3.3.1 Neurological Deficits of the Extremities

Question 1

Patient wakes up and one morning and complains of numbness in the left arm. Patient has weakness affecting wrist extension and finger extension. What is the most likely diagnosis?

Answer 1

Radial nerve compression

Question 2

What is entrapment neuropathy?

Answer 2

Mechanical Compression of a nerve in a narrowed anatomic compartment.

Question 3

Patient wakes up and one morning and complains of numbness in the left arm. Patient has weakness affecting wrist extension and finger extension. It is found that they have radial nerve compression. What would lead you to think that it was distal vs proximal?

Answer 3

It would be thought to be distal due to no involvement of the tricep brachii

Question 4

Patient complains of 3 months of episodic burning of the left lateral thigh. Decreased sensation to cold left lateral thigh. NO WEAKNESS. What is your diagnosis?

Answer 4

Meralgia Paresthetica

Question 5

What are the characteristics of Carpal Tunnel Syndrome?

Answer 5

Question 6

What is neuropraxia?

Answer 6

Question 7

Patient presents with pain in the picture below. What is the diagnosis?

Answer 7

Superficial Radial neuropathy

Question 8

Patient wakes up and one morning and complains of numbness in the left arm. Patient has weakness affecting wrist extension and finger extension. What are the muscles that would be affected?

Answer 8

Extensor carpi radialis - radial extension of hand

Extensor carpi ulnaris - ulnar extension of hand

Extensor digitorum - extension of the digits 3-5

Question 9

What is axonotmesis?

Answer 9

Question 10

What is neurotmesis?

Answer 10

Question 11

Woman presents with right foot weakness. She has weakness in ankle dorsiflexion, ankle eversion, and toe extension. As well as weakness in the hip L5 hip abductors. What is your diagnosis? What made you choose this instead of the other?

Answer 11

L5 Radiculopathy. This is the diagnosis due to involvement of L5 hip abductors. If there was no involvement of the hip abductors then it would be thought to be the peroneal nerve.

Question 12

What are the covered parts?

Answer 12

Question 13

What are the covered parts?

Answer 13

Question 14

What are the covered parts?

Answer 14

Question 15

32 year old man with right hand numbness and arm weakness. Patient has weakness of bicep, tricep, and flexor carpi radialis. What is your diagnosis? Why would you choose this over another diagnosis?

Answer 15

C6 Radiculopathy

Involvement of both the bicep and tricep displays that there in more involvement than just a single nerve. This will have involvement of the musculocutaneous, Radial, and median nerve.

Question 16

What are the two patterns of neurological deficits?

Answer 16

Focal - affecting one side or limb suggesting a more distal injury

Diffuse - bilateral suggesting a more proximal injury

Question 17

What is Meralgia Paresthetica and what is the cause?

Answer 17

Entrapment of the lateral femoral cutaneous nerve beneth the inguinal ligament. Due to weight gain, tight belts and tool belts.

Question 18

What are the covered parts?

Answer 18

Question 19

53 year old man with 6 months of episodic radiating down the right leg to the lateral mallelous. On pin prick, there is decreased sensation in the distribution shown. Very mild weakness of plantar flexion. What is your diagnosis?

Answer 19

It is discogenic S1 radiculopathy.

Question 20

What is the treatment for Carpal Tunnel Syndrome?

Answer 20

Question 21

60 year old patient with constant numbness and weakness of the hand for 3 months. Decreased sensation to pin volar on 1st, 2nd, 3rd, and radial aspect of 4th digit. Patient has mild weakness of thumb ABduction and other muscles are normal. What is your diagnosis?

Answer 21

Carpal tunnel syndrome.

Question 22

What are the symptoms of Carpal Tunnel Syndrome?

Answer 22