Upper Limb Nerve Lesions

Question 1

what are the root nerves for the long thoarcic nerve? What does it innervate?

Answer 1

C5 C6 C7 reach your arm up to heaven; anterior serratus

Question 2

if the long thoarcic nerve C567 is damaged

Answer 2

winged scapula and the patient has difficulty raising the arm above the head; decreased medial rotation of the scapula

Question 3

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Question 4

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Question 5

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Question 6

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Question 7

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Question 8

Answer 8

upper brachial plexus damage (C5 and C6)

Question 9

Upper brachial plexus injuries are called _____

Answer 9

Erb’s- Palsy or Erb’s- Duchenne Palsy

Question 10

Answer 10

Erb-Duchenne Palsy; Resulting limb is adducted, internally rotated, pronated and extended at the elbow

Question 11

Answer 11

Lower brachial plexus injuries typically results from upper limb being suddenly pulled superiorly…grasping a limb during a fall or breech birth

This type of trauma can stretch or avulse C8 & T1 (sometimes C7) ventral rami (lower roots)

Question 12

Lower brachial plexus lesions are referred to as ____

Answer 12

Klumpke Palsy

Question 13

klumpkes or erbs palsy is more common?

Answer 13

erbs palsy (upper brachial plexus lesions/damage)

Question 14

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Question 15

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Question 16

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Question 17

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Question 18

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Question 19

suprascapular nerve roots

Answer 19

C5 C6

Question 20

If roots C5 and C6 are damaged

Answer 20

supraspinatus and infraspinatus muscles are not innervated and cannot laterally move scapula; weak abduction = weakened supraspinatus

Question 21

thoracodorsal nerve roots

Answer 21

C 678

Question 22

if thoracodorsal nerve is damaged

Answer 22

decreased innervation of latissimus = decreased rowing climbing and pushing up out of a chair; decreased extension, adduction, and medially rotating arm

Question 23

axillary nerve roots

Answer 23

C5 and C6

Question 24

axillary nerve innervates

Answer 24

nInnervates the deltoid and teres minor

Question 25

if the axillary nerve is damaged

Answer 25

decreaed abduction and loss of rounded contour of deltoid region; weakened lateral rotation of arm (teres minor); Loss of sensation to lateral aspect of arm/shoulder region

Question 26

axillary nerve damage can be common in

Answer 26

Can occur in surgical neck fractures of the humerus and shoulder dislocations

Question 27

muscolocutaneous nerve innervates and roots

Answer 27

innervates anterior portion of the forearm

C5 C6 and C7

Question 28

if the muscoloctaneous nerve is damaged

Answer 28

• weakened flexion of the arm
• weakened suppination of the arm
• sensory loss to the lateral portion of the arm

Question 29

Brachial plexus lesions affect the ____ rami of several spinal nerves and therefore affect

Answer 29

ventral; motor and sensory

Question 30

1.Upper brachial plexus injuries… caused by lesions of ___ ventral rami

Answer 30

C5 & C6

Question 31

Lower brachial plexus injuries… caused by lesions of ___ ventral rami (sometimes C7)

Answer 31

C8 & T1

Question 32

nUpper brachial plexus injuries typically occur due to excessive ______

Answer 32

lateral stretching between the head & shoulder (motorcycle, equestrian, football injuries- “stinger”); Obstetrical trauma can also injure these roots

Question 33

Erb’s palsy can also causes a _____ fingers and wrist curl into flexion

Answer 33

“waiters tip hand”

Question 34

Klumpskys are devastating injuries as they _____ of the hand causing muscle imbalances between the digital flexors and extensors; aka ____ hand and can also lead to horners disease

Answer 34

paralyze the short intrinsic muscles; claw hand

Question 35

high median nerve damage results in

Answer 35

hand of benediction

1.Weakness/paralysis of many of the anterior forearm muscles

2.Atrophy of thenar muscles (loss of opposition)

3.Sensory deficits in 3½ fingers

4.When these patients attempt to make a “fist”….cannot flex the thumb, 2nd or 3rd digits due to loss of flexion power (FPL, FDS & ½ FDP) – referred to as the Hand of Benediction

Question 36

____ nerve damage can result in “ape-hand” appearance

Answer 36

median nerve

Question 37

Sensory testing area for ____ nerve is between the thumb and index finger on dorsum of the hand

Answer 37

radial

Question 38

nCommon clinical sign is wrist drop- inability to extend wrist or fingers

Answer 38

radial nerve damage

Question 39

_____ lesions affect most of the intrinsic hand muscles resulting a thin weakened hand (loss of interossei)

Hence, difficulty performing fine motor tasks, open doors, jars….

Answer 39

Ulnar nerve

Question 40

When these patients attempt to make a “fist”…4th & 5th digits cannot flex properly due to the loss of ____ portion of the FDP and associated lumbricals… resulting in a “claw hand”

Answer 40

ulnar