Compressed Neuropathy DSA Flashcards
What is neuropathy?
Functional or pathological changes in the peripheral nervous system
What are biomechanical causes of neuropathy?
- space occupying lesions (ex. cysts)
- degenerative causes
- post traumatic causes (ex. fracture)
- mechanical (ex. muscle spasm)
What are systemic causes of neuropathy?
pregnancy
hypothyroidism
diabetes
Explain the anatomy of a nerve
Describe nerve injuries degrees 1-5
Where can the radial nerve become entrapped?
- high on the humerus
- radial tunnel
- at the wrist
What do we see when the radial n is trapped high on the humerus? what causes this?
What do we see when the radial n is trapped in the radial tunnel? what causes this?
What do we see when the radial n is trapped at the wrist? what causes this?
What sensory sx are present in anterior interosseous syndrome?
none
What test indicates anterior interosseous syndrome?
OK sign –> they can’t do it
tx: elbow can be splinted in 90o of flexion for up to 12 weeks
Pt. has parasthesia of their 4th and 5th digits, medial elbow pain with decreased intrinsic m. strength, sx are reproduced with elbow flexion and wrist extension, what sign do you expect to be positive? how do you treat?
ulnar n. entrapment - cubital tunnel syndrome
+ Tinel’s sign, + Froment’s sign
tx: padded elbow sleeve to limit terminal elbow flexion and provide cushioning
What causes carpal tunnel. syndrome?
medial n. entrapment as it passes under flexor retinaculum
What sx do you see with carpal tunnel syndrome?
nighttime numbness of lateral 3.5 digits, tingling, wrist pain, thenar atrophy
dx: EMG
Compression of the brachial plexus and/or subclavian vessels is known as…
thoracic outlet syndrome
sites of compression:
scalene triangle
costoclavicular passage
pectoralis minor attachment at coracoid process
Pt presents with weakness of UE, numbness in medial arm and forearm and hand, and it is made worse by painting their ceiling. You suspect…
thoracic outlet syndrome
“Weakness, paresthesia of medial arm, forearm, and hand exacerbated by overhead activities”
What tests are done for thoracic outlet syndrome?
What is the cause, etiology, and sx of meralgia paresthetica?
Where does the compression occur in common fibular nerve compression?
as nerve winds around fibular neck and enters fibular tunnel
What position can can common fibular nerve compression?
“strawberry pickers palsy”
time spent squatting
What can cause tarsal tunnel syndrome?
Pt presents with a vague burning and tingling sensation on the plantar surface of the foot. Their gait is fine, but pain is felt on plantar surface. How do you treat?
Myofascial release, HVLA
NSAIDs, rest, US, PT, acupuncture
Tarsal Tunnel Syndrome
What is the neuropathy that compresses the deep fibular nerve?
anterior tarsal tunnel syndrome
sx: pain over dorsomedial aspect of foot & worse at rest,
weakness of extensor digitorum brevis
etiology: trauma, talonavicular dysfunction, prolonged plantar flexion, compression from shoes
