Upper limb nerve lesions Flashcards

1
Q

numbness over lateral forearm, elbow help in extension with forearm pronated
(weak elbow flexion and forearm supination)
no biceps reflex
wasting of anterior compartment of arm

A

musculocutaneous nerve palsy

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2
Q

What might cause a radial nerve palsy?

A

fractures - humerus or radius
stab wounds to antecubital fossa, forearm, wrist
crutch palsy
saturday night palsy (=pt falls asleep w arm hanging over back of chair)
honeymoon palsy (=some falls asleep w head on pt’s arm)
very tight plaster casts, wristbands, handcuffs
prolonged tourniquet use

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3
Q

What might cause a musculocutaneous nerve palsy?

A

stab wound to the upper arm

N.B. this nerve injury is very rare, as the nerve is protected by the overlaying biceps muscle

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4
Q

numbness over upper outer arm
shoulder adducted and internally rotated
(very weak shoulder abduction, flexion, extension and external rotation)
shoulder bones very prominent (deltoid wasting)

A

axillary nerve palsy

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5
Q

What might cause an axillary nerve palsy?

A

fracture of surgical neck of humerus
stab wound to posterior shoulder
anterior shoulder dislocation
crutch palsy (pressure of crutches on armpits)

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6
Q

numbness over thenar eminence and lateral aspect of hand
weak forearm pronation, wrist flexion and abduction and weak finger flexion (of first 3 fingers), weak pincer grip
can’t make a fist - hand of benediction deformity
wasting of anterior forearm and thenar eminence

A

median nerve palsy

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7
Q

What might cause an ulnar nerve palsy?

A

humerus fracture
stab wounds to antecubital fossa, forearm, wrist –> including venepuncture and cannulas!
compression of cubital tunnel in elbow
compression of Guyon’s canal in wrist

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8
Q

numbness of skin on posterior arm and forearm and back of hand
arm and wrist flexed
(weak elbow, wrist, thumb, MCPJ extension)
no triceps + supinator reflexes
wasted triceps and posterior forearm
WRIST drop

A

radial nerve palsy

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9
Q

What might cause a median nerve palsy?

A

humerus fracture
stab wounds to antecubital fossa, forearm, wrist –> including venepuncture and cannulas!
self harm wrist lacerations
carpal tunnel syndrome

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10
Q

numbness over hypothenar eminence and two medial fingers
weak wrist flexion and adduction
weak flexion of ring and little fingers
claw hand

A

ulnar nerve palsy

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11
Q

atrophy of supraspinatus and infraspinatus muscles

A

suprascapular nerve palsy

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12
Q

winging of scapula on arm abduction

A

long thoracic nerve palsy

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13
Q

claw hand in all digits atrophy of intrinsic hand muscles

sensory loss along ulnar border of hand and forearm

A

lower trunk of brachial plexus (C8/T1) = Klumpske’s palsy

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14
Q

limp arm, medially rotated, extended at elbow and pronated with hand pointing backwards (Waiter’s tip)
loss of sensation over lateral arm and forearm

A

upper brachial plexus (C5/C6) = Erb’s palsy

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15
Q

What might cause an upper brachial plexus injury?

A

motorcycle accidents

doctor pulling on baby’s arm during birth

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16
Q

What might cause a lower brachial plexus injury?

A
motorcycle accidents
breech birth (baby's arm above head)