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Upper Limb
Traction
Stab wounds
coracobrachialis
Thus:
The limb hangs limply by the
side, and is medially rotated
The forearm is pronated and
extended
There is loss of sensation down
metacarpophalangeal joints
(the extensor digitorum is
unopposed by the lumbricals
and interossei and extends
the metacarpophalangeal
joints).
Flexion of the interphalangeal
mastectomy surgical
procedure.
The serratus anterior muscle:
Pulls the medial border of
neck of humerus
Deltoid and teres minor
muscles become paralyzed
Abduction of the shoulder is
impaired. The paralyzed
deltoid wastes rapidly (loss of
rounded contour of the
shoulder)
Loss of sensation over the
lower half of deltoid muscle
Radial Nerve
The radial nerve is commonly damaged:
in the axilla
supinator tunnel)
Injury to the superficial branch
Radial Nerve Injury in the Axilla
In the axilla the nerve may
be injured by:
Pressure of the upper end
humerus
Callus formation
tourniquet.
The injury to radial nerve occurs
most commonly in the distal part
of the groove beyond the origin of
the nerve to the triceps &
anconeus (so that extension of
the elbow is possible), and
beyond the origin of the
cutaneous nerves
Motor :The long extensors of the
forearm are paralyzed and this
will result in a "wrist drop".
Sensory: Loss of sensation from
small area overlying the first
dorsal interosseous muscle
Injury to the Deep Branch of the Radial
Nerve
It may be damaged in fractures of the proximal end
of the radius or during dislocation of the radial
head.
Motor:.
Intact forearm extension and flexion with intact hand
extension. Only weakness of finger extensors.
Nerve supply to the supinator and extensor carpi radialis
longus will be undamaged and because the later muscle
is powerful it will keep the wrist joint extended and wrist
drop will not occur.
Sensory: There will be no sensory loss since this
is a motor nerve.
Injury to the Superficial Branch of the Radial
Nerve
It may be damaged as a result of stab injury, or
pressure from handcuffs & tight bangles
Motor: There will be no motor loss since this is a
sensory nerve.
Sensory: There is a small loss of sensation
over the dorsal surface of the hand and the
dorsal surfaces of the roots of the lateral three
fingers
Median Nerve Lesions
Injury of median nerve at
different levels cause different
syndromes.
The most serious disability of
median nerve injuries is the:
Loss of opposition of the
forearm
All long flexors of the
3½ fingers
Distal part of the dorsal
medial epicondyle
At the wrist, where it lies with the ulnar
profundus
Small muscles of the hands,