FACTS & HINTS

HIGH-YIELD FACTS

Clinical Points

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Brachial Plexus Injury

Disease, trauma or excessive stretching (because of birth trauma) of the posterior triangle of the neck or axilla maydamage brachial plexus Results in paralysis and anaesthesia in the distribution of the affected nerves

Various terms used to describe the different lesions

Erb's palsy affects areas supplied bynerves from superior part of the plexus Klumpke's palsy affects areas supplied bynerves from the inferior part

Carpal Tunnel Syndrome

Aresult of compression of the median nerve as it passes under flexor retinaculum

Compression caused byanyprocess that significantlyreduces the size of the carpal tunnel: inflammation of the synovial sheaths, fluid retention, and infection

Pain or paraesthesia felt in the lateral 3½ digits, mayradiate toward the elbow and is often worse at night Also loss of sensation and diminished control of the median nerve-innervated muscles

Surgical division of the flexor retinaculum maybe necessaryto relieve symptoms

Ulnar Nerve Injury

Ulnar nerve maybe compressed as it passes behind medial epicondyle of the humerus or through the Guyon canal at the wrist Pain and/or paraesthesia felt at medial aspect of the elbow radiating to the medial forearm and medial 1½ digits

Also maybe weakness of the intrinsic muscles of the hand

Radial Nerve Injury

Palsyof the radial nerve common after prolonged pressure on the back of the arm byresting it against a hard surface (such as back of movie theater seat-the "Saturday night palsy")

Nerve mayalso be injured in fractures of humerus as it winds along spiral groove Extensors of the wrist are paralyzed, resulting in a wrist drop

Triceps not affected unless the nerve is injured proximallyin the axilla

MNEMONICS

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