Post on 02-Jun-2015
Radial nerve
Supplies:
TricepsBrachioradialisSupinatorAll extensors in the forearmAbductor pollicis longusA small patch of skin at the
base of the thumb
Causes of injury:
Crutch palsy
Fracture of humerus
Tourniquet palsy
Causes of injury:Dislocation of elbowFractures around elbowSurgical accidentsBullet or knife
Signs and symptoms
Wasting of the above musclesWrist dropLoss of supination of extended elbow.Weak abduction of thumbSensation loss at the base of thumb.
Treatment
Open wounds: Repair or graftClosed wounds: Spontaneous recovery during 8-12 weeks. If not: Exploration and repairIf repair failed: Tendon transfer
Median nerve
Supplies:All flexors in the forearm except:Flexor carpi ulnarisUlnar ½ of flexor digitorum profundusThe two pronatorsThenar eminence musclesLateral two lumbricalsSkin: lateral ⅔ of palm + lateral 3½ fingers
(palmar surface)
Causes:
Forearm fractures
Elbow dislocation
Gun shot OR Stab woundCarpal Dislocation
Symptoms and Signs:
All above muscles are wasted
Weak wrist flexion
Weak pronation
Pointing index sign is +ve
Thumb abduction is weak
Sensation loss and trophic ulcers
Treatment:
Repair or graft
Ulnar nerve
Supplies:
Two flexors in the forearm
Hypothenar eminence muscles
Eight interossei and two lumbricals
Abduction and Adduction of the fingers
Flexion of M.P.J
Extension of I.P.J
Adductor pollicis
Causes
Injuries
Pressure of a deep ganglion in the wrist
Fractures around elbow
Cubitus valgus deformity
Nerve entrapment in the cubital tunnel
Symptoms and signs
Hypothenar wasting
Wasting of the interossei(first dorsal interosseous
Claw hand
Loss of thumb adduction (Froment’s test)
Sensation loss
Treatment
Repair or Graft
Tendon transfer
Femoral nerve
Supplies:
Quadriceps muscle
Iliopsoas muscle
Skin: (1) Anterior of thigh
) 2 (Medial aspect of the leg.
Causes
Gunshot
Bleeding into the thigh
Traction during operation
Symptoms and signs
Loss of knee extension
Hand- knee gait
Numbness of skin
↓Knee jerk.
TreatmentSuturing OR Grafting