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Neurology > 2: Peripheral Mononeuropathies > Flashcards

2: Peripheral Mononeuropathies Flashcards

1
Q

What is carpal tunnel syndrome

A

Compression Median.N within carpal tunnel

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2
Q

What is the main risk factor for carpal tunnel syndrome

A

FH (Genetic)

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3
Q

What fractures predispose to median nerve injury

A

Distal radius

Lunate

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4
Q

What occupation predisposes to carpal tunnel syndrome

A

Jobs that involve repeated flexion and extension of the wrist

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5
Q

What 5 conditions predispose to carpal tunnel syndrome

A 
OA
RA
Diabetes
Pregnancy
Hypothyroidism 
Oedema - HF
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6
Q

Where does median nerve arise

A

Lateral (C5-C7) and Median (C8-T1) trunk

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7
Q

What is a branch of the median nerve

A

Anterior interosseous nerve

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8
Q

What does damage to anterior interossus nerve cause

A

Loss of pronation of forearm and weakness of thumb and finger flexion

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9
Q

How do mild symptoms of carpal tunnel syndrome present

A
  • Parasthesia over thumb, second finger and middle-finger which is worse at night
  • Symptoms may be improved by patient putting arm over bed
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10
Q

How does severe carpal tunnel present

A

Weakness in pincer grip

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11
Q

What are 4 signs of carpal tunnel syndrome

A
  • +ve Tinels
  • +ve Phalens
  • Weakness thumb abduction
  • Thenar wasting
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12
Q

How may median nerve damage present

A

Pope blessing sign

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13
Q

What is pope blessing sign

A

Inability to flex first three digits

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14
Q

When does pope blessing sign occur

A

Damage to median nerve - not carpal tunnel syndrome

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15
Q

What is ordered in carpal tunnel syndrome

A

NCS

EMG

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16
Q

What is it called when ulna.N is compressed at the elbow

A

Cubital Tunnel Syndrome

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17
Q

What is it called when ulna.N is compressed at the wrist

A

Guyon Canal Syndrome

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18
Q

What can cause cubital tunnel syndrome

A

Trauma
Prolonged periods leaning on elbow
Tumour

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19
Q

What causes guyon canal syndrome

A

Cycling - rest on edge of hand

Hook of hamate fracture

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20
Q

What are motor signs of ulna nerve entrapment

A

Ulna Claw
Fromnent
Waterburg sign

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21
Q

What is claw hand deformity

A

Extension at MCP and Flexion at PIP

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22
Q

What is waternberg sign and what is it caused by

A

Permanent abduction little finger due to weak third interoessi

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23
Q

What is froment sign

A

When pinching a piece of paper there is flexion at IP joint to compensate for weakness in adductor policies brevis

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24
Q

What sensory loss occurs in ulna.N palsy

A

Hypothenar eminence

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25
Q

What will be seen in cubital tunnel syndrome

A

Pain referred to fore-arm

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26
Q

Where does the ulna nerve arise from

A

Medial cord (C8-T1)

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27
Q

What is the ulna paradox

A

Close to the paw the worse the claw

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28
Q

Explain ulna paradox

A

Ulna nerve innervates medial half of the flexor digitorum profundus. If ulna nerve is damaged higher up this looses innervation and reduces flexion at the PIP = meaning hand only appears with extension at MCP

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29
Q

What is used to investigate ulna nerve palsy

A

NCS

EMG

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30
Q

What are two causes of radial nerve palsy

A

saturday night palsy

humerus fracture

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31
Q

What is Saturday night palsy

A

draping arm over furniture for prolonged periods of time

32
Q

What causes saturday night palsy

A

Intoxication

Anesthesia

33
Q

why may a fractured humerus cause damage to radial nerve

A

As radial nerve runs in spiral groove

34
Q

where does the radial nerve arise from

A

Posterior cord (C5-T1)

35
Q

what is the main clinical feature of radial nerve palsy

A

Wrist drop

36
Q

what are symptoms of radial nerve palsy

A
  • Loss extension fingers and hand

- Loss extension at the wrist

37
Q

where may sensory loss occur in radial nerve palsy

A

Anatomical snuffbox

38
Q

if damaged in the arm what does radial nerve palsy cause

A

loss elbow extension

39
Q

if damaged the fore-arm what does radial nerve palsy cause

A

weak supination

40
Q

what is Erbs palsy

A

damage to upper brachial plexus

41
Q

what nerve roots are damaged in erbs palsy

A

C5-C6

42
Q

what are 3 causes of erbs palsy

A
  • Excessive lateral traction when delivering shoulder dystocia
  • Excessive lateral neck flexion
  • Trauma: fall on head
43
Q

what position will the arm be in in Erbs Palsy

A

Extended and internally rotated = waiter’s tip

44
Q

what is waiter’s tip position

A

Extended and internally rotated

45
Q

what is a sign of erbs palsy in infants

A

Asymmetrical morro reflex

46
Q

what does loss of innervation to biceps and brachioradialis cause in erbs palsy

A

Loss supination and flexion

47
Q

what does impaired innervation to infraspinatus in Erbs palsy cause

A

Impaired external rotation

48
Q

what does impaired innervation to deltoid cause in erbs palsy

A

Impaired abduction

49
Q

what is used to manage erbs palsy

A

Bracing - external rotation and flexion

50
Q

what is Klumpke’s paralysis

A

damage to lower brachial plexus

51
Q

what nerve roots are affected in klumpke’s palsy

A

C8-T1

52
Q

what are the two causes of klumpke’s paralysis

A
  • Excessive abduction
  • Pancoast tumour
  • Cervical rib
53
Q

what may cause hyperabduction of the arm

A

Holding onto branch when hanging from a tree

54
Q

what may cause compression leading to klumphes paralysis

A

Pancoast tumour

Cervical rib

55
Q

what is lost in Klumpke paralysis

A

Intrinsic muscles of the hand movement

56
Q

what is foot drop

A

weakness in dorsiflexors of the foot

57
Q

what can cause foot drop

A
  • common perineal nerve injury
  • sciatic nerve injury
  • L5 radiculopathy
58
Q

what causes common perineal nerve injury

A
  • Fibular head fracture

- Compression = sitting cross-legged, cast

59
Q

what gait does foot drop lead to

A

High-stepping

60
Q

what movements are weak in common perineal nerve lesion

A

Dorsiflexion

Eversion

61
Q

where is sensation lost in common perineal nerve injury

A

Dorsum of the foot and between first and second toe

62
Q

what roots does common perineal nerve originate

A

L4-S2

63
Q

what can cause axillary nerve palsy

A
  • Fracture at surgical neck of humerus

- Anterior shoulder dislocation

64
Q

how does axillary nerve palsy present

A

Impaired abduction and external rotation of the arm

65
Q

where does axillary nerve arise

A

C5-C6

66
Q

what does damage do musculcutaneous nerve cause

A

Loss flexion and supination

67
Q

where does musculocutaneous nerve arise

A

C5-C7

68
Q

what can damage long-thoracic nerve

A

Lymph node clearance in mastectomy

69
Q

what does long thoracic nerve damage cause

A

Winged scapula

70
Q

how will phrenic nerve damage present

A

Elevation diaphragm on that side

71
Q

what nerve compression causes anaesthesia over lateral aspect of the thigh

A

lateral femoral cutaneous nerve

72
Q

what can cause lateral femoral cutaneous nerve palsy

A

compression under ilioinguinal ligament due to increase in intra-abdominal pressure (pregnancy, tumour)

external compression (belts, pants)

local compression (tumour)

73
Q

what nerve can be damaged in lymph node biopsy from posterior triangle of the neck

A

axillary nerve

74
Q

what nerve can be damaged in thyroidectomy

A

recurrent laryngeal nerve

75
Q

what nerve can be damaged when using Lloyd Davies stirrups

A

common perineal nerve

76
Q

what nerve can be damaged in inguinal hernia repair

A

ilioinguinal nerve

Neurology (26 decks)

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