Upper Limb Nerve Injuries

Question 1

Can regenerate if damaged as long as the cell body is not damaged and there is a pathway to travel upon to reach the deinnervated organ

Answer 1

Peripheral nerves

Question 2

The rate of peripheral nerve regeneration averags about

Answer 2

1 cm per week

Question 3

When a nerve that contains many axons is damaged, what will regain function first, proximal or distal structures innervated by that nerve?

Answer 3

Proximal

Question 4

If the median nerve is lesioned at the level of the elbow, what will regain function first, the forearm or hand?

Answer 4

Forearm

Question 5

Can be caused by stretch of the UPPER trunk caused by forceful separation of the shoulder away from the neck

Answer 5

Erb’s Palsy

Question 6

The proximal limb muscles, i.e. intrinsic shoulder muscles and most muscles of the axillary wall are affected by

Answer 6

Erbss Palsy

Question 7

In Erb’s Palsy, the limb tends to be held such that the shoulder is in an

Answer 7

Extended, adducted, and internally rotated position and forearm is pronated

Question 8

In Erb’s Palsy, sensory loss is along the lateral side of the distal arm and proximal forearm, in other words, at the

Answer 8

C5 and C6 dermatomes

Question 9

The appearance of the arm in Erb’s Palsy is called the

Answer 9

Waiters tip sign

Question 10

Can be caused by stretch or compression of the LOWER trunk such as by upward traction on the limb or compression in the region of the “thoracic outlet” (e.g. cervical rib)

Answer 10

Klumpke’s Palsy

Question 11

What is affected by Klumpke’s Palsy?

Answer 11

The distal limb (i.e. intrinsic muscles of the hand) are affected

Question 12

Thenar mucles and the interossei may be atrophied in

Answer 12

Klumpke’s Palsy

Question 13

What are some visual suggestors of Klumpke’s Palsy?

Answer 13

Clawing of digits II-V and loss of abduction/adduction in the fingers

Question 14

Klumpke’s Palsy results in sensory loss along the medial side of the distal arm and proximal forearm, i.e. the

Answer 14

C8 and T1 dermatomes

Question 15

May be caused by a fracture of the surgical neck of the humerus or a glenohumeral dislocation

Answer 15

Axillary nerve injury

Question 16

Axillary nerve injury results in denervation of the

Answer 16

Deltoid

Question 17

Results in sensory loss on the skin overlying the deltoid

Answer 17

Axillary nerve injury

Question 18

May be caused by a fracture of the shaft of the humerus, fracture or dislocation of the head of the
radius, dislocation of the head of the humerus, or upward pressure in the floor of the axilla

Answer 18

Radial nerve injury

Question 19

May cause wrist drop and difficulty in making a fist because of the inability to stabilize the wrist

Answer 19

Radial nerve injury

Question 20

With a radial nerve injury, cutaneous sensory loss may occur on the

Answer 20

Dorsum of radial portion of hand

Question 21

Which type of radial nerve injury results in more motor/sensory loss, a more proximal or a more distal injury?

Answer 21

Proximal

Question 22

May be caused by trauma in the cubital fossa (e.g. supracondylar fracture) or at the wrist (e.g.
laceration), compression in the carpal tunnel or compression passing through the pronator teres

Answer 22

Median nerve injuries

Question 23

Long term denervtion cause by a median nerve injury may result in

Answer 23

Thenar atrophy, loss of opposition, unapposed thumb (ape hand), and clawing of digits II and III

Question 24

Can result in clawing of digits II and III and ape hand

Answer 24

Median nerve lesions

Question 25

If the median nerve injury is at the level of the wrist, then flexion and abduction of the thumb is still possible because of the

Answer 25

Flexor pollicis longus and abductor pollicis longus

Question 26

The flexor pollicis longus will be paralyzed and thumb flexion will not be possible if the median nerve injury is at the level of the

Answer 26

Elbow

Question 27

Proximal median nerve injury results in ulnar deviation of the hand upon flexion at the wrist due to the paralysis of the

Answer 27

Flexor carpi radialis

Question 28

Proximal median nerve injury results in ulnar deviation of the hand upon flexion at the wrist due to the loss of flexion of digits I through III resulting from paralyzed

Answer 28

Flexor pollicis longus and brevis, flexor digitorum superficialis and radial half of flexor digitorum profundus

Question 29

Proximal median nerve injury results in a hand shape called the

Answer 29

Hand of benediction

Question 30

Proximal median nerve injury results in sensory loss to the

Answer 30

Lateral portion of palmar surface of the hand and digits I-III

Question 31

May be caused by trauma in the region of the medial epicondyle of the humerus or at the heel of the hand

Answer 31

Ulnar nerve injury

Question 32

What are some physical symptoms of ulnar nerve injury?

Answer 32

Loss of abduction and adduction of digits II-V (interosseous muscles), and clawing most prominently in digits IV and V (lumbrical muscles)

Question 33

Results in radial deviation of hand upon flexion at the wrist (paralysis of flexor carpi ulnaris) and loss of flexion of the DIP of digits IV and V (flexor digitorum profundus)

Answer 33

Proximal Ulnar injury

Question 34

An uncommon injury. Not likely to be injured by skeletal injuries such as fractures or dislocations

Answer 34

Musculocutaneous nerve injury

Question 35

A musculocutaneous injury my occur by a

Answer 35

Penetrating wound

Question 36

What are some physical symptoms of a musculocutaneous nerve injury?

Answer 36

Loss of function of anterior arm muscles, i.e. weakness of shoulder flexion, extreme weakness of elbow flexion, and weak supination

Question 37

Which elbow flexor can still be used when there is a musculocutaneous injury?

Answer 37

Brachioradialis

Question 38

With an ulnar nerve injury, there is cutaneous sensory loss on the

Answer 38

Medial side of the hand

Question 39

With a musculocutaneous injury, there is sensory loss to the

Answer 39

Lateral side of the forearm

Question 40

The distal continuation of the musculocutaneous nerve, which results in sensory loss when musculocutaneous nerve is injured

Answer 40

Lateral antebrchial cutaneous nerve

Question 41

May be caused by trauma to the chest wall or surgical injury during axillary surgery

Answer 41

Long Thoracic Nerve

Question 42

Presents as winging of the scapula due to loss of the serratus anterior muscle

Answer 42

Long thoracic nerve injury

Question 43

With a long thoracic nerve injury, there will be limitation in

Answer 43

Upward rotation of scapula

Question 44

Is there any cutaneous sensory loss with a long thoracic nerve injury?

Answer 44

No

Question 45

A thoracodorsal injury would present with

Answer 45

Weakness of shoulder extension, adduction, and internal rotation due to loss of latissimus dorsi

Question 46

Is there any cutaneous sensory loss for a thoracodorsal injury?

Answer 46

No

Question 47

May be caused by trauma in the posterior triangle of the neck or at the base of the skull

Answer 47

Spinal accessory nerve injury

Question 48

The physical symptoms of a spinal accessory nerve injury are?

Answer 48

Shoulder drop and inability to fully abduct or flex at the shoulder due to loss of the trap

Question 49

Is there any cutaneous sensory loss with a spinal accessory nerve injury?

Answer 49

No

Question 50

May stimulate the axon or may interfere with transmission along the axon

Answer 50

Compression of the axon

Question 51

What is the delay period before a damaged axon will begin to regenerate?

Answer 51

Approximately 2 weeks

Question 52

Provide a pathway for axon regeneration

Answer 52

Endoneurium and Schwann cells

Question 53

Can be caused by downward force on the scapula and downward pull on the serratus anterior

Answer 53

Long Thoracic Nerve

Question 54

Because the serratus anterior attaches the medial border of the scapula to the chest wall, paralysis of this muscle results in

Answer 54

Winging

Question 55

The more distal the radial nerve injury, the

Answer 55

Less severe

Question 56

If you want to test one motor function to see if the radial nerve is injured, test

Answer 56

Wrist Extension

Question 57

Houses 4 tendons of the flexor digitorum superficialis, 4 tendons of the flexor digitorum profundus, the tendon of the palmaris longus, and the median nerve

Answer 57

Carpel Tunnel

Question 58

``` If a nerve is injured, the digit with the injured nerve will be pulled in the direction opposite of the function of the denervated muscle, because of ```

Answer 58

Antagonistic muscles

Question 59

In a median nerve injury, we see clawing of the digits due to

Answer 59

Lumbrical paralysis

Question 60

Does not go through the caprel tunnel, but goes through the Guyon's canal under the palmar carpel ligament

Answer 60

Ulnar nerve

Question 61

Erb's Palsy is an injury to which spinal nerve?

Answer 61

C5 and C6

Question 62

Klumpke's Palsy is an injury to which spinal nerves?

Answer 62

C8 and T1