Upper limb nerve injuries Flashcards
What branches of the brachial plexus are effected in Erb’s palsy?
C5/C6
What branches of the brachial plexus are effected in Klumpke’s paralysis?
C8/T1
What are the features of Erb’s palsy?
Waitor’s tip position due to abductors and external rotators being paralysed
Loss of sensation over C5/C6 dermatomes
What are the features of Klumpke’s paralysis?
Paralysis of the small muscles of the hand leading to claw hand
Loss of sensation over C8/T1 dermatomes
What branches of the brachial plexus make up the radial nerve?
C5-T1
What are the features of a low lesion of the radial nerve?
Posterior interosseus nerve damaged - fracture of elbow or forearm
Loss of CMC extension
No sensory loss!
What are the features of a high lesion of the radial nerve?
Fracture of shaft of humerus where nerve is in radial groove
Wrist drop
Loss of sensation over anatomical snuffbox
Triceps function normally
Very high lesions eg axilla, cause paralysis of triceps + wrist drop
What branches of the brachial plexus make up the ulnae nerve?
C8-T1
Where are the two sites the ulnar nerve can be damaged?
At the elbow - Ulnar paradox - looks better, but is worse
At the wrist
What are the features of an ulnar nerve lesion?
Wrist - Ulnar claw - intrinsic muscle hand paralysis
Elbow - Ulnar paradox - Less clawing as FDP is paralysed
Weakened interossei
Loss of sensation over little finger
What tests can be done for an ulnar nerve lesion?
Cannot cross fingers
Froment’s sign - Flexion of interphalangeal joint of the thumb when trying to hold paper between thumb + finger (indicated weak adductor pollicis - innervated by T1)
What branches of the brachial plexus make up the Median nerve?
C6-T1
What sites can the median nerve be damaged?
Antecubital fossa
Wrist
What are the features of median nerve damage?
Flexor pollicis longus effected
Index finger interphalangeal joint flexion effected
Loss of sensation in median distribution
HAND OF BENEDICTION
If at wrist - effects abductor pollicis brevis
