UE Neurology

Question 1

What does an injury to the superior part of the Brachial Plexus affect? How does this happen? How does this present?

Answer 1

C5 and C6 anterior rami

Result of dramatically increasing the angle between the Neck and the Shoulder –> stretching rupture or avulsion of spinal roots off spinal cord

ADducted and medially Rotated Arm, Extended Elbow= Erb-Duchenne Palsy or Waiter’s Tip position

Question 2

How does injury to the Inferior part of the Brachial Plexus happen? How does this present?

Answer 2

Increase angle between the trunk and upper limb

Affects short muscles of the Hand and results in “Claw Hand” when try to make a fist (Klumpke Paralysis)

Question 3

How do the cords of the brachial plexus get compressed? How does this present?

Answer 3

Prolonged periods of working with the upper limb extended over the Head

Pain radiating down the Arm, loss of sensation, tingling of the arms and weakness of the Hands

Question 4

How can the Msuculocutaneous N. get injured? What is the affect?

Answer 4

Blunt force trauma

anterior brachial muscles paralyzed

Question 5

What can result from injury to the Axillary N.?

Answer 5

Atrophy fo the Deltoid M.

Loss of sensation over the superolateral Arm where the Superior Lateral Brachial Cutaneous N. exits

Question 6

What happens when the Median N. is injured in the Wrist?

Answer 6

Results in an aDducted Thumb and thenar eminence atrophy= Ape’s Hand

Question 7

What happens when the Median N. is injured in the Elbow?

Answer 7

Inhibits flexion of 2nd and 3rd digits= Hand of Benediction

- as well as symptoms of Ape’s Hand

Question 8

Where are the 4 places that injury to the Ulnar N. typically occur? What is the overall result?

Answer 8

Posterior to the Medial Humeral Epicondyle
Between Ulnar and Humeral Heads of the Flexor Carpi Ulnaris M. (carpal tunnel)
Wrist
Hand

Extensive loss of sensory and motor control in the hand –> Claw Hand

Question 9

How does Handlebar Neuropathy occur?

Answer 9

Ulnar N. compressed when pressure placed on the Hamulus of the Hamate B.

Produce sensory loss on the medial side of the hand and weakness of the intrinsic hand muscles

Question 10

How can Wrist Drop happen?

Answer 10

Injury to the Radial N.

Impairment of the elbow extension and thumb aBduction and extension