Karteikarten
Brachial Plexus
Karten in diesem Stapel (13)
- 1What are the lumbricals? Which lumbricals are innervated by the median nerve? Ulnar nerve? What movement are they responsible for?1) Four muscles in the hand
2) Median nerve = 3rd and 4th digit (middle and index finger); Ulnar nerve = 1st and 2nd digit
3) Flexion MCP and extension IP - 2What movement are the dorsal interossei responsible for? Palmar interossei? Which nerve innervates them?1) Finger abduction
2) Finger adduction
Dorsal interossei also help with MCP flexion and IP extension
Ulnar nerve - 3Musculocutaneous nerve Roots? Motor function? Sensory innervation? Classic Injury? Deficit?1) C5-C7
2) Elbow flexion (biceps brachii) and supination
3) Lateral part of forearm
4) Isolated injury rare
5) Impaired function ^^ - 4Axillary Nerve Roots? Motor function? Sensory innervation? Classic Injury? Deficit?1) C5, C6
2) Shoulder abduction (deltoid)
3) Inferior region of the deltoid muscle
4) Humeral neck fracture/dislocation
5) Flattened deltoid, loss of sensation in regimental badge area - 5Radial Nerve Roots? Motor function? Sensory innervation? Classic Injury? Deficit?1) C5-C8
2) Extension (Elbow - triceps reflex, wrist, fingers, thumb)
3) Interosseous web
4) Humeral midshaft fracture
5) Wrist drop, loss of sensation - 6Median Nerve Roots? Motor function? Sensory innervation? Classic Injury? Deficit (Proximal vs. distal)1) C5-T1
2) LOAF muscles, forearm flexors (pronation and wrist flexion)
3) Palmar aspect of lateral 3.5 fingers
4) Carpal tunnel syndrome
5) Proximal - loss of supination and hand of benediction. Distal - carpal tunnel syndrome, reduced movement of thumb - 7Ulnar Nerve Roots? Motor function? Sensory innervation? Classic Injury? Deficit (proximal vs distal)?1) C8, T1
2) Intrinsic muscles except LOAF, forearm flexor compartment (wrist flexion)
3) Medial 1.5 fingers
4) Medial epicondyle fracture
5) Distal = claw hand, proximal (elbow) = claw hand less severe as loss of long flexors as well as medial lumbricals. Loss of sensation and abduction/adduction - 8Long thoracic Roots? Motor function? Sensory innervation? Classic Injury? Deficit?1) C5, C6, C7 (wings to heaven)
2) Serratus anterior
3) N/A
4) Sports injury - blow to ribs, or following mastectomy
5) Winging of scapula - 9What are the LOAF muscles?L = Lateral two lumbricals
O = opponens pollis
A = Abductor pollis brevis
F = Flexor pollis brevis
(i.e. lateral two lumbicals and thenar (thumb) muscles are controlled by median nerve) - 10Explain hand of benediction sign following median nerve injuryWhen patient tries to make a fist, they cannot flex the lateral MCP leaving those two fingers pointing upwards in a 'hand of benediction'
- 11Explain the ulnar nerve paradoxProximal injury (i.e. at the elbow) results in a less severe claw hand - this is because the long flexors and the medial lumbricals have lost innervation, therefore there is unopposed extension and the medial fingers don't claw.
In a distal injury (i.e. at the wrist) - the long flexors are still intact so there is slight flexion of the IPs leading to a clawed appearance. - 12How does Erb-Duchenne palsy present? Which nerve roots are damaged? Cause of injury?1) Waiter's tip - wrist flex and pronated, shoulder internally rotated, elbow extended
2) C5, C6 (upper branch injury)
3) Should dystocia - 13How does Klumpke's palsy present? Which nerve roots have been damaged? Cause of injury? Associated condition due to damage?1) Intrinsic muscles of the hand paralysis (T1) and claw hand - hyperextended metacarpopharyngeals and flexed IPs (unopposed action of long flexors and extensors)
2) C8 and T1 (lower branch injury)
3) Shoulder dystocia or sudden jerk of hand
4) Horner's syndrome - T1 injury: ptosis and miosis
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- MSK year 4 Karteikarten am Brachial Plexus, erstellt von Anna Hogarth am 03/03/2021.
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- Anna Hogarth
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