Cervical Spine II

Question 1

The ulnar nerve can get entrapped where

Answer 1

Guyons canal at wrist
Cubital tunnel at elbow

Question 2

What is 2nd and 1st most common peripheral n entrapment sites?

Answer 2

1: CTS for median
2: cubital tunnel for ulnar

Question 3

What are the medial, lateral, floor and roof of cubital tunnel?

Answer 3

Lateral: medial edge trochlea and olecrenon
Medial: medial epicondyle
Roof: arcuate lig/cubital tunnel retinaculum
Floor: UCL

Question 4

Cubital tunnel sensation deficits

Answer 4

Medial arm, 5th digit, medial 1/2 of 4th digit

Question 5

Cubital tunnel motor

Answer 5

Affects hand intricacies but spares FCU/FDP (no wrist flex weakness)

Weak hypothenar, interossei, adductor policis (lateral pinch)

Question 6

Special tests for cubital tunnel syndrome

Answer 6

Elbow flx test (1-3m)
Lateral pinch weakness
Wartenbergs sign
ANTT

Question 7

Where does ulnar n get entrapped in guyons canal

Answer 7

Between piriformis and hamate and splits into deep branch that goes lateral and sensation branch stays medial

Question 8

Causes of ulnar n entrapment in guyons canal

Answer 8

Carpal ganglions
Hamate fx
Extrinsic trauma/compression

Question 9

Guyons canal entrapment causes what type of sx?

Answer 9

Can be isolated motor or sensory or both

Question 10

Sx of Guyons canal

Answer 10

Claw hand

Question 11

What is distinguished between C8/T1 vs ulnar n

Answer 11

EPL innervated by radial n (c8) so will be strong in ulnar n issues

C8/T1 sensation will not affect digits like ulnar n will

Question 12

Median n entrapment sites

Answer 12

Lig of struthers
Carpal tunnel / wrist
Pronator teres
Ant interosseous nerve

Question 13

Med n entrapment at lig of struthers

Answer 13

Rare, only 1% of pop have this lig

Question 14

Median n entrapment at pronator teres sites

Answer 14

1. Thickened lacertus fibrosis when it connects to pronator teres
2. Pronator teres hypertrophy of fibrous bands within muscle

Question 15

Median n entrapment at pronator teres sx

Answer 15

Prox forearm pain and hand pain increased by pronation and wrist flexion. No night pain. Sensory issues radial hand and first 3.5 digits

Question 16

Median n entrapment at any interroseus nerve sx

Answer 16

No sensory issues, weakness in FDL (pinch grip)

Question 17

Median n entrapment at wrist sx

Answer 17

CTS

Pain at night, parasthesias in palm and first 3.5 fingers, thenar and 1 and 2 lumbricals weak (opposition)

Question 18

C6/c7 vs median n problems

Answer 18

C6/c7 - will have reflex issues and brachioradialis (inn by radial nerve, c6) strong

Median n- sensation issues in first 3 fingers

Question 19

Radial n sx

Answer 19

Mixed motor and sensory, dorsal sensation sx in arm and hand and radial 3 fingers

Weak supinator, wrist ext, thumb ext/abd, finger MP ext

Question 20

Radial PIN sx

Answer 20

Most common site for radial n
No sensation loss
Weak ext, night pain

Question 21

PIN entrapment sites

Answer 21

Fibrous bands anterior radial head
Avascular arcade
ECRB
Supinator

Question 22

C6/C7 vs Pin

Answer 22

PIN motor only no sensation issues