WEEK 5 LESIONS

Question 1

What is the general theme of myotomes?

Answer 1

All proximal muscles are innervated by more superior brachial plexus spinal segments. More distal are innervated by lower brachial plexus spinal segments

Question 2

What does etiology mean?

Answer 2

The cause or manner in which something is inflicted

Question 3

What are the 3 reasons nerve lesions occur?

Answer 3

1) direct trauma or stretching -stab wound, dislocations
2) entrapment/compression- contriction
3) neuritis- chemical toxins, viruses, inflammation

Question 4

Lesions of spinal nerves results in?

Answer 4

Weakness of the muscles innervated by it, NOT loss. Remember anatomical insurance

Question 5

Lesion of what results in paralysis?

Answer 5

Peripheral nerve

Question 6

The position of a limb after injury depends on?

Answer 6

The antagonistic activity of intact muscles after injury

Question 7

Skin areas supplied by spinal nerves (dermatomes) are different from?

Answer 7

Skin areas supplied by peripheral nerves (but they are correlated)

Question 8

Partial or complete loss of sensation in an area is dependent upon?

Answer 8

Extent of damage

Question 9

How can sensation manifest after injury?

Answer 9

Pain, paresthesia, or anesthesia

Question 10

Categories of injuries

Answer 10

1) lesions to the roots/trunks of plexus
2) direct branches off the plexus
3) lesions to the peripheral (terminal) branches

Question 11

What is another name for peripheral branches?

Answer 11

Terminal branches

Question 12

Lesion to C5-C6

Answer 12

Etiology- widened neck angle/downward traction
Sensory- lateral surface of arm, forarm, and hand (thumb side)
Motor- more proximal musculature (deltoid, RCM, rhomboids, levator scapulae, anterior arm muscles)

Question 13

Waiters Tip

Answer 13

Lesion C5-C6: loss of abduction and lateral rotation, weakness of forearm flexors and supination

Question 14

Lesion to C8-T1

Answer 14

Etiology- upward motion
Sensory- medial forearm and hand
Motor-intrinsic muscles of the hand

Question 15

Claw hand

Answer 15

Lesion to C8-T1: MCP joint hyperextension, loss of all IP extension; loss of thenor, hypothenar, adductor, lumbricals and interossei (Ulnar nerve)

Question 16

Dorsal scapular lesion

Answer 16

Weakness of scapular elevation, retraction, and inferior rotation

Question 17

Long thoracic lesion

Answer 17

Winged scapula (serratus anterior)

Question 18

Suprascapular nerve lesion

Answer 18

Weakness of abduction intiation and lateral rotation (supraspinatus and infraspinatus)

Question 19

Pectoral nerve lesion

Answer 19

Weakness of adduction and medial rotation

Question 20

Subscapular nerve lesion

Answer 20

Weakness in medial rotation and instability of GH joint (subscapularis)

Question 21

Thoracodorsal nerve lesion

Answer 21

Weakness of extension, adduction and medial rotation (latissimus dorsi)

Question 22

Square shoulder indicates?

Answer 22

Lesion of C5-C6: paralysis of deltoid and teres minor

Question 23

Lesion in axilla in spiral groove (C5-T1)

Answer 23

Sensory-loss of posterior strip of arm, forearm and hand
Motor- loss of forearm extension, weak forearm flexion, loss of wrist extension/MCP/thumb extension&abduction/weakness in supination

Question 24

Wrist drop

Answer 24

Lesion in axilla groove (C5-T1), loss of wrist extension/MCP/thumb extension&abduction/weakness in supination

Question 25

Radial nerve in forearm (C5-T1)

Answer 25

Sensory- loss of over dorum of hand (lateral 3.5 digits)

Motor- loss of thumb extension/abduction, weakness of MCP extension, maybe wrist?

Question 26

Musculocutaneous n lesion (C5-C7)

Answer 26

Paralysis of coracobrachialis, biceps, brachii and brachialis, loss of lateral forearm sensation, weakness in flexion and supination

Question 27

Benediction sign

Answer 27

Lesion of all of median nerve (C5-T1)

Question 28

Ape hand

Answer 28

Lesion of median nerve (C5-T1) at wrist like carpal tunnel

Question 29

Partial claw hand

Answer 29

Ulnar nerve (4&5 loss of sensation and movement)