Upper Extremity Injuries

Question 1

___ palsy is often caused by a delivery problem where the baby’s shoulder gets stuck behind the mother’s pubic bone causing the brachial plexus to be tractioned

Answer 1

Erb’s

Question 2

The result of this injury is a classic physical position of the wrist, commonly called “waiter’s tip”

Answer 2

Erb’s Palsy

Question 3

___ palsy is injury to the UPPER trunk of the brachial plexus, while ____ palsy is injury to the LOWER trunk.

Answer 3

Erb’s, Klumpke’s

Question 4

This type of palsy commonly occurs during birth when the baby is forcefully pulled from the birth canal by abduction of the arm

Answer 4

Klumpke’s palsy

Question 5

Often, ____ syndrome (of the eye) accompanies Klumpke’s Palsy

Answer 5

Horner’s (Ptosis and small pupil)

Question 6

What deformity of the hand occurs with Klumpke’s palsy due to loss of the lumbricals (via the ulnar nerve)?

Answer 6

Claw-hand

Question 7

TOS can occur in what 3 places?

Answer 7

1. Interscalene triangle (Anterior/Middle scalenes)
2. Costoclavicular triangle (clavicle, 1st rib, scapula)
3. Subcoracoid space (deep to cor. Process and pec minor tendon)

Question 8

Which trunk of the brachial plexus is at the highest risk of being affected by TOS?

Answer 8

Lower trunk (think Ulnar N)

Question 9

Adson’s test is testing for which syndrome of TOS? (There are 3 syndromes)

Answer 9

Anterior scalene syndrome

Question 10

Wright’s (hyperabduction) test is for which TOS syndrome?

Answer 10

Pectoralis Minor syndrome

Question 11

___ syndrome is an idiopathic pathology of the upper trunk of the brachial plexus (axillary, musculocutaneous, suprascapular, dorsal scapular) where the patient experiences severe, acute, burning pain in the shoulder and upper arm w/no apparent cause

Answer 11

Parsonage-Turner (Acute brachial plexus neuritis)

Question 12

This nerve can be compressed as it pierces the middle scalene muscle. Patient would have pain along the vertebral border of the scapula and over the shoulder.

Answer 12

Dorsal scapular

Question 13

____ syndrome can occur in whiplash injuries or with overhead occupations, such as electrician or painter.

Answer 13

Dorsal scapular nerve

Question 14

Scapular winging might be due to ____ nerve entrapment (or weakness of serratus anterior)

Answer 14

Long thoracic

Question 15

Suprascapular nerve syndrome would affect what two muscles?

Answer 15

Supraspinatus, infraspinatus

Question 16

A common entrapment site is in the “quadrangular space” (posterior shoulder/scapula). What nerve gets entrapped here?

Answer 16

Axillary

Question 17

____ palsy occurs most often due to wearing tight wrist bands. It involves the superficial radial nerve and occurs where it exits from under the brachioradialis muscle (9cm proximal to radial styloid). This causes paresthesia in the HAND ONLY

Answer 17

Wartenberg’s