Class 4 - Nerve Compression/Entrapment & Compartment Syndrome

Question 1

Pathophysiologically, how do nerves respond to compression and entrapment?

Answer 1

nerve inflammation, increased vascular permeability -> local edema -> impaired nerve transmission

Question 2

Recovery of the nerve after use of a tourniquet can take…

Answer 2

10 weeks

Question 3

What is MERALGIA PARESTHETICA?

Answer 3

lateral femoral cutaneous nerve entrapment

Question 4

Bernhardt-Roth syndrome is sensory/motor/both

Answer 4

sensory only

Question 5

Where is the common site of entrapment of the LCFN (Bernhardt-Roth syndrome)?

Answer 5

inguinal ligament

usually d/t pregnancy, tight clothes, obesity, lying in fetal position for long periods

Question 6

Symptoms of meralgia paresthetica can include…

Answer 6

paresthesia/numbness/pain of upper lateral thigh area

usually unilateral

walking or standing my aggravate

Question 7

Surgery for meralgia paresthetica is only used for people with…

Conservative measures include…

Answer 7

severe and long-lasting symptoms

weight loss, wearing looser clothing, taking NSAIDs

Question 8

Nerve roots for the femoral nerve are…

Answer 8

L2-L4

Question 9

If a patient describes instability ‘buckling’ of the knee when going up/down stairs, they may have what nerve syndrome?

Answer 9

femoral

Question 10

If a patient describes instability ‘buckling’ of the knee when going up/down stairs, they may have what nerve syndrome?

Answer 10

femoral

Question 11

Abnormal knee reflex, atrophic quads, weakness in straightening the knee can all be signs of…

Answer 11

femoral nerve syndrome

Question 12

For femoral nerve syndrome, surgery may be useful to… but is usually used only if…

Answer 12

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

Question 13

The nerve roots for the obturator nerve are…

Answer 13

L2-L4

Question 14

Obstetric palsy/obturator nerve paralysis can be caused by…

Answer 14

difficult delivery
forceps delivery
surgery for cervical cancer to spare fertility…

Question 15

Obstetric palsy includes sensory symptoms of:

and motor symptoms of:

Answer 15

sensory: medial thigh/groin pain & sensory loss
motor: weakness with leg adduction

Question 16

The best test for dx of obstetric palsy is…

Answer 16

EMG

Question 17

The common fibular nerve comes from dorsal branches of what nerve roots?

Answer 17

L4-S2

Question 18

Common causes of common peroneal nerve dysfunction include…

Answer 18

knee injury/trauma
fibular fracture
longterm constriction of lower leg
pressure to the knee from position of deep sleep/coma

Question 19

What are 3 areas the common fibular nerve can be compressed?

Answer 19

1. between biceps femoris tendon, lateral head of gastrocs & head of fibula
2. fibular tunnel
3. anterior tarsal tunnel (rare) - trapped under retinaculum

Question 20

Baker’s cysts, ganglia from the superior TFJ and schwannomas or neurofibromas in the popliteal fossa can all cause entrapment of…

Answer 20

the common fibular nerve

Question 21

“Slapping gait” can be seen with what nerve entrapment?

Answer 21

common fibular (drop foot)

Question 22

Basically, if a nerve is entrapped, your treatment options are GENERALLY:

Answer 22

1. surgery to decompress OR remove tumors
2. corticosteroids to decrease inflammation
3. conservative treatment like massage, physio, bracing, cushioning, etc