Lecture Exam 2 - Neuropathies and Plexopathies of the Upper Limb

Carpal Tunnel Syndrome, Laceration of Thenar Eminence, Suicide attempts

Causes of Distal Median Neuropathy

Median Nerve, Flexor Pollicis Longus Tendon, Tendons of Flexor Digitorum Superficialis and Profundus

Contents of Carpel Tunnel

Carpal Tunnel Syndrome (CTS)

Causes sensory deficits to digits 1-4 and motor supply to thenar muscles

Ulnar Canal Syndrome

Compression of the nerve as it passes through pisfiform and hook of handmate

PIP and DIP hyperflexion, weakness in adduction/abduction in digits 2-5 and pollex (positive froment sign)

Ulnar Canal Syndrome signs

Cubital Tunnel

Contains the Medial Epicondyle of the Humerus, ulnar nerve, olecranon, Flexor Carpi Ulnaris Muscle

Cubital Tunnel Syndrome

paralysis of Flexor Carpi Ulnaris Muscle and Ulnar half of Flexor Digitorum Profundus Muscle

clawing is less pronounced at DIP joint, weakness in flexion in digits 4 and 5, radial deviation of the wrist

Cubital tunnel syndrome signs

Proximal Median Nerve

Injury to nerve as it passes deep to the Pronator Teres and Flexor Digitorum Superficialis Muscles. 

Proximal Median Nerve Injury

Paralysis of Flexor Carpi Radialis Muscle, Flexor Digitorum Superficialis Muscle, Radial half of Flexor Digitorum Profundus Muscle

flexion defect in digits 2-3, weakened flexion in digits 4-5, Hand of Benediction Sign when attempting to make fist, unlar deviation

Signs of Proximal Median Nerve Injury

Radial nerve lesions

transverse fractures of the humerus can cause this

weakness of forearm flexion, wrist-drop sign, sensory lossof radial side of dorsal hand

Radial nerve lesions signs

Erb-Duchenne Palsy

Excessive angulation between the shoulder and neck

C5 and C6 Spinal nerves

Roots affected in Erb-Duchenne Palsy

Arm is extended adducted, medially rotated (waiters tip deformity)

Signs of Erb-Duchenne Palsy

Klumpke Palsy

Excessive angulation between the upper limb and trunk

C8 and T1 spinal nerves

Roots affected in Klumpke Palsy

Clawing of digits 2-5

Signs of Klumke palsy