grip
ulnar
What do these indicate: Intrinsic wasting Loss of palmer arch Fromont’s Sign Wartenberg’s Sign Bouvier’s Maneuver
ulnar nerve damage
What muscle originates on a finger flexor and inserts onto a finger extensor?
the lumbricals
come from flexor digitorum profundus and attach to lateral band of extensor hood
What does this:
Passes palmer to axis of rotation of MCP
Dorsal to axis of PIP
Origin and insertion into tendon
lumbricals
In messed up ulnar injury, what muscle gets the most messed up?
the abductor digiti minimi
How do you differentiate ulnar nerve lesion at guyons vs elbow?
if you damage it at elbow, you wont have cutanous innervation on the dorsal side of your wrist near the pinky, but if you have it, then it is nerve damage at the wrist.
Where can you get ulnar nerve entrapment?
any level at root (C8-T1) Plexus (cervical rib, pancoast tumor) Cubital tunnel (elbow) Guyons canal (wrist)
What are these borders for: Arcade of Struthers Intermuscular septum Medial head Tricep Anconeus Epitrochlearis Osborns Ligament Flexor Carpi Ulnaris
Cubital tunnel
