Upper limb nerve lesions Flashcards
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
musculocutaneous nerve palsy
What might cause a radial nerve palsy?
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
What might cause a musculocutaneous nerve palsy?
stab wound to the upper arm
N.B. this nerve injury is very rare, as the nerve is protected by the overlaying biceps muscle
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)
axillary nerve palsy
What might cause an axillary nerve palsy?
fracture of surgical neck of humerus
stab wound to posterior shoulder
anterior shoulder dislocation
crutch palsy (pressure of crutches on armpits)
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
median nerve palsy
What might cause an ulnar nerve palsy?
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
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
radial nerve palsy
What might cause a median nerve palsy?
humerus fracture
stab wounds to antecubital fossa, forearm, wrist –> including venepuncture and cannulas!
self harm wrist lacerations
carpal tunnel syndrome
numbness over hypothenar eminence and two medial fingers
weak wrist flexion and adduction
weak flexion of ring and little fingers
claw hand
ulnar nerve palsy
atrophy of supraspinatus and infraspinatus muscles
suprascapular nerve palsy
winging of scapula on arm abduction
long thoracic nerve palsy
claw hand in all digits atrophy of intrinsic hand muscles
sensory loss along ulnar border of hand and forearm
lower trunk of brachial plexus (C8/T1) = Klumpske’s palsy
limp arm, medially rotated, extended at elbow and pronated with hand pointing backwards (Waiter’s tip)
loss of sensation over lateral arm and forearm
upper brachial plexus (C5/C6) = Erb’s palsy
What might cause an upper brachial plexus injury?
motorcycle accidents
doctor pulling on baby’s arm during birth