Upper Limb Nerve Injuries

Question 1

Origin of median nerve

Answer 1

Brachial plexus
C5-T1 roots
Medial and lateral cords

Question 2

Median nerve

Motor high lesion

Answer 2

Only loss of FDP to Index, FPL
All FDS
Pronator Teres
Flexor carpi radialis

Question 3

Median nerve

Motor low lesion

Answer 3

All the thenar muscles palsy except Adductor pollicus

Question 4

Median nerve injury

Sympathetic

Answer 4

Loss of sweating, no washerman’s response to radial 2/3rd of palm

Question 5

Origin of radial nerve

Answer 5

Posterior cord of the brachial plexus

Question 6

Radial nerve high lesion

Answer 6

Triceps, wrist extensors (ECRL/B), extensors of the fingers @ MCPJ level and thumb extension/abduction not working

Wrist and finger drop

Question 7

Radial nerve low lesion

Answer 7

Wrist drop

Wrist extensors are not affected

Only fingers and thumb extension @ MCPJ level are affected

Question 8

Origin of ulnar nerve

Answer 8

Medial code of brachial plexus

Question 9

Ulnar Nerve examination for the palm

Answer 9

Wasting of hypothenar muscles

Flat metacarpal arch

Abduction of little finger

Question 10

Ulnar nerve examination of the dorsal aspect

Answer 10

Wasting of intrinsic muscles

Wasting of adductor pollicis

Clawing of the fingers

Question 11

Ulnar nerve examination

How to test sensation

Answer 11

Tinel sign

Question 12

Movement: Ulnar n. Exam

Answer 12

Abduction and
adduction of the fingers and
opposition of the little finger

Pinch and grip strength

Question 13

Fromet sign

Answer 13

Thumb interphalangeal hyperflexion with keypunch by FPL

The thumb flexes at theinterphalangeal jointwhile pinching a piece of paper to compensate for a weakadductor pollicis muscle

Question 14

Jeanne’s sign

Answer 14

hyperextension of the thumb’smetacarpophalangeal joint with key pinch

• thumb is straight when making OK 👌

Question 15

Wartenberg’s sign

Answer 15

Inability to adduct extended little finger

Question 16

Duchenne sign

Answer 16

Clawing of the ring and small fingers

Question 17

Pollock’s sign

Answer 17

Inability to flex DIP of the ring and small fingers in high palsies

Question 18

Carpal tunnel syndrome causes

Answer 18

ICRAMPS

Idiopathic 
Colles. Cushings 
Rheumatoid 
Acromegaly. Amyloid 
Myxoedema, mass, mellitus (diabetes)
Pregnancy 
Sarcoidosis. SLE

Question 19

Carpel Tunnel Syndrome Symptoms

Answer 19

1. Aching and parasethesia (thumb, index, middle and half of ring finger)
2. Worse at night
3. Forearm pain
4. Dropping things

Question 20

Carpel Tunnel Syndrome Symptoms

Answer 20

1. Aching and parasethesia (thumb, index, middle and half of ring finger)
2. Worse at night
3. Forearm pain
4. Dropping things

Question 21

Signs of carpel tunnel syndrome

Answer 21

1. If severe: thenar wasting, trophic ulcers
2. Weakness of thumb abduction
3. Tinel’s sign
4. Phalen’s sign
5. Median compression test

Question 22

Complications of surgery

Carpal Tunnel Syndrome

Answer 22

1. CRPS
2. Tendon hypertrophic scar pillar pain
3. Neuroma in Palmar branch
4. Tenosynovitis / tendon adhesions
5. Bowstring of tendons