arm conditions Flashcards
what are s&s of pancoast tumour?
persistent arm pain and numbness (upper medial arm, 4th and 5th digit)
weakness of hands (intrinsic muscles and finger flexors)
horner’s syndrome
signs of lung cancer (cough, SOB, fatigue, night sweats, weight loss, haemoptosis)
what are the signs of horner syndrome
miosis (pupil constriction)
ptosis (drooping of eyelid)
semi-facial anhidrosis (sweating of half of the face)
what diagnosis can pancoast tumour mimic?
thoracic outlet syndrome
which structures of the brachial plexus are first affected by pancoast tumour?
lower branches of brachial plexus (C8-T1)
what symptoms can be expected in a LMNL?
decreased deep tendon reflexes
weakness
atrophy
fasciculations
hypo-reflexia
which conditions involve median nerve entrapment?
pronator teres syndrome
carpal tunnel syndrome
high median nerve tunnel syndrome
what is the sensory innervation of the median nerve?
the dorsal aspect of the thumb and index finger
the palmar aspect of the thumb, index middle and half of the ring finger
the palm of the hand
the medial forearm
which muscles does the median nerve innervate?
pronator teres
palmaris longus
flexor digitorum superficialis
what are s&s of pronator teres syndrome?
aching pain in the proximal forearm
pain worse by exercise
what are s&s of carpal tunnel syndrome?
tingling/numbness of palmar aspect of thumb, index, middle and half of ring finger
shaking hands reliefs pain
wakes patient at night
which special tests are positive in carpal tunnel syndrome?
tinel’s
phalen’s
carpal tunnel compression test
which conditions involve ulnar nerve entrapment?
cubital tunnel syndrome
guyon’s canal syndrome
which muscles are innervated by the ulnar nerve?
forearm flexors including:
flexor carpi ulnaris
flexor digitorum profundus
what is the sensory innervation of the ulnar nerve?
medial forearm
medial wrist
dorsal and palmar aspect of the little and half of the ring finger
where is the cubital tunnel in the elbow?
between the medial epicondyle of the humerus and the olecranon of the ulna
what are s&s of the cubital tunnel syndrome?
aching pain around the medial epicondyle
worse by repetitive movement
why type of sport/profession is risk factor for cubital tunnels syndrome?
throwing sports
racquet sports
desk work
which structures form guyon’s canal?
pisiform
hamate
piso-hamate ligament
what are s&s of guyon’s canal syndrome?
paraesthesia and tingling of the intrinsic muscles of the hand
cold intolerance of the hand
what type of sport is a risk factor for Guyon canal syndrome?
cycling
which condition involves radial nerve entrapment?
arcade of Frohse
what structures from the arcade of frohse?
fibrous band between two heads of the supinator muscle
which structures are innervated by the sensory branches of the radial nerve?
the anterolateral arm
distal posterior arm
posterior forearm
posterolateral wrist and hand
which muscles are innervated by the radial nerve?
triceps branchii
anconeus
extrinsic extensors of wrist and hand
which branch of the radial nerve is entrapped in the arcade of frohse?
posterior interosseous nerve
what are s&s of arcade of frohse entrapment?
pain over arcade of frohse
pain on supination
what causes a burner or stinger?
sudden lateral flexion of the neck + depression of the shoulder leading to traction of the brachial plexus
what are symptoms of a burner or stinger?
neck pain
pain and numbness in the arm
weakness of the arm
tingling in the arm
what is brachial neuritis or neuralgic amytrophy?
nerve damage that affects the chest, shoulder and arm
what are s&s of brachial neuritis?
acute onset
excruciating unilateral shoulder pain
flaccid paralysis of the shoulder
what is thoracic outlet syndrome caused by?
compression of the brachial plexus, subclavian artery and vein between the shoulder girdle and the 1st rib
what are s&s of TOS?
pain in arm, shoulder and chest
hands feel like it is going to sleep
hand weakness
which special test’s are positive in TOS?
roo’s
Adson’s and reversed Adsons
hyperabduction test
costoclavicular test
