1. Gross anatomy Web ex
Upper limb
Lower limb

2. Upper limb
Lesions of the Brachial Plexus
Fractures

5. Erb-Duchenne’s Palsy Injury to C5-6 at Erb’s point
Muscles paralysed – Deltoid,
biceps, brachialis,
barachioradialis
Posture – waiter’s tip deformity
Mechanism of injury : fall on shoulder or excessive pulling of head of new born during delivery

7. Klumpke’s palsy Injury to C8-T1
Muscles paralyzed – small muscles of hand
Deformity Claw hand
Mechanism : Sudden superior pull on upper

8. Clawed hand due to loss of innervation of Intrinsic muscle of the hand
Symptoms:
Clawed hand due to loss of innervation of
Intrinsic muscle of the hand

9. Radial nerve

10. wrist-drop
The characteristic clinical sign of radial nerve injury is wrist-drop.

11. Fracture of the Humeral Shaft
A midhumeral fracture may injure the radial nerve in the radial groove in the humeral shaft.
Fracture is not likely to paralyze the triceps because of the high origin of the nerves to two of its three heads.

12. Main Effect: Radial Nerve Injury in Axilla: Mechanism:
SATURDAY NIGHT PALSY
Radial Nerve Injury in Axilla:
Mechanism:
Crutches pressing in axilla
Saturday night palsy!
Main Effect:
WRIST DROP

13. Axillary nerve

14. Note the left deltoid muscle atrophy.

15. Median nerve

16. Carpal Tunnel syndrome
Common in computer professionals.
Due to constant dorsiflexion of wrist while typing the keyboard

17. Ulnar nerve

19. Rotator cuff muscles

20. Fractures
Clavicle
Humerus
Radius
Scaphoid

21. Junction of Medial 2/3rd and Lateral 1/3rd

22. Humerus Fractures Fracture of Surgical Neck of Humerus
Damage to Axillary nerve and Post. Circumflex humoral Artery
Fracture of Mid Shaft Humerus
Damage to Radial Nerve and Deep artery of Arm
Fracture of Medial Epicondyle
Damage to Ulnar Nerve
study
Fracture of Supracondylar part:
Damage to median nerve and Brachial artery

23. Overall : Dorsal Displacement of Wrist and Hand
Fall on Out stretched Hand
Overall : Dorsal Displacement of Wrist and Hand
Specifically: Dorsal and Proximal Displacement of Distal segment of fractured radius
This is more common in older person

25. Case 1

27. Case 4

28. Case 5

29. Lower limb

30. Lower limb Nerve lesions in lower limb
Injuries of hip, knee and ankle joint

31. branches of the Lumbar plexus

32. branches of the Sacral plexus

33. Nerve Injuries Injury to femoral nerve Injury to obturator nerve
Injury to superior gluteal nerve
Injury to inferior gluteal nerve
Injury to sciatic nerve
Injury to tibial nerve
Injury to common fibular nerve
Injury to deep fibular nerve
Injury to superficial fibular nerve

34. Injury to femoral nerve
Weakness of hip flexion
Iliopsoas, rectus femoris, and sartorius
Knee extension
Quadriceps femoris
Loss of sensation over anterior thigh and medial leg and foot

35. Injury to superior gluteal nerve
Loss of thigh abduction & medial rotation
Gluteus medius, gluteus minimus, and tensor fasciae latae
Positive Trendelenburg sign

36. Injury to inferior gluteal nerve
Weakened hip extension
Gluteus maximus
Most noticeable when climbing stairs or standing from a seated position

37. 37

38. Injury to common fibular nerve
Footdrop and loss of eversion
May cause sensory loss over lateral leg and dorsum of foot
Causes
Direct trauma as nerve passes superficially around neck of fibula

39. Joints
Hip joint
Knee joint
Ankle joint

40. Dislocation of hip joint
Posterior dislocation
Posterior tearing of joint capsule
Dislocated femoral head lies on posterior surface of ischium
Occurs in head-on collision
Damage to Ischiofemoral ligament
Complications
Sciatic nerve may damage.

41. Knee joint
Unhappy triad
Anterior drawer sign
Posterior drawer sign

42. Unhappy triad(TCL,MEDIAL MENISCUS AND ACL)

43. Knee Joint Injuries
Anterior drawer sign: This injury causes the free tibia to slide anteriorly under the fixed femur.

44. Posterior drawer sign:
PCL ruptures allow the free tibia to slide posteriorly under the fixed femur.

45. Ankle joint

46. Ankle Injuries
The lateral ligament is injured because it is much weaker than the medial ligament.
The anterior talofibular ligament part of the lateral ligament is most vulnerable and most commonly torn during ankle sprains.

47. Case 1

48. Case 2

49. Case 3
During a football game, a player sustains a powerful blow to the lateral side of his weight-bearing leg. He experiences excruciating knee pain and is unable to walk. The three structures most likely to be injured are the
Anterior cruciate and lateral collateral ligaments and the lateral meniscus
Anterior cruciate and medial collateral ligaments and the medial meniscus
Posterior cruciate and lateral collateral ligaments and the lateral meniscus
Posterior cruciate and medial collateral ligaments and the lateral meniscus
Posterior cruciate and medial collateral ligaments and medial meniscus