Nerve lesions in upper limb
Quick synopsis
  • Carpal tunnel: weak abductor pollicis brevis, numb 3 and a half fingers.
  • Ulnar nerve: weak finger abduction, numb 1 and half finger.
  • Radial nerve palsy: wrist drop, numb on dorsum web between thumb and index. 
Nerve  Symptoms, Signs and most common cause
 Axillary
  • Pain: shoulder tip
  • Cause: fracture neck of humerus, dislocated shoulder, deep IM injection.
  • Motor weakness: deltoid.
  • Sensory loss: small area over deltoid
  • Reflex: none
Musculo-
cutaneous 
  • Pain: Lateral forearm  to wrist.
  • Cause: rarely damaged.
  • Motor weakness: biceps and brachialis.
  • Sensory loss: dorsum of thumb.
  • Reflex: biceps.
Radial
  • Pain: dorsum of thumb and index.
  • Cause: Crutch palsy, Saturday night palsy, fractured humerus.
  • Motor weakness: Triceps, wrist and finger extensors, brachioradialis and supinator of forearm.
  • Sensory loss: dorsum of thumb and index.
  • Reflex: triceps and supinator jerks.
Median
  • Pain: thumb, index and middle finger, often spread up to forearm.
  • Cause: 
  • Motor weakness: 
    • at elbow: wrist flexors
    • Anterior interosseus nerve: long finger flexors to thumb, index and middle fingers
    • Wrist: abductor pollicis brevis.
  • Sensory loss: thumb, index, middle and half of ring finger.
  • Reflex: finger jerk.
Ulnar
  • Pain: Little finger and half of ring finger.
  • Cause: 
    • Elbow: local trauma, prolonged pressure, repeated minor trauma, fractured olecranon.
    • Wrist: local trauma, ganglion cyst at wrist.
  • Motor weakness: All small muscles in hand except Abductor pollicis brevis.
  • Sensory loss: Little finger and half of ring finger.
  • Reflex: none

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