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Lesioned by trauma
- Lesioned by fracture of surgical
- neck; dislocation of
- the humerus; intramuscular
Radial Nerve in Sprial Groove?
Lesioned by midshaft fracture of humerus
- (deep branch)?
- Stretched by subluxation
- of radius
Recurrent branch of median nerve?
- Lesioned by
- Lesioned by trauma to heel of the hand;
- fracture of hook of hamate
- Compressed in carpal tunnel syndrome
- and by dislocated lunale
Anterior interosseous nerve?
Compressed in deep forearm
Ulnar at Elbow?
- Fracture of medial epicondyle or
- repeat minor trauma
Median Nerve at elbow:
- compressed by supracondylar fracture of humuerus;
- Pronator teres syndrome
Crutch/ Sat Night
Lower trunk of
- brachial plexus?
- Compressed by cervical rib
- 1 or by Pancoast tumor of lung;
- i leads to Klumpke's palsy
- Compressed by
- cervical disk les1on
Axillary Deficits and Signs?
- abduction at shoulder
- S: Over deltoid muscle
- Sign:Atroph ied deltoid
Radial (CS-Tl) Deficits and Signs?
- m:"BEST extensors"Brachiorad
- ial is,
- Extensors of
- wrist and fingers,
- Supinator, Triceps
- s:Posterior arm and
- dorsal hand and
- sign: Wrist Drop
Median (CS-CB, Tl) Deficits and Signs?
- m:Opposition of thumb
- Lateral fi nger flexion
- Wrist flexion
- s:Dorsal and palmar
- aspects of lateral
- 3 1/z fingers, thenar
- em mence
- sign:Ape hand"; " Pope's
- blessing" ( hand)
Ulnar (CB, Tl) Deficits and Signs?
- m:Medial fi nger flexion
- Wrist flexion
- s:Medial 1 1/z fi n gers,
- sign:Radial deviation of
- wrist upon wrist
- (CS-C7)Deficits and Signs?
- m:Biceps, brach ialis,
- Flexion of arm at
- s:Lateral forearm
Erb-Duchenne palsy ("walter's tip")?
- Traction or tear of the upper trunk of the
- brach ial plexus (C5 and C6 roots); seen i n
- i n fants following trauma dur i n g del ivery.
- Findings : l i mb hangs by side (paralysis of
- abductors), medially rotated (paralysis of lateral
- rotators), forearm is pronated ( loss of biceps) .
Klumpke's palsy and thoracic outlet syndrome?
- An embryologic or childbirth defect affecting inferior trunk of brach ial plexus ( C 8 , Tl ) ; a cervical
- rib can compress subclavian artery and inferior trunk, resulting in thoracic outlet syndrom e :
- Atrophy o f t h e thenar a n d hypothenar eminences
- Atrophy of the interosseous muscles
- Sensory deficits on the medial side of the forearm and hand
- D isappearance of the rad ial pulse upon movi ng the head toward the ipsilateral side
- Can be caused by long-standing injur y to ulnar nerve at hook of hamate (e.g., by fal l i n g onto
- outstretched hand) . D istal ulnar nerve lesion -+ loss of medial lumbrical fu nction -+ inability to
- extend 4th and 5th digits ( "clawing") when tryi ng to open the hand.
- Can be caused by carpal tunnel syndrome or dislocated lunate. Distal median nerve lesion (after
- branch conta i n i n g C 5-C7 branches off to feed forearm flexors) -+ loss of latera l l umbrical
- function ; 2nd and 3rd digits are clawed upon attempted Finger extension.
- Proximal median nerve lesion causes loss of lateral Finger flexion and thumb opposition . When
- asked to make fist, 2nd and 3rd digits remain extended and thumb remains unopposed, which
- looks l ike the hand of benediction or " Pope's blessing."
- Proximal median nerve lesion- loss of opponens poll icis muscle function -+ unopposable thumb
- (i nabil ity to abduct thumb) , hence "ape hand."
Klumpke's total claw?
- Lesion of lower trunk ( C 8 , Tl) of brach ial plexus-+ loss of function of all lumbrica l s ; forearm
- Long thoracic nerve
- Hand muscles
- Finger fl exors (fed by part of median nerve with C 5 -C7) and Finger extensors (fed by radial nerve)
- are unopposed -+ clawing of all digits
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