Clinical Lecture: Peripheral Nerve Entrapment. Flashcards
Nerve entrapment
Nerve acted on and compressed
Nerve entrapment pitfalls
Double crush syndrome
Peripheral neuropathy
What symptoms do patients report
Positive- abnormal level of excitability, earlier stages.
Negative - later stages
Carpel tunnel
Median nerve entrapment under ligament
Innovates LOAF muscles Of hand
9 tendons and median nerve all squashed together
Symptoms similar to any nerve entrapment
Positive
Negative
Most common entrapment is nerve
Woman more common than men
Mostly 40-60
Associated with many conditions but usually idiopathic
Diagnosing and taking carpel tunnel syndrome
Specific History- median nerve related, Pain reported in fingers not wrist
Examination: look, feel, move, special test — atrophy Of palm muscles, no Joint deformities
Tinel test — tapping carpal tunnel and slightly proximal, tingling mean positive
Phalens test, prayer sign, recreates symptoms
Nerve conduction test
MRI
Treatment:
Activity modification
Splinting (especially at night)
Corticosteroid infections
Surgery
Differential diagnosis for carpal tunnel
Other sites Of median nerve entrapment
Cubital tunnel syndrome
Symptoms at ring and little finger
Ulna compression
Can be eased by keeping elbow strait
Weakness and clumsiness, tingling etc
Physio, activity modification
Surgery to decompress
Ulna claw
Ulna nerve entrapment
More of a claw if tapped nearer wrist than elbow
Special tests for cubital tunnel syndrome
Froments test:
Pull paper hold with thumb
Tinels at cubital
Feel fire ulna nerve instability at the elbow
Saturday night Palsy
Wristdrop caused by compression of radial nerve, physio but temporary
Lower limb nerve entrapment
Meralgia parasetetica- lateral cutaneous nerve Of thigh- trapped under inguinal ligament
Common pereneal nerve palsy- causes foot drop
Tarsal tunnel syndrome
Anatomy of nerves
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