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Testing Nerves of the Upper Limb

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studyhelper1's version from 2010-07-22 10:02

Section 1

Question Answer
avulsionspinal nerve torn from spinal cord.
rupturespinal nerve torn beyond CNS.
neuromaspinal nerve torn and partially healed.
neuropraxiaspinal nerve stretched and damaged (most common).
anesthesialoss of sensation.
memorize

Section 2

Question Answer
Upper Brachial Plexus injuries: akaErb-Duchenne Palsy
Upper Brachial Plexus injuries: causes1. damage to root of C5 & C6 2. traumatic lateral neck bending (during childbirth; from fall on shoulder)
Upper Brachial Plexus injuries: symptomsparalysis or weakness of shoulder and arm
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Section 3

Question Answer
Lower Brachial Plexus injuries: akaKlumpke Palsy
Lower Brachial Plexus injuries: causes1. damage to roots of C8 and T1 2. traumatic hyperabduction of arm (childbirth)
Lower Brachial Plexus injuries: symptomsparalysis or weakness of short muscles of hand
Lower Brachial Plexus injuries: manifestations"claw hand"
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Section 4

Question Answer
Accessory nerve: muscle testedtest trapezius function
How to test trapezius functionelevate scapula (shrug) against resistance while palpating superior border of muscle
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Section 5

Question Answer
Axillary nerve damage: causes1. fracture of surgical neck of humerus 2. dislocation of glenohumeral joint 3. improper use of crutches 4. intramuscular injections
Axillary nerve damage: motor manifestationsparalysis of deltoid; atrophy of deltoid
Axillary nerve damage: sensory manifestationloss of sensation on lateral shoulder
Axillary nerve damage: sensory nervesuperior lateral cutaneous nerve of arm
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Section 6

Question Answer
Medial and Lateral Pectoral nerves: muscle testedPectoralis major
Medial and Lateral Pectoral nerves: how to test (clavicular head)abduct 90 then move anteriorly against resistance while palpating muscle.
Medial and Lateral Pectoral nerves: how to test (sternocostal head)abducted 60 - then adducted against resistance while palpating muscle.
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Section 7

Question Answer
Suprascapular nerve: muscles testedsupraspinatus; infraspinatus
Suprascapular nerve: how to test (supraspinatus)abduct fully adducted humerus against resistance.
Suprascapular nerve: how tot est (infraspinatuslaterally rotate adducted humerus against resistance.
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Section 8

Question Answer
Thoracodorsal nerve: muscle testedlatissimus dorsi
Thoracodorsal nerve: how to testarm abducted 90 degrees; adducted against resistance while anterior border of muscle is palpated
Thoracodorsal nerve: when is it susceptible to injury?during surgery in interior part of axilla
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Section 9

Question Answer
Long thoracic nerve: injury to whic rootsC5,6,7
Long thoracic nerve: manifestationswinged scapula
Long thoracic nerve: muscle involvedserratus anterior
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Section 10

Question Answer
Dorsal scapular nerve: manifestationscapula on ipsilateral side will be deviated laterally relative to scapula on normal side
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Section 11

Question Answer
Musculocutaneous nerve: motor musclesbiceps; coracobrachialis; brachialis
Musculocutaneous nerve: motor manifestationweak elbow flexion and forearm supination
Musculocutaneous nerve: sensory manifestationloss of sensation on lateral surface on forearm
Musculocutaneous nerve: sensory nervelateral cutaneous nerve of forearm
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Section 12

Question Answer
Bicipital reflextests musculocutaneous nerve and C5,C6 spinal nerves
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Section 13

Question Answer
Radial nerve: motor musclestriceps; brachioradialis; supinator and extensors of wrist and fingers
Radial nerve: motor manifestation"wrist drop" patient unable to extend wrist.
Radial nerve: lesions is beyond humerustriceps not effected
Radial nerve: sensory manifestationloss of sensaton on lateral elbow, posterior forearm and dorsum of hand
Radial nerve: sensory nervesinferior lateral cutaneous nerve of arm; posterior cutaneous nerve of forearm; superficial branch of radial nerve
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Section 14

Question Answer
Median nerve: motor musclesfinger and wrist flexors (most), thenar muscles, and 1st and 2nd lumbricals
Median nerve: motor symptomscan't flex proximal IP joints of digits 1-3; can't flex distal IP joints on digits 2 and 3.
Median nerve: motor manifestation"Benediction hand" when attempting to make a fist.
Median nerve: sensory manifestationloss of sensation in lateral palm and tips of digits 1-3
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Section 15

Question Answer
Ulnar nerve: motor musclesflexor carpi ulnaris; medial part of FDP; most intrinsic hand muscles.
Ulnar nerve: motor symptomswrist adduction impaired; lateral deviation of wrist flexion; MP joints become hyperextended
Ulnar nerve: motor manifestationcannot flex digits 4 and 5 when making a fist.
Ulnar nerve: sensory manifestationloss of sensation in medial palm and tip of digit 5.
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Section 16

Question Answer
Flexion: dorsal rootC6
Flexion: musclesbiceps (all); brachialis; brachioradialis
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Section 17

Question Answer
Extension: dorsal rootC7
Extension: musclestriceps (all); anconeus
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Section 18

Question Answer
Pronation: dorsal rootsC6, 7, 8
Pronation: musclesPronator teres, Pronator quadratus
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Section 19

Question Answer
Supination: dorsal rootsC5,6
Supination: musclesbiceps (all); supinator
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