Bennett 2

Question 1

Common peroneal nerve

Answer 1

• Causes
  
  • cast pressure
  • bedridden patient
  • high fibular fractures
  • crossin glegs
• PAIN AND PARESTHESIAS over LATERAL leg and dorsum of the foot
  
  • WEAKNESS IN DORSIFLEXION of foot (drop foot gait)

Question 2

Superficial peroneal nerve

Answer 2

• Causes:
  
  • Trunk injury
    
    • altered sensation to lateral mid leg and distal over dorsum
  • Medial dorsal cutaneous nerve
    
    • due to excessive tight shoes
  • Intermediate dorsal cutaneous nerve
    
    • tight shoes or ankle arthroscopy

Question 3

Deep peroneal nerve

Answer 3

• Compression for tight shoes
• cavus foot exposes the nerve to compression
• compression for overactive extensor digitorum brevis

DEEPER INTO THE FOOT AND INTO THE 1st METATARSAL SPACE

Question 4

Tibial nerve (tarsal tunnel)

Answer 4

• Pain and paresthesias at the ankle
• tapping on nerve cause tingling at the site of tapping (tinel’s sign)
  
  • can also be felt prximal and distal to the site of tapping (VILLIOUX SIGN)
• diagnosed via EMG, NVC

Question 5

TREATMENT

Answer 5

• remove space occupying lesions
• aspirate cysts
• reduce inflammation (NSAIDS)
• physical therapy to mobilize scar tisue
• Vena comitans –> compression stocking or surgical ligation

Question 6

Morton’s neruoma

Answer 6

• Signs
  
  • numbness tingling to third and fourth toes with PINCHING PAIN under ball of foot
  • POSITIVE MULDER’S CLICK to the thirs interspace (compressing)
• TX
  
  • metatarsal pad placed behind the metatarsal to LIFT AND SEPARATE
  • cortisone injection
  • surgical exicision

Question 7

Endogenous vs exogeneous

Answer 7

• Endogenous
  
  • Compartment syndrome-edema of the fascial comaprtments of the leg leading to NERVE INFARCTION
  • INTRANEURAL HEMATOMA –> direct nerve contusion or injection that causes intraneural bleeding and compression
• Exogenous
  
  • Direct trauma
  • microtrauma
  • space occupying lesion
  • cast pressure
  • improper tourniquet
  • biomechanical

Question 8

Sunderland classification

Answer 8

1. Conduction deficit without axonal damage
2. axon severed without braeching endoneurium
3. disorganizaiton of internal fascicles
4. axonal rupture with perineurial disruption
5. complete loss of continuity

Question 9

Sedden classficiation

Answer 9

• Neuropraxia
  
  • compression injury resultin gin myelin sheath degeneration. conduction deficit without axonal destruction
• Axonotmesis
  
  • axonal and myelin sheath disruption without disruption of endoneurial tube
• Neruotmesis = gross nerve disuription