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Testing Nerves of the Upper Limb

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

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Section 1

Question	Answer
avulsion	spinal nerve torn from spinal cord.
rupture	spinal nerve torn beyond CNS.
neuroma	spinal nerve torn and partially healed.
neuropraxia	spinal nerve stretched and damaged (most common).
anesthesia	loss of sensation.
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Section 2

Question	Answer
Upper Brachial Plexus injuries: aka	Erb-Duchenne Palsy
Upper Brachial Plexus injuries: causes	1. damage to root of C5 & C6 2. traumatic lateral neck bending (during childbirth; from fall on shoulder)
Upper Brachial Plexus injuries: symptoms	paralysis or weakness of shoulder and arm
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Section 3

Question	Answer
Lower Brachial Plexus injuries: aka	Klumpke Palsy
Lower Brachial Plexus injuries: causes	1. damage to roots of C8 and T1 2. traumatic hyperabduction of arm (childbirth)
Lower Brachial Plexus injuries: symptoms	paralysis 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 tested	test trapezius function
How to test trapezius function	elevate scapula (shrug) against resistance while palpating superior border of muscle
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Section 5

Question	Answer
Axillary nerve damage: causes	1. fracture of surgical neck of humerus 2. dislocation of glenohumeral joint 3. improper use of crutches 4. intramuscular injections
Axillary nerve damage: motor manifestations	paralysis of deltoid; atrophy of deltoid
Axillary nerve damage: sensory manifestation	loss of sensation on lateral shoulder
Axillary nerve damage: sensory nerve	superior lateral cutaneous nerve of arm
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Section 6

Question	Answer
Medial and Lateral Pectoral nerves: muscle tested	Pectoralis 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 tested	supraspinatus; infraspinatus
Suprascapular nerve: how to test (supraspinatus)	abduct fully adducted humerus against resistance.
Suprascapular nerve: how tot est (infraspinatus	laterally rotate adducted humerus against resistance.
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Section 8

Question	Answer
Thoracodorsal nerve: muscle tested	latissimus dorsi
Thoracodorsal nerve: how to test	arm 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 roots	C5,6,7
Long thoracic nerve: manifestations	winged scapula
Long thoracic nerve: muscle involved	serratus anterior
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Section 10

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

Question	Answer
Musculocutaneous nerve: motor muscles	biceps; coracobrachialis; brachialis
Musculocutaneous nerve: motor manifestation	weak elbow flexion and forearm supination
Musculocutaneous nerve: sensory manifestation	loss of sensation on lateral surface on forearm
Musculocutaneous nerve: sensory nerve	lateral cutaneous nerve of forearm
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Section 12

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

Question	Answer
Radial nerve: motor muscles	triceps; brachioradialis; supinator and extensors of wrist and fingers
Radial nerve: motor manifestation	"wrist drop" patient unable to extend wrist.
Radial nerve: lesions is beyond humerus	triceps not effected
Radial nerve: sensory manifestation	loss of sensaton on lateral elbow, posterior forearm and dorsum of hand
Radial nerve: sensory nerves	inferior 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 muscles	finger and wrist flexors (most), thenar muscles, and 1st and 2nd lumbricals
Median nerve: motor symptoms	can'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 manifestation	loss of sensation in lateral palm and tips of digits 1-3
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Section 15

Question	Answer
Ulnar nerve: motor muscles	flexor carpi ulnaris; medial part of FDP; most intrinsic hand muscles.
Ulnar nerve: motor symptoms	wrist adduction impaired; lateral deviation of wrist flexion; MP joints become hyperextended
Ulnar nerve: motor manifestation	cannot flex digits 4 and 5 when making a fist.
Ulnar nerve: sensory manifestation	loss of sensation in medial palm and tip of digit 5.
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Section 16

Question	Answer
Flexion: dorsal root	C6
Flexion: muscles	biceps (all); brachialis; brachioradialis
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Section 17

Question	Answer
Extension: dorsal root	C7
Extension: muscles	triceps (all); anconeus
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Section 18

Question	Answer
Pronation: dorsal roots	C6, 7, 8
Pronation: muscles	Pronator teres, Pronator quadratus
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Section 19

Question	Answer
Supination: dorsal roots	C5,6
Supination: muscles	biceps (all); supinator
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