Upper Extremity Nerves

Question 1

Axillary: injury

Answer 1

Fractured surgical neck humerus
Anterior dislocation humerus

Question 1

Axillary: roots

Answer 1

C5-C6

Question 2

Axillary: presentation

Answer 2

Flattened deltoid
No abduction shoulder >15degrees
Loss of sensation deltoid and lateral arm

Question 3

Musculocutaneous: roots

Answer 3

C5-C7

Question 4

Musculocutaneous: injury

Answer 4

Upper trunk compression

Question 5

Musculocutaneous: presentation

Answer 5

Reduced biceps reflex (C5-C6)
Loss of sensation dorsal and radial forearm
Loss of forearm flexion and supination

Question 6

Radial: roots

Answer 6

C5-T1

Question 7

Radial: injury

Answer 7

Saturday night palsy (compression axilla)
Midshaft fracture
Repeated forearm pronation/supination (screw driver)

Question 8

Radial: presentation (injury above elbow, e.g. Sat night palsy)

Answer 8

Loss of sensation posterior arm/forearm/hand
Wrist drop with reduced grip strength

Question 9

Radial: presentation (injury below elbow)

Answer 9

Distal paresthesias without wrist drop

Question 10

Radial: presentation midshift fracture

Answer 10

Triceps function and posterior arm sensation spared

(Loss of sensation posterior arm/forearm/hand
Wrist drop with reduced grip strength)

Question 11

Median: roots

Answer 11

C5-T1

Question 12

Median: proximal injury

Answer 12

Supracondylar fracture humerus

Question 13

Median: distal injury

Answer 13

CTS and wrist laceration

Question 14

Median: presentation (general)

Answer 14

Hand Benedict/ape hand
Loss of wrist flexion
Loss of LOAF (lateral 2 Lumbricals, Opponens pollicis, Abductor pollicis rbevis, Flexor pollicis brevis)

Question 15

Median: presentation (proximal injury)

Answer 15

Hand of Benedict (when making fist)
Loss of sensation thenar eminance and lateral 3.5 fingers

Question 16

Median: presentation (distal injury)

Answer 16

Ape hand (when extending fingers)

Question 17

Ulnar: roots

Answer 17

C8-T1

Question 18

Ulnar: injury

Answer 18

Fractured medial epicondyl humerus
Hook of hamate fracture (fall on outstretched hand)
Hook of hamate compression (cycling)

Question 19

Ulnar: presentation

Answer 19

Ulnar claw (extension)
Reduced flexion ulnar fingers, abduction/adduction fingers, thumb adduction, 2 ulnar lumbricals

Question 20

Ulnar: presentation (proximal)

Answer 20

Radial deviation of wrist upon flexion

Question 21

Recurrent branch of median nerve: roots

Answer 21

C5-T1

Question 22

Recurrent branch of median nerve: injury

Answer 22

Superficial laceration of palm

Question 23

Recurrent branch of median nerve: presentation

Answer 23

Ape hand
Loss of thenar muscle group
No loss of sensation