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Nerve Injuries Affecting the Upper Extremity

Topic: Pharmacology

Created on Friday, December 22 2006 by jdmiles

Last modified on Friday, December 22 2006.

A Greek female deity was gouged in the axilla by a Narwhal 6 weeks ago. She presents to your clinic today complaining of numbness in the area shaded in green in the image above. She also, as pictured, is unable to extend her arm at the elbow. Abduction at the shoulder has been spared.
Needle EMG is likely to show fibrillations in which of the following muscles?

 
        A) Extensor indicis
 
        B) Latissimus dorsi
 
        C) Supraspinatus
 
        D) Lumbricals III
 
        E) Flexor digitorum profundus II
 

 


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This question was created on December 22, 2006 by jdmiles.
This question was last modified on December 22, 2006.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) extensor indicis

This answer is correct.


The sensory and motor deficits this patient complains of are consistent with a radial nerve injury. The extensor indicis is one of the muscles innervated by the radial nerve. As the injury was several weeks earlier, one could now expect to see fibrillations on needle EMG.   (See References)

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B) latissimus dorsi

This answer is incorrect.


The sensory and motor deficits this patient complains of are consistent with a radial nerve injury. The latissimus dorsi is not innervated by the radial nerve. It receives innervation directly off the brachial plexus.   (See References)

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C) supraspinatus

This answer is incorrect.


The sensory and motor deficits this patient complains of are consistent with a radial nerve injury. The supraspinatus is not innervated by the radial nerve. It receives innervation directly off the brachial plexus.   (See References)

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D) lumbricals III

This answer is incorrect.


The sensory and motor deficits this patient complains of are consistent with a radial nerve injury. The lumbricals III is not innervated by the radial nerve. It is innervated by the ulnar nerve.   (See References)

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E) flexor digitorum profundus II

This answer is incorrect.


The sensory and motor deficits this patient complains of are consistent with a radial nerve injury. The flexor digitorum profundus II is not innervated by the radial nerve. It is innervated by the median nerve.   (See References)

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References:

1. Preston, D.C., and Shapiro, B.E. (2005). Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations, 2nd Edition. Elsevier, Philadelphia. Pp. 663-666.
2. Bickley, L.S., and Hoekelman, R.A. (1999). Bates' Guide to Physical Examination and History taking, 7th Edition. Lippincott, Philadelphia. Pp. 163-244.
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pharmacology
Nerve Injuries Affecting the Upper Extremity
Question ID: 12220603
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 12/22/2006
Modified: 12/22/2006
Estimated Permutations: 932083200

User Comments About This Question:

1 user entries
 

jdmiles
physiology Comment Dec 29, 2008 @ 08:29

Venus



 
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