Upper Limb Nerves

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    28-Dec-2015
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Compilation of Axillary, Musculocutaneous, Radial, Medial, and Ulnar nervesTheir normal and abnormal function and most common injuries

Transcript of Upper Limb Nerves

  • UpperLimbNervesBy:RameezandKashif

    NERVES

    Axillary

    C5C6

    MusculocutaneousC5C7

    Median C5T1

    Ulnar C8T1

    RadialC5T1

    SENSORYSUPPLY

    LateralArm

    LateralForearm

    Lateral3digits:LateralPalm

    Medial1digits:MedialPalm.MedialForearm

    Dorsumofhandover1stwebandanatomicsnuffbox.Posteriorarmandforearm

    MOTORFUNCTIONS

    DeltoidAbductShoulder15110degrees.TeresMinorLateralrotationofshoulder

    AllthemusclesofAnteriorCompartmentofArm.BBCBracialis,BicepsBrachii,Coracobracialis.>FlexElbow>Supination(Biceps)

    A.Forearm:AllthemusclesintheAnteriorCompartmentofforearnexcept1musclebyulnarnerve(flexorcarpiunlarisandulnarhalfofflexordigitorumprofundas)>FlexwristandAlldigits>PronationHand:1,2LOAF

    1stn2ndLumbricals(Digit2&3)>FlexMCPandExtendPIP&DIP

    A.ForearmAnteriorCompartment:1musclenotsuppliedbythemediannerveFlexorCarpiUlnarisandUlnarhalfoftheFlexorDigitorumProfundus.>Flexwrist(weak)andDigits4and5.Hand:3,4LOAF

    3rd&4thLumbricalsHypothenarMuscles(OAFdigitiminimi)

    PosteriorCompartmentMusclesoftheArmandForearm.>ExtendMCP,wristandelbowJoints.>Supination(Supinatormuscle)

  • ThenarCompartmentOppoonensPollicis(thumbopposition),AbductorPollicisbrevis,FlexorPollicisBrevis

    Allinterossei(DAB+PAD)>alsoassistlumbricalsindigits25.AdductorPollicis(thumbadduction)

    MANIFESTATIONOFINJURY

    Adduction&MedialRotationLossofsensationoflateralarm.

    ExtendedelbowandPronatedforearm.

    *Weakenedwristflexionwithulnardeviation

    *Lossofpronation*AbsenceofflexionatLat.3digitshandofbenediction*Lossofthumboppositionapehand*Lossof1st2lumbricals*thenaratrophy*lossofsensationoverthenareminanceanddorsalandpalmaraspectsoflateral3.5fingerswithproximallesion.MedianClaw(ExtendingDigits)

    *Weakenedwristflexionwithradialdeviation

    *Lossofhypothenarmuscle(atrophy),3rd&4thlumbricals(weakinterphalengealextension),allinterossi(lossofabductionandadductionofdigits25)Adductorpollicis(lossofthumbadduction).Lossofsensationovermedial1.5fingersincludinghypothenareminance.UlnarClaw(onextendingfingers)*Alwaysrememberthatthedistallesionwillcauseproblemsinextendingthefingers.ProximallesionswillpreventinFlexingtheFingers.

    LossofextensionattheMCP,wristandelbow.WeakornosupinationDecreasedgripstrength(wristextensionnecessaryformaximalactionofflexors).Lossofsensationoverarm,forearmanddorsalhandanddorsumofthumb.WristDrop

  • ApehandandPopesBlessing(onmakingfist)

    CAUSESOFINJURYTONERVES

    SurgicalNeckFractureofHumerus

    AnteriorDislocationofHumeralhead

    Erbspalsy:(WhenAxillary,MusculocutaneousandSuprascapulanervesareallinjured)

    UppertrunkCompression

    ErbsPalsy:(WhenAxillary,MusculocutaneousandSuprascapulanervesareallinjured)

    s

    CarpalTunnelCompression

    Supracondylarfractureofhumerus

    Pronatorteressyndrome

    Dislocatedlunate

    Fractureofmedialepicondyleofhumerus

    Fractureofhookofhamate

    fractureofclavicle

    Klumpke`spalsy:TotalClawHand

    Saturdaynightpalsy

    Midshaftfractureofhumerus

    Sublaxationofradius

    Dilocatedhumerus