Upper Limb Nerve Injuries

Question 1

Fracture surgical head of humerus

Answer 1

Axillary nerve

Question 2

Fracture mid shaft humerus

Answer 2

Radial nerve

Question 3

Fracture distal humerus

Answer 3

Median nerve

Question 4

Fracture medial epicondyle humerus

Answer 4

Ulnar nerve

Question 5

Injury to lateral chest wall causing winging of scapula

Answer 5

Long thoracic nerce

Question 6

Ipsilateral weakness of shoulder elevation

Answer 6

Accessory CN XI nerve

Question 7

Injury/surgery to posterior wall of axilla, Unable to raise the trunk with the upper limb, unable to use crutches

Answer 7

Thoracodorsal nerve

Question 8

Scapula located farther than usual from the midline on the ipsilateral side

Answer 8

Dorsal Scapular nerve

Question 9

Dislocation of glenohumeral joint or compresison from incorrect use of crutches

Answer 9

axillary nerve

Question 10

waiters tip position, medial rotation arm, extended elbow, adducted shoulder

Answer 10

Superior brachial plexus injury, C5, C6

Question 11

Superior brachial plexus injury - which muscles are affected

Answer 11

Muscles supplies by C5, C6, deltoid, biceps, brachialis, brachioradialis

Question 12

Klumpe paralysis, which nerves affected?

Answer 12

inferior brachial plexus injury, C8, T1

Question 13

Claw hand deformity, Caused by? and what muscles?

Answer 13

Inferior brachial plexus injury, C8, T1 - short muscles of the hand affected.

Question 14

Injury to radial nerve high in arm - what muscles affected? what clinic signs?

Answer 14

Injury above the origin of its braches to triceps will result in paralysis of triceps - brachioradialis, supinator, and extensors of wrist and fingers. Clinically results in wrist drop.

Question 15

Injury to radial nerve in the radial groove. What muscles affected?

Answer 15

Posterior forearm muscles - triceps may be weakened because medial head affected but not long or lateral heads

Question 16

Injury in knife fight to the axilla - weakness of elbow flexion and supination and loss of sensation over the lateral surface of the forearm. What nerve and muscles involved?

Answer 16

Musculocutaneous nerve. Biceps brachii, coracobrachialis, brachialis. consequently lateral cutaneous nerve of forearm also affected.

Question 17

Pronator syndrome - pain and tenderness in proximal aspect forarm

Answer 17

Median nerve compression near the elbow as it passes between the two heads of pronator teres.

Question 18

unable to flex PIPJ 1-3 MC.
weakness to flexion of PIPJ 4-5 MC.
loss of Flexion DIPJ 2-3 MC
"hand of benediction" sign
Loss of thenar muscle function at base of thumb.

Answer 18

Median nerve injury at elbow. Supplies FDP, FDS, 1st and 2nd lumbricals

Question 19

Injury to posterior medial epicondyle humerus. Numbness medial aspect of palm and 1.5 digits and “claw hand” deformity

Answer 19

ulnar nerve injury

Question 20

Inability to extend thumb or MCP joints. No Sensory loss

Answer 20

Injury to deep branch of radial nerve in forearm

Question 21

loss of sensation of lateral 3.5 digits. Poor thumb coordination due to weakness of APB and opponens pollicis

Answer 21

compression of median nerve in carpal tunnel

Question 22

Anterior wrist laceration. Loss of thumb opposition and fine control of 2nd, 3rd digits. Loss of sensation in these areas also

Answer 22

Median nerve injury

Question 23

Minor laceration to thenar eminence. Loss of ability to oppose thumb - “Ape hand” deformity.

Answer 23

Recurrent branch of median nerve supplying the thenar muscles

Question 24

hypothesia in the medial 1.5 fingers. Weakness of intrinsic muscles. “clawing” of 4th and 5th digits.

Answer 24

Guyon Tunnel Syndrome - compression of ulnar nerve at the wrist as it passes between the pisiform and the hook of the hamate.

Question 25

Sensory loss medial side of hand after sustained pressure over palm of hand following a long distance bike ride.

Answer 25

Handlebar neuropathy - compression of ulnar nerve by hook of hamate

Question 26

Inability to extend the MCPJs, Inability to extend the wrist - held in flexed position. Small area of anaesthesia over dorsum of lateral hand

Answer 26

Radial nerve injury