AP13 - nerve trauma and MSK disease Flashcards
how might you analyse pain?
SOCRATES sight onset character radiation associations time exacerbations severity
What pain is associated with a subarachnoid haemorrhage?
thunderclap
How is pain experienced in a heart attack?
phrenic nerve transmits pain, dermatomes for spinal nerve of its’ origin experience the pain
Where might someone with gallstones experience pain?
shoulder, as it irritates the phrenic nerve, with dermatomes here
What are the 4 cardinal signs of inflamation?
rubor - redness
calor - heat
tumor - swelling
pain - dolor
Why is it important that the patient is warm when conducting motor and sensory assessments?
there is a direct relationship between temperature and conductance velocity along sensory and motor fibres
what is spastic gait?
Who might have it?
drags feet while walking
it is often observed in people with cerebral palsy or MS
What is scissors gait?
who might have it?
legs bend inwards
spastic paraplegics
What is steppage gait?
toes point towards the ground, may scrape the ground
problems with sciatic nerve
What is waddling gait?
short steps, swinging body
What is propulsive gait?
head and neck pushed forward
name 2 common sites where the common peroneal nerve might be damaged
lateral ankle or the knee
How might severe compression of the peroneal nerve present?
foot drop, unable to flex foot upwards at the ankle
often a distinctive gait where the knee is raised higher (steppage gait)
What other injury might give the same symptoms as peroneal nerve damage?
what other symptoms might this injury present with?
sciatic nerve damage
posterior thigh and leg weakness
pain radiating down path of sciatic nerve
What injuries might damage the radial nerve?
midshaft humeral fractures
Erb’s palsy or Klumpke’s palsy
radial tunnel syndrome
How is radial tunnel syndrome characterised?
posterolaeral elbow pain
weakness of extention of wrist and 3rd digit
What is supinator syndrome
radial tunnel syndrome really, moer specific for compression at the arcade of Frohse
What is the arcade of Frohse and its’ relationship to the radial nerve?
formed by a fibrous band between 2 heads of supinator muscle
the deep branch of the radial nerve passes beneath the arcade with the vessels known as the leash of henry
What are the roots of the long thoracic nerve?
C5-C7
What might cause damage to the long thoracic nerve?
trauma (very long nerve)
direct blow to ribs
stretching
sustained weight bearing over shoulder
How might damage to the long thoracic nerve be characterised?
winged scapula
How would you test for long thoracic nerve damage?
serratus wall test
or resisted flexion with the arm below the horizontal will place the serratus under maximum resistance and will demonstrate winging
How might proximal damage to radial nerve present?
hand of benediction
How might distal damage to the radial nerve be characterised?
pinch sign (when doing the ok sign)
