Clinical Examples

Long thoracic Nerve Damage

Winged scapula, loss of some protraction

Ulnar Nerve lesion

Claw Hand (flexion of PIP 3-5), weal ulnar deviation and finger AB/ADduction

Median Nerve Damage (proximal to elbow)

weak/absent pronation, wrist/MCP/PIP flexion

Median Nerve damage (distal to elbow, proximal to wrist)

Hand of Benediction (loss of MCP/PIP/DIP 1-3 flexion)

How to determine Ulnar/Median damage

test AB/ADduction. If positive, likely ulnar, if negative, likely median

Upper trunk lesion/Erb’s palsy

typically in child birth. due to traction btw neck and shoulder

Loss of: ABduction, External rotation, supination, elbow flexion, sensation in lateral shoulder

Lower trunk lesion/Klumpke’s palsy

Tension between arm and axilla (hanging from tree ex.)

damager to C8/T1- claw hand is present

Radial nerve lesion location (honeymoon/Saturday Night Palsy)

Anywhere from posterior cord to hand (triangle interval, radial groove, supinator are most common)

Radial Nerve Lesion symptoms

Wrist drop, loss of elbow extension

Stenosing tenosynovitis/ Trigger Finger

Distended annular ligament 2

nodule on flexor tendon 1

Indirect inguinal hernia

Enters deep inguinal ring LATERAL to inferior epigastric artery

distends spermatic cord

exits superficial ring

Direct inguinal hernia

protrudes through wall in inguinal triangle medial to inferior epigastric artery

Common Axillary injuries

proximal fracture of humerus, humeral subluxation

Pyloric Stenosis

Most seen in babies

hypertrophy of pyloric sphincter

projectile vomiting is main symptom

hiatal hernia

part of stomach herniates above /through esophageal hiatus

Meralgia

Damage to Lateral Femoral cutaneous nerve

numbness and burning sensation

Pulmonary collapse

compromised pressure vacuum in lung cavity

Carpal tunnel syndrome

Median nerve becomes compressed in Carpal tunnel

FDP/FDS tendons become inflamed