Class 4 - Nerve Compression/Entrapment & Compartment Syndrome Flashcards
Pathophysiologically, how do nerves respond to compression and entrapment?
nerve inflammation, increased vascular permeability -> local edema -> impaired nerve transmission
Recovery of the nerve after use of a tourniquet can take…
10 weeks
What is MERALGIA PARESTHETICA?
lateral femoral cutaneous nerve entrapment
Bernhardt-Roth syndrome is sensory/motor/both
sensory only
Where is the common site of entrapment of the LCFN (Bernhardt-Roth syndrome)?
inguinal ligament
usually d/t pregnancy, tight clothes, obesity, lying in fetal position for long periods
Symptoms of meralgia paresthetica can include…
paresthesia/numbness/pain of upper lateral thigh area
usually unilateral
walking or standing my aggravate
Surgery for meralgia paresthetica is only used for people with…
Conservative measures include…
severe and long-lasting symptoms
weight loss, wearing looser clothing, taking NSAIDs
Nerve roots for the femoral nerve are…
L2-L4
If a patient describes instability ‘buckling’ of the knee when going up/down stairs, they may have what nerve syndrome?
femoral
If a patient describes instability ‘buckling’ of the knee when going up/down stairs, they may have what nerve syndrome?
femoral
Abnormal knee reflex, atrophic quads, weakness in straightening the knee can all be signs of…
femoral nerve syndrome
For femoral nerve syndrome, surgery may be useful to… but is usually used only if…
remove tumors on the nerve if present
relieve pressure on the nerve if that’s the cause
symptoms do not go away and there is difficulty walking
The nerve roots for the obturator nerve are…
L2-L4
Obstetric palsy/obturator nerve paralysis can be caused by…
difficult delivery
forceps delivery
surgery for cervical cancer to spare fertility…
Obstetric palsy includes sensory symptoms of:
and motor symptoms of:
sensory: medial thigh/groin pain & sensory loss
motor: weakness with leg adduction
The best test for dx of obstetric palsy is…
EMG
The common fibular nerve comes from dorsal branches of what nerve roots?
L4-S2
Common causes of common peroneal nerve dysfunction include…
knee injury/trauma
fibular fracture
longterm constriction of lower leg
pressure to the knee from position of deep sleep/coma
What are 3 areas the common fibular nerve can be compressed?
- between biceps femoris tendon, lateral head of gastrocs & head of fibula
- fibular tunnel
- anterior tarsal tunnel (rare) - trapped under retinaculum
Baker’s cysts, ganglia from the superior TFJ and schwannomas or neurofibromas in the popliteal fossa can all cause entrapment of…
the common fibular nerve
“Slapping gait” can be seen with what nerve entrapment?
common fibular (drop foot)
Basically, if a nerve is entrapped, your treatment options are GENERALLY:
- surgery to decompress OR remove tumors
- corticosteroids to decrease inflammation
- conservative treatment like massage, physio, bracing, cushioning, etc
