drooping wrist
Introduction
Introduction The scapula is a typical symptom of dyskinesia in the type of symptoms of sacral nerve paralysis. The phrenic nerve consists of C5-8, which governs upper limb paralysis, elbow muscle, diaphragm, supinator, extensor and lupus. The main functions are elbow extension, wrist extension and extension.
Cause
Cause
The phrenic nerve can be paralyzed by the support of the trap in the axillary fossa. The upper part of the sacral nerve is close to the dorsal radial sulcus in the middle part of the humerus. It is from the medial side of the upper arm to the lateral side. When the humeral shaft is fractured, it is easily damaged, or the epiphysis is formed after the fracture. Damaged; the arm is replaced by a pillow during sleep, the upper arm is abducted for a long time during surgery, and the tourniquet is improperly placed on the upper limb, etc.; lead poisoning and alcoholism can also selectively damage the phrenic nerve.
Examine
an examination
1. Movement disorders:
The typical symptom is the wrist.
1 High injury (above the triceps branch of the triceps) leads to complete paralysis of the phrenic nerve. The extensor muscles of the upper extremities are completely paralyzed. The elbow, wrist and metacarpophalangeal joints cannot be straightened. When the forearm is straight, it cannot be rotated. In the anterior position, the tendon tendon does not bend the elbow joint in the semi-rotation.
2 1/3 of the humerus (below the triceps branch) is damaged, and the triceps function is intact.
3 Injury of the lower end of the tibia or the upper third of the forearm, the diaphragm, the supinator, and the wrist muscle are preserved.
4 In the middle of the forearm, less than 1/3 of the injury, only the index finger, no hanging wrist.
5 close to the wrist injury (each exercise has been issued), no paralysis of the nerves.
2. Symptoms of sensory disorder: only the back of the hand and the first and second metacarpal space are sensory.
Diagnosis
Differential diagnosis
(1) musculocutaneous neuropathy: mainly showing biceps and upper arm muscle atrophy, upper arm flexion side flat, elbow joint flexion weakening, anterior wall showing external rotation position, unable to flex the elbow joint, forearm rotation restricted, biceps, the biceps tendon reflex disappeared, the anterior wall was dysfunctional, and the periosteal reflex was weakened or disappeared.
(B) arm paralysis from the nerve: upper arm plexus injury, the upper arm can not be abducted, the forearm can not flex, the arm can not be external rotation, the forearm can not be rotated, the arm straight extension is internal rotation and internal retraction. The sensory impairment is not obvious. Muscle atrophy in the shoulder and upper arm, and the biceps and periosteal reflexes weakened or disappeared. The lower wall clasp finger wrist can not flex, the finger can not be abducted and adducted, the thumb can not flex, adduct, abduction, the little finger can not do the palm movement, the forearm and the ulnar side of the hand have a feeling of decline. The size of the fish is shrinking. The hand is swollen, bruised, and the nails become brittle. There may be Horner's sign, and the face and neck are sweating abnormally.
