Proximal vs. Distal Radial Nerve Paralysis Answer Question 1 • The radial nerve is principally derived from which spinal cord segments in the dog? A. B. C. D. E. C5-T3 C6-T2 C7-T1 Correct Answer C7-8 T1-2 Although some contributions may come from C6 and T2, more than 95% of the contributions are from these three nerves: C7, C8, T1 Answer Question 2 • Weight support can be radically affected by radial nerve lesions since it is the principle nerve innervating the _____ of the thoracic limb. A. B. C. D. E. Shoulder extensor muscles Distal extensor muscles Elbow flexor So-called “antigravity” muscles Correct Answer Majority of all muscles Extensors of the elbow joint (Triceps brachii m.) are innervated by the radial nerve- extension of this joint is the principle action countering gravitational forces on the thoracic limb needed to support weight Answer Question 3 • Which principle muscle group is innervated by the proximal divisions of the radial nerve? A. B. C. D. E. Triceps brachii Correct Answer Abductor pollicis longus The triceps brachii muscle passes distally from the Extensor carpi radialis scapula and proximal Common digital extensor humerus and attaches to the olecranon; it is the largest Biceps brachii mass of muscle extending the elbow joint Answer Question 4 • Which diagram is correct for sensory innervation by the radial nerve? (area innervated in red) Answer C is correct. Sensory innervation emanating primarily from the superficial branch of the radial nerve innervates the distal two-thirds of the cranial antebrachium and dorsum of the manus C Answer Question 5 • Which muscle is innervated by the deep branch of the radial nerve? A. B. C. D. E. Triceps brachii Biceps brachii Extensor carpi radialis Correct Answer Deep digital flexor The extensor carpi radialis a principle member of the Latissimus dorsi craniolateral extensor group all of which are innervated by the deep branch of the radial nerve Answer Question 6 • “Knuckling over” during attempts to walk with radial nerve paralysis are due, in part, to Knuckling over is loss of paralysis of which muscle? A. B. C. D. E. extension in the distal limb from paralysis of the craniolateral extensor group; the CDE muscle is a principle member of this group that extends the carpus, metacarpus and digits Triceps brachii Anconeus Flexor carpi radialis Deep digital flexor Common digital extensor Correct Answer Answer Question 7 • Patients with distal radial nerve injury will: A. Have the same motor deficits as with proximal injuries B. Have the same sensory deficits as with proximal injuries Correct Answer C. Have profound limping from lack of weight support In either proximal or distal injuries, the sensory branches in D. Not have sensory deficits the superficial branch are E. Will have only motor deficits afflicted leading to sensory deficits over the distal two-thirds of the dorsal antebrachium and dorsal manus Answer Question 8 This is due to the preservation of the caudal brachial muscles (triceps brachii) which extend the elbow and counter gravity • The main difference in proximal versus distal radial nerve injuries is: A. Preserved weight support in those with proximal injuries B. Preserved weight support in those with distal injuries Correct Answer C. Preserved sensation in those with proximal injuries D. Preserved sensation in those with distal injuries E. NOTHING: clinically, they are identical Answer Question 9 The location of the paresthetic sensations is in the area of deficits thus they chew on the dorsal distal aspects of the limb; self-mutilation can be extreme and they will auto-amputate digits • Patients with paresthesia (burning, itching, tingling) from radial nerve injuries often: A. Chew on their armpits B. Chew on the paw, especially over the dorsal aspect Correct Answer C. Chew on the medial elbow region D. Chew on the paw, especially on the palmar aspect damaging the pads E. Chew on their lateral scapular region Answer Question 10 • Paralysis of the proximal radial nerve is common in cases of: A. B. C. D. E. Radial fractures Elbow region tumors Ulnar fractures Brachial plexus avulsion Correct Answer Cephalic injection trauma Brachial plexus avulsion is a nerve root disorder and will likely include the roots of C7-T1 which give rise to the radial nerve; All other choices here are too far distal on the limb to affect the proximal divisions of the radial nerve that innervate the triceps brachii muscle