Upper Extremity Neurology

Question 1

Erb-Duchenne Palsy or “waiter’s tip position”

Answer 1

• injury to superior part of brachial plexus (typically affect c5 and c6 anterior rami)
• usually a result of dramatically increasing the angle between neck and shoulder
• can stretch, rupture or avulse the spinal roots off spinal cord
• will have adducted and medially rotated arm and an extended elbow

Question 2

Claw hand or Klumpke paralysis

Answer 2

• injury to inferior part of brachial plexus (less common)
• result of dramatically increasing the angle between the trunk and upper limb
• typically affects short muscles of hand

Question 3

What does working for long period with the upper limb extended over the head cause?

Answer 3

• compression of cords of brachial plexus

- results in pain radiating down the arm, loss of sensation, tingling of arms and weakness of the hands

Question 4

Injury to what nerve would render the anterior brachial muscles paralyzed?

Answer 4

Musculocutaneous N

Question 5

Injury to what nerve results in atrophy of deltoid muscle and loss of sensation over the superolateral arm where the superior lateral brachial cutaneous N exists

Answer 5

Axillary N.

Question 6

What causes apes hand?

Answer 6

Injury of the median N in the wrist

-results in an adducted thumb and their eminence atrophy

Question 7

Hand of benediction

Answer 7

• injury to the median n at elbow
• inhibits flexion of 2nd and 3rd digits
• as well as symptoms of ape hand

Question 8

Where does injury of ulnar nerve typically occur?

Answer 8

• posterior to the medial humeral epicondyle
• between ulnar and humeral head of flexor carpi ulnaris M(cubital tunnel)
• at the wrist
• in the hand

Question 9

What are symptoms of ulnar N injury

Answer 9

• extensive loss of sensory and motor control in the hand

- when an indiv tries to make a fist it appears as claw hand

Question 10

Handlebar neuropathy

Answer 10

• when ulnar n is compressed when pressure is placed on the hamulus of the hamate B when riding a bike
• can produce sensory loss on the medial side of the hand and weakness of the intrinsic hand muscles

Question 11

Wrist drop

Answer 11

Injury of radial nerve

- impairment of elbow extension and thumb abduction and extension