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Axillary Nerve (C5 C6)

Injury or compression of median Nerve at wrist (eg Carpel tunnel syndrome)
  1. Supplied Muscles
    1. No supply in axilla & arm
    2. Forearm, All flexors except flexor carpi ulnaris & medial half of flexor digitorum profundus (supplied by ulnar n.).
  2. Sensory
    1. Palmar aspect
      1. Lateral half palm
      2. Lateral 3½ finger
    2. Dorsal aspect
      1. Distal part of lateral 3½ finger
Clinical Presentation
  1. Injury at wrist level
    1. Loss of opposition of thumb
    2. Ape thumb deformity
    3. Pen test for loss of action of Abductor poilicis brevis
    4. Sensory loss- lateral 3-1/2 digits & 2/3 palm (autonomous zone is tip of index and middle finger).
      1. Pen test
        • Ape thumb deformity
        • Loss of opposition & abduction of thumb
      2. In median nerve palsy, the thumb is adducted & laterally rotated and lies in same plane as rest of finger, due a to unopposed action of extensor pollicislongus (radial n.) & adductor pollicis (ulnar n.); condition Ape thumb deformity.
  2. Injury at elbow level
    1. Pronators are paralysed so forearm is kept in supine position.
    2. Long flexors are paralysed (except FCU & FDP medial ½) so wrist flexion is weak & accompanied by adduction.
    3. Flexion of terminal phalynx of thumb is lost because of paralysis of FPL
    4. Flexion of inter phalangeal joints of index & middle fingers is lost so there is Pointing index or positive Oschner clasp & Benediction test

Benedict sign

Oscher sign

Klein Nioh or OK SIGN

Ape thumb
Anterior dislocation of lunate may cause median nerve compression, making its reduction an emergency.

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