(8) Compression Neuropathy Flashcards
What is neuropathy?
Functional or physiological changes in the PNS
What is compression neuropathy?
Process where a nerve becomes entrapped as it passes through a narrow tunnel or passage
What are (4) categories of biomechanical causes of neuropathy?
Space occupying lesions
Degenerative causes
Post-traumatic causes
Mechanical
What are 3 major systemic causes of neuropathy?
Pregnancy
Hypothyroidism
Diabetes
What is a MAJOR pathologic change associated with chronic neuropathy?
Ischemia
What is the best and worst form of nerve injury? (Classification)
1st degree (neurpraxia) = Least severe
5th degree = Most severe
1st degree nerve injury
aka?
Neuropraxia
2nd degree nerve injury
aka?
Axonotmesis
3rd-5th degree nerve injury
aka?
Neurotmesis
Where are the 3 sites for entrapment for the radial nerve?
- High on the humerus
- Radial tunnel
- Wrist
Anterior interosseous syndrome is caused by the ________ n.
Anterior interosseous syndrome is caused by the median n.
What are the symptoms associated with anterior interosseous syndrome?
NO SENSORY SYMPTOMS
What test can you use to identify anterior interosseous syndrome?
“OK” sign –> Patient is unable to hold and resist tip to tip of the thumb to index pinch
What are the symptoms of ulnar nerve entrapment?
Parasthesia to the 4th and 5th digits
Medial elbow pain radiating to the hand w/ decreased intrinsic muscle strength
(+) Tinel’s sign at elbow
Symptoms reproduced w/ elbow flexion and wrist extension
What test do you use to identify cubital tunnel syndrome?
Froment’s sign
Pt must flex thumb in order to pinch paper b/w 1st and 2nd digits
What is the most common compression syndrome?
Median nerve entrapment
What are the symptoms of median nerve entrapment?
Nighttime numbness of lateral 3 1/2 digits
Tingling
Wrist pain
Dropping things
Thenar atropy
What is the gold standard for diagnosing median nerve entrapment?
EMG
What is thoracic outlet syndrome?
Compression of the brachial plexus and/or subclavian vessels
What are the symptoms of thoracic outlet syndrome?
Weakness
Paresthesia of medial arm, forearm and hand
What are 4 tests you can perform to find thoracic outlet syndrome?
EAST Test/Roos test
Military/Costoclavicular maneuver
Adson’s test
Wright’s HyperABduction Test
What nerve is involved in meralgia paresthetica?
Lateral femoral cutaneous nerve
Etiology of meralgia paresthetica?
Very intense athletics
Obesity
Tight girdle/belt/clothing
Seat belt misplacement or post accident
Anatomic anomaly
Symptoms of meralgia paresthetica?
Numbess or burning pain on anterolateral thigh
Hyperesthesia to the point of not putting anything in pockets
Trophic skin changes
(+) Tinnel’s sign 1cm medial and inferior to the ASIS
What is common fibular nerve compression?
Compression as nerve winds around the fibular neck and enters the fibular tunnel
Etiology of common fibular n. compression?
Leg hooked over a rail (bedridden, comatose)
Ankle sprains
Trauma to fibular head
New meditators (due to lotus position)
Idiopathic
What is the other name for common fibular n. compression?
Strawberry pickers palsy
What is tarsal tunnel syndrome?
Compression of posterior tibial n. in the tarsal tunnel behind the medial malleolus with the overlying flexor retinaculum
Symptoms of tarsal tunnel syndrome?
Pain on plantar surface of foot
What nerve is affected with anterior tarsal tunnel syndrome?
Deep fibular nerve
What is anterior tarsal tunnel syndrome?
Deep fibular nerve is compressed at the inferior extensor retinaculum
Symptoms of anterior tarsal syndrome?
Pain over dorsomedial aspect of foot
Weakness of extensor digitorum brevis
Etiology of anterior tarsal tunnel syndrome?
Trauma
Talonavicular dysfunction
Prolonged plantar flexion
Compression from shoes
