Upper Extremity Nerve Injuries: Diagnosis, Motor & Sensory Testing Simplified скачать в хорошем качестве

Upper Extremity Nerve Injuries: Diagnosis, Motor & Sensory Testing Simplified

Educational animated video describes nerve injury in the upper extremity Long thoracic nerve injury: C5, C6, C7 •Medial winging of the scapula Axillary nerve injury •Dislocation of the humeral head •Numbness over the deltoid region of the shoulder. •Weakness of shoulder abduction due to deltoid weakness. Anterior interosseous nerve injury •Fracture dislocations around the elbow. •The patient cannot do the O.K sign •Typical pinch attitude with nerve injury Posterior interosseous nerve injury •The patient can perform wrist extension, but not finger extension Normal radial nerve function •Extension of the wrist and the fingers •A radial nerve injury may occur with fractures involving the distal third of the humeral shaft. Median nerve injury- Carpal tunnel syndrome •Phalen’s maneuver is a diagnostic test used to determine if a patient has carpal tunnel syndrome. It involves pushing the backs of the hands together for one minute. This compresses the carpal tunnel and is positive when it causes the same symptoms as carpal tunnel syndrome. •Tinel’s test is positive when tapping on the nerve worsens the tingling of the fingers. •Thenar atrophy is commonly associated with carpal tunnel syndrome. •Carpal tunnel release is performed by cutting through the transverse carpal ligament to release the compressed nerve. Ulnar nerve injury- Cubital tunnel syndrome •Cubital tunnel syndrome occurs due to compression of the ulnar nerve at the elbow. • Due to cubital tunnel syndrome, the patient cannot cross or abduct the fingers. •Froment’s test: When pinching a piece of paper between the thumb and index finger, the thumb IP joint will flex if the adductor pollicis muscle is weak. •Numbness and tingling on half of the ring finger and the entire little finger are common symptoms of ulnar nerve entrapment. •Cubital tunnel release is accomplished by dividing the ligament to decrease nerve compression or transposition of the nerve. Lower ulnar nerve injury- Claw hand •The claw hand deformity is a symptom of lower ulnar nerve entrapment below the elbow and typically causes flexion and clawing of the 4th and 5th fingers Quizzes 1. Which nerve injury is associated with medial winging of the scapula? Correct answer: Long thoracic nerve A. Axillary nerve B. Ulnar nerve C. Long thoracic nerve D. Radial nerve Explanation: The long thoracic nerve innervates the serratus anterior. Injury to it causes medial scapular winging. 2. An anterior dislocation of the humeral head most likely injures which nerve? Correct answer: Axillary nerve A. Radial nerve B. Axillary nerve C. Ulnar nerve D. Median nerve Explanation: The axillary nerve runs near the surgical neck of the humerus and is at risk during shoulder dislocations. 3. A patient cannot abduct the shoulder and has numbness over the deltoid. Which nerve is affected? Correct answer: Axillary nerve A. Musculocutaneous nerve B. Radial nerve C. Axillary nerve D. Suprascapular nerve Explanation: The axillary nerve innervates the deltoid, responsible for shoulder abduction and sensation over the deltoid area. 4. In anterior interosseous nerve injury, the patient is unable to do what? Correct answer: Make an "O.K" sign A. Flex the wrist B. Extend the fingers C. Make an "O.K" sign D. Abduct the thumb Explanation: AIN injury weakens the flexor pollicis longus and FDP to the index, preventing the O.K sign. 5. A patient has difficulty with finger extension but can extend the wrist. What is the diagnosis? Correct answer: Posterior interosseous nerve injury A. Median nerve palsy B. Radial nerve palsy C. Posterior interosseous nerve injury D. Anterior interosseous nerve injury Explanation: The PIN affects finger extensors but spares the wrist extensors. 6. A fracture of the distal third of the humerus is likely to damage which nerve? Correct answer: Radial nerve A. Median nerve B. Radial nerve C. Axillary nerve D. Ulnar nerve Explanation: The radial nerve wraps around the humerus and is vulnerable at the distal shaft. 7. What clinical finding is typical of carpal tunnel syndrome? Correct answer: Thenar atrophy A. Claw hand B. Loss of finger abduction C. Thenar atrophy D. Wrist drop Explanation: Median nerve compression at the wrist causes thenar muscle wasting over time. 8. Phalen’s test is used to diagnose what condition? Correct answer: Carpal tunnel syndrome A. De Quervain’s tenosynovitis B. Carpal tunnel syndrome C. Cubital tunnel syndrome D. Guyon’s canal syndrome Explanation: Phalen’s maneuver compresses the carpal tunnel to elicit symptoms of median nerve compression. 9. Tinel’s sign is positive when tapping over which nerve reproduces symptoms? Correct answer: Median nerve A. Radial nerve B. Ulnar nerve C. Median nerve D. Axillary nerve Explanation: Tinel’s sign is commonly used at the wrist for carpal tunnel, affecting the median nerve. 10. Which muscle is weak in a positive Froment’s sign? Correct answer: Adductor pollicis