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Upper nerve lesions

Nerve lesions of the upper limb

* * What will injury to the axillary nerve cause? Muscle and sensation? What is a common way of injuring the axillary nerve? paralysis of the deltoid muscle and teres minor, loss of cutaneous sensation over the lower half of the deltoid muscle; badly adjusted crutches or shoulder joint dislocations
Pressure of badly adjusted crutches, fractures, and dislocation of the proximal humerus by a drunkard falling asleep with one arm over the back of the chair can harm what nerve/ The Radial nerve
What muscles are compromised in a radial nerve palsy? What actions are compromised? Triceps, brachioradialis, supinator, and ALL EXTENSORS are paralyzed; inability to EXTEND elbow or wrist joint-->wristdrop (unopposed wrist flexors); supination still posible (biceps brachii)
What sensory sensation is lost in a radial nerve palsy (at the axilar level)? loss of sensation down posterior surface of the lower part of the arm and down narrow strip of the back of the forearm; sensory loss on th elateral part of the dorsum of the hand and dodrsal surface of the roots of the lateral 3.5 fingers
A fracture of the shaft of the humerus or prolonged pressure on the back of the arm would most likely injure what nerve? What are the symptoms? Cause injury in the radial nerve; wristdrop same, extension of the elbow may NOT be impaired (damage usually below triceps brachii); loss of sensation on the dorsal surface of the lateral part of the hand and dorsal surface of roots of lateral 3.5 fingers
What would an injury of the median nerve at the elbow region cause? What could cause it? Pronator muscles of the forearm and long flexor muscles @ WRIST and FINGERS (except flexor carpis ulnaris and medial 1/2 of flexor digitorum profundus) paralyzed, thenar muscles and 1st 2 lumbricals parazlyzed; suprachondylar fracture of the humerus
How would a patient with a median nerve injury at the level present (muscle action)? Forearm is kept supine (loss of pronators); wrist flexion is weak + accompanied by adduction (loss of flexor carpi ulnaris)-->hand of papal benediction + ape like hands; thumb is adducted; inability to oppose thumb
What sensory loss would a patient with a median nerve injury at the elbow region present? Skin sensation on the lateral half or less of the palm of the hand and the palmar aspect of the lateral three one and a half finers; sensory loss also occurs on the skin of the distal part of the dorsal surfaces of the lateral three and one-half fingers
What is the most common site of injury of the median nerve? The wrist, where it lies in the interval between the tendons of the flexor carpi ulnaris and the flexor digitorum superficialis, overlapped by the palmaris longus tendon
What would you observe in a median nerve wrist injury? Paralysis of the thenar muscles and the first two lumbricals; wasted thenar eminence; thumb is adducted; inability to oppose thumb; sensory losses would be same as those in elbow lesion
What is the cause of carpal tunnel syndrome? Caused by compression of the median nerve in the carpal tunnel (MOST COMMON COMPRESSION NEUROPATHY)
What are the symptoms of carpal tunnel syndrome? Burning pain or pins and needles along distribution of the median nerve to the lateral 3 1/2 fingers and weakness of the thenar muscles
Would you expect to see sensory loss over the thenar eminence in carpal tunnel syndrome? No (area is supplied by the palmar cutaneous branch of the median nerve, which passes superficially to the flexor retinaculum)
An injury at themedial epicondyle of the elbow would likely hurt what nerve? The ulnar nerve
What would an ulnar nerve lesion result in (what muscles are compromised)? Flexor carpi ulnaris, medial 1/2 of flexor digitorum profundus, small muscles of the hand EXCEPT the thenar muscles, and the first 2 lumbrical muscles
What actions are impaired in an ulnar nerve lesion at the elbow level? Flattening medial part of the forearm due to wasting of the flexor carpi ulnaris and the medial 1/2 of the flexor digitorum profundus; abduction and adduction of the fingers impossible (interosseous muscles); impossible to adduct thumb (adductor pollicis)
What would a person with an ulnar nerve lesion at the elbow level look like? Hyperextension of the knuckle joints due to unopposes action of the extensor digitorum due to paralysis of the interosseus muscles and lumbricals 3 and 4; flexion of interphalangeal joints (4th and 5th most prominent); hypothenar eminence wasted
What sensory deficit would an ulnar nerve lesion at the elbow level cause? Loss of sensation over the anterior and posterior surfaces of the medial third of the hand and medial one and one half fingers
What would an ulnar nerve lesion at the wrist level cause? Clawhand more obvious; marked flexion of the terminal phalanges; small muscles of hand paralyzed and show wasting EXCEPT for muscles of thenar eminence and first 2 lumbricals
What would an ulnar nerve injury at the wrist cause in terms of skin sensation? Anterior and posterior surfaces of the medial 1/3 of the hand and the medial 1 1/2 fingers
Created by: karkis77



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