MSK Upper Extremity nerves

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created 5 years ago by Garyvanlue
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1

Damage to the axillary nerve presents after what with what?

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Fracture surgical neck of humerus

Anterior dislocation of humerus

Flattened deltoid/loss of abduction >15 degrees

loss of sensation over deltoid and lateral arm

2

Damage to musculocutaneous nerve presents how?

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Upper trunk compression (C5-C7)

Loss of forearm flexion/supination

Loss of sensation over lateral forearm

3

Damage to the radial nerve presents how?

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Mid shaft humerus fracture

compress of axilla(Saturday night palsy)
wrist drop

decrease grip strength

loss of senstation over posterior arm/forearm dosal hand

4

Median nerve damage cause and findings?

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Supracondylar fracture or humerus

Carpal tunnel or wrist laceration

APE/Pope's blessing

wrist flexion, thumb, 2,3 digit

Loss of sensation over 1,2,3 and 1/2 4 digit

Tinel sign +

5

Ulnar nerve damage cause and findings?

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Fracture of medial epicondyle

Fracture hook of hamate

Claw hand/radial deviation of wrist with flexion

Loss of sensation over the 1/2 4 and 5 digit

6

Recurrent branch of median nerve

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Superficial laceration of palm

Ape hand

loss of thenar muscle group

NO SENSATION loss

7

Brachial plexus is made up of which nerve roots?

C5-T1

8

What is the composition of the long thoracic nerve?

C5-C5-C7 roots

9

draw the brachial plexus

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10

What is Erb palsy(waiter's tip)?

Injury

Cause

muscle

function

presentation

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UPPER roots C5-C6 (traction injury)

Causes: Infants traction neck

Muscle: Deltoid/Supraspinatus/Infraspinatus/Biceps

Function Look at the picture

abduction/Lateral rotation/ flexion/supination

11

What is the Klumpke palsy?

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Klumpke monkey (Lower traction injury C8-T1)

Cause: Upward force on delivery(grapping a tree)

Muscle: Intrinsic hands muscles

Presents: Total claw hand

12

Thoracic Outlet Syndrome(TOS)

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Compression of lower trunk and subclavian vessels

Cause: Cervical rib/Pancoast tumor

Similar to Klumpke

13

Winged scapula

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Nerve: Long thoracic (C5-C7)

Cause: Axillary node dissection /Stab

Muscle: Serratus anterior

Function: unable to anchor scapula to thoracic cage

14

Hand lesions

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The more distal the lesion the worse it is

the more proximal the better because more nerve fibers contribute to the action of the muscle

15

Where are the thenar and hypothenar eminence on the hand?

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Thenar is lateral

Hypothenar is medial

16

What muscles compose the thenar eminece?

OAF (pollicis means thumb)
Opponens pollicis

Abductor pollicis brevis

Flexor pollicis brevis

17

What muscles make up the hypothenar emience?

OAF (digiti minimi means pinky finger)

Opponens digiti minimi

Abductor digiti minimi

Flexor digit minimi

18

What muscles adduct the fingers and which muscles abduct the hand?

DAB = Dorsal interossei - ABduct

PAD = Palmar interossei - ADDuct

19

What do the lumbrical muscles do in the hand?

flex at MCP

Extend PIP/DIP