SGS7 - Case 3

SGS7 - Case 3

A 40-year-old man presented with a history of right upper limb weakness. The weakness was noted after he had fractured his right clavicle following a fall from a horse. He had also noticed numbness of his right shoulder and arm. On examination, there was weakness of elbow extension, wrist extension, forearm supination and shoulder abduction and the triceps jerk was absent. There was reduced sensation over the lateral aspect of the shoulder and over the postero-lateral aspect of the forearm.

Open Ended

Name FOUR muscles or muscle groups are likely to have been affected to cause the motor deficits seen in this patient.

Open Ended

How do you know that biceps brachii is not likely to be involved in this patient?

Open Ended

What other deficits would you expect to see if biceps was involved?

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What upper limb nerve supplies sensation to the skin of the

lateral side of the shoulder?

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What upper limb nerve supplies sensation to the skin of the

posterolateral surface of the arm?

Open Ended

Explain the circuitry of the triceps jerk. What type of reflex is this? Can you demonstrate it?

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What nerves do you deduce are affected in this patient?

Open Ended

How is it possible that these two nerves could be affected by the same injury?

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What structure is most likely to have been affected in this patient?