Disease (deformaty) Injured nerve Cause Results/ effect Picture

Erb-Duchenne Palsy Injury to the upper trunk [C5 and C6],
Ear = upper affecting the suprascapular &
musculocutaneous nerves loss lateral
rotators, flexors of elbow, & supinators
Birth injury [ difficult delivery]
- Adducted Shoulder: due to paralysis of
deltoid and supraspinatus
- Medially Rotated: paralysis of infraspinatus,
teres minor and posterior fibres of deltoid
- Elbow fully extended: paralysis of elbow
Flexors (biceps, brachialis & brachioradialis)
- Forearm pronated: due to paralysis of
biceps and supinator

Policeman's tip position

[waiter’s tip]

Klumpke’s paralysis Injury to the lower trunk [C8 and T1]/ Infants—difficult delivery - forearm is supinated
[Klumpkes palsy] Affecting intrinsic muscles of the hand & - the wrist & fingers are hyperextended
partial palsy of the lower roots
the flexors
of of the wrist and fingers - flexion at IP and MCP joints
the brachial plexus

claw hand the reverse of writing position

Ulnar claw ulnar nerve lesion at the wrist - Fracture of medial epicondyle of humerus
- Fractured hook of hamate) from
fall on outstretched hand
- paralysis of lumbrical Ms. to 4th & 5th digits Flexion & clawing of 4th & 5th fingers at the
loss of flexion at MCP joint & loss of IP joints due to unopposed action of flexor
extention at IP joints Digitorum profundus
- hyperextension of MCP joints (extensor digit.)
- flexion of IP joints
- Loss of sensation of palmar aspect of medial
11/2 fingers including hypothenar eminence

clawing is seen when the patient is asked to

Winging Scapula Injury to the long thoracic nerve
of serratus anterior
Paralysis axillary surgery or trauma to chest wall
may damage long thoracic nerve
extend the fingers
Paralysis of serratus anterior:
1. Medial border of scapula not opposed to
rib cage
2. Shoulder protraction and abduction
impaired

patient cannot push against the wall

Wrist Drop Radial Nerve [C5-T1] Affecting Triceps
brachii, anconeus, supinator, brachioradialis
(extensor muscles of forearm)
- mid shaft fracture damage radial N - Inability to extend the hand
- Injury & Crutch palsy - inability to fully extend forearm
- Honymoon palsy
- Saturday-night palsy
- Long-term pressure on the nerve
- Long-term/repeated constriction of wrist
Ape Hand Median nerve (C5-T1) at the flexor
(Carpal tunnel syndrome) retinaculum (at wrist)
Ape Hand Median nerve At the wrist above the flexor
retinaculum
Hand of benediction Median nerve or anterior interosseous nerve supracondylar fracture that occurs by
[popes blessing] at the elbow or wrist
Fractures of Humerus - Surgical neck fracture Axillary nerve
- Radial groove (mid shaft) Radial nerve
- Distal end of humerus Median nerve
(Not always bcz it is not in direct relation)
- Medial epicondyle Ulnar nerve.
- ulnar nerve injury at the elbow
NO clawing
Loss sensation of dorsal aspect of the 4th & 5th fingers
penetrating wounds (stab wounds or broken
glass) of the forearm.
falling on an outstretched hand
- fractures of greater tubercle results
from falling on the hand when the arm
is abducted
- fracture of body of humerus result
from a direct blow to the arm or by
indirect injury as falling on the
oustretched hand.
Motor: Thenar eminance is flattened, Thumb is
- Inability to Oppose Thumb extended, laterally rotated & adducted
- wasting of the thenar eminence (Weak motor
function of thumb, index & middle fingers)
Sensory:
- Burning pain or ‘pins and needles’ along the
distribution of median nerve to dorsal and
palmar aspects of lateral 3½ fingers
- No sensory changes over the palm
Motor:
- Thenar muscles are paralyzed thenar
eminence becomes flattened
- lose of Opposition and abduction of thumb
- thumb and lateral two fingers are arrested
in adduction and hyperextension position
Sensory:
- Palmer aspect of the lateral 3½ fingers
- Distal part of the dorsal surface of the lateral
3½ fingers
- paralysis of lumbrical Ms. To 3rd & 2th digits
loss of flexion at MCP joint
- paralysis of flexor digitorum profundus to 2nd
& 3rd digits loss of flexion at distal IP joint
- It is seen when the patient is asked to
Make a fist the fingers the 2nd & 3rd fingers
will remain extended.
- Also patient cannot do the OK sign [adult]
- pointed index sign [infant]
Depending on the type of nerve that is
injured