Upper Limb Nerve Injuries
Terms
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Upper Trunk
C5 and C6 -
Level of Injury:
- Neck (posterior triangle)
Symptoms:
- "Walter's Tip" = Erb-Duchenne paralysis
- Forearm protonated, plam facing backwards
- Numbness in pad of thumb -
Lower Trunk
C8 and T1 -
Level of Injury:
- Neck (posterior triangle)
Symptoms:
- "Claw's Hand" = Klemke's paralysis
- Atrophy of intrinsic hand muscles
- Numbness in pad of 5th finger - Long Thoracic n. (C5-C7)
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Level of Injury:
- Axillar (superior) / chest wall
Symptoms:
- Winged scapula with protraction - Suprascapular (C5,C6)
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Level of Injury:
- Scapular notch
Symptoms:
- Difficulty starting aBduction - Spinal Accessory (C1-5)
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Level of Injury:
- Posterior triangle
Symptoms:
- lateral winging with aBduction - Musculocutaneous (C5,C6)
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Level of Injury:
- Axillary / coracobrachialis
Symptoms:
- Severe weakness of forearm flexion and supination
- numbness in lateral forearm - Axillary (C5,C6)
-
Level of Injury:
- Surgical neck of humerus and quadrangular space
Symptoms:
- Shoulder aBduction/elevation above horizontal - Radial n in jury at level of radial groove
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Symptoms:
- "Saturday night palsy"
- Wrist drop - loss of extension of hand only (triceps still intact)
- Elbow extension is good
- Weak wrist extension
- Numbness of 1st and 2nd dorsal webspace - Radial injury at neck of radius (deep radial) - lateral epicondyle / supinator
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Symptoms:
- No wrist drop
- No sensory loss
- Weak 2nd MC-P joint extension - Median (C5-T1)
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Level of Injury:
- Axilla/arm/elbow
Symptoms:
- Weak pronation
- Weak thumb opposition
- Numbness of pad of 2nd finger