You are asked to review a 62 year old woman who presents with a numb left arm. On examination you note she lacks sensation to the skin over the medial aspect of the forearm. The skin over the medial aspect of the forearm is supplied by which of the following nerves:
Cutaneous Nerve | Origin | Skin Supplied |
---|---|---|
Lateral supraclavicular nerve | Cervical plexus (C3, C4) | Upper half of deltoid muscle |
Superior lateral cutaneous nerve of the arm | Axillary nerve | Lower half of deltoid muscle |
Inferior lateral cutaneous nerve of the arm | Radial nerve | Lateral arm below deltoid muscle |
Medial cutaneous nerve of the arm | Brachial plexus (C8, T1) | Medial arm |
Intercostobrachial nerve | Second intercostal nerve (T2) | Axilla |
Posterior cutaneous nerve of the arm | Radial nerve | Posterior arm |
Medial cutaneous nerve of the forearm | Brachial plexus (C8, T1) | Medial forearm |
Posterior cutaneous nerve of the forearm | Radial nerve | Posterior forearm |
Lateral cutaneous nerve of the forearm | Musculocutaneous nerve | Lateral forearm |
Superficial branch of radial nerve | Radial nerve | Lateral dorsum of hand and lateral three and a half digits |
Palmar cutaneous branch of ulnar nerve | Ulnar nerve | Medial half of palm |
Dorsal cutaneous branch of ulnar nerve | Ulnar nerve | Medial dorsum of hand and medial one and a half fingers |
Superficial branch of ulnar nerve | Ulnar nerve | Palmar surface of medial one and a half digits |
Palmar cutaneous branch of median nerve | Median nerve | Lateral half of palm |
Palmar digital branch of median nerve | Median nerve | Palmar surface and fingertips of lateral three and a half digits |
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Biochemistry | Normal Value |
---|---|
Sodium | 135 – 145 mmol/l |
Potassium | 3.0 – 4.5 mmol/l |
Urea | 2.5 – 7.5 mmol/l |
Glucose | 3.5 – 5.0 mmol/l |
Creatinine | 35 – 135 μmol/l |
Alanine Aminotransferase (ALT) | 5 – 35 U/l |
Gamma-glutamyl Transferase (GGT) | < 65 U/l |
Alkaline Phosphatase (ALP) | 30 – 135 U/l |
Aspartate Aminotransferase (AST) | < 40 U/l |
Total Protein | 60 – 80 g/l |
Albumin | 35 – 50 g/l |
Globulin | 2.4 – 3.5 g/dl |
Amylase | < 70 U/l |
Total Bilirubin | 3 – 17 μmol/l |
Calcium | 2.1 – 2.5 mmol/l |
Chloride | 95 – 105 mmol/l |
Phosphate | 0.8 – 1.4 mmol/l |
Haematology | Normal Value |
---|---|
Haemoglobin | 11.5 – 16.6 g/dl |
White Blood Cells | 4.0 – 11.0 x 109/l |
Platelets | 150 – 450 x 109/l |
MCV | 80 – 96 fl |
MCHC | 32 – 36 g/dl |
Neutrophils | 2.0 – 7.5 x 109/l |
Lymphocytes | 1.5 – 4.0 x 109/l |
Monocytes | 0.3 – 1.0 x 109/l |
Eosinophils | 0.1 – 0.5 x 109/l |
Basophils | < 0.2 x 109/l |
Reticulocytes | < 2% |
Haematocrit | 0.35 – 0.49 |
Red Cell Distribution Width | 11 – 15% |
Blood Gases | Normal Value |
---|---|
pH | 7.35 – 7.45 |
pO2 | 11 – 14 kPa |
pCO2 | 4.5 – 6.0 kPa |
Base Excess | -2 – +2 mmol/l |
Bicarbonate | 24 – 30 mmol/l |
Lactate | < 2 mmol/l |