Compressed Neuropathy DSA

Question 1

What is neuropathy?

Answer 1

Functional or pathological changes in the peripheral nervous system

Question 2

What are biomechanical causes of neuropathy?

Answer 2

• space occupying lesions (ex. cysts)
• degenerative causes
• post traumatic causes (ex. fracture)
• mechanical (ex. muscle spasm)

Question 3

What are systemic causes of neuropathy?

Answer 3

pregnancy

hypothyroidism

diabetes

Question 4

Explain the anatomy of a nerve

Answer 4

Question 5

Describe nerve injuries degrees 1-5

Answer 5

Question 6

Where can the radial nerve become entrapped?

Answer 6

1. high on the humerus
2. radial tunnel
3. at the wrist

Question 7

What do we see when the radial n is trapped high on the humerus? what causes this?

Answer 7

Question 8

What do we see when the radial n is trapped in the radial tunnel? what causes this?

Answer 8

Question 9

What do we see when the radial n is trapped at the wrist? what causes this?

Answer 9

Question 10

What sensory sx are present in anterior interosseous syndrome?

Answer 10

none

Question 11

What test indicates anterior interosseous syndrome?

Answer 11

OK sign –> they can’t do it

tx: elbow can be splinted in 90^o of flexion for up to 12 weeks

Question 12

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?

Answer 12

ulnar n. entrapment - cubital tunnel syndrome

+ Tinel’s sign, + Froment’s sign

tx: padded elbow sleeve to limit terminal elbow flexion and provide cushioning

Question 13

What causes carpal tunnel. syndrome?

Answer 13

medial n. entrapment as it passes under flexor retinaculum

Question 14

What sx do you see with carpal tunnel syndrome?

Answer 14

nighttime numbness of lateral 3.5 digits, tingling, wrist pain, thenar atrophy

dx: EMG

Question 15

Compression of the brachial plexus and/or subclavian vessels is known as…

Answer 15

thoracic outlet syndrome

sites of compression:

scalene triangle

costoclavicular passage

pectoralis minor attachment at coracoid process

Question 16

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…

Answer 16

thoracic outlet syndrome

“Weakness, paresthesia of medial arm, forearm, and hand exacerbated by overhead activities”

Question 17

What tests are done for thoracic outlet syndrome?

Answer 17

Question 18

What is the cause, etiology, and sx of meralgia paresthetica?

Answer 18

Question 19

Where does the compression occur in common fibular nerve compression?

Answer 19

as nerve winds around fibular neck and enters fibular tunnel

Question 20

What position can can common fibular nerve compression?

Answer 20

“strawberry pickers palsy”

time spent squatting

Question 21

What can cause tarsal tunnel syndrome?

Answer 21

Question 22

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?

Answer 22

Myofascial release, HVLA
NSAIDs, rest, US, PT, acupuncture

Tarsal Tunnel Syndrome

Question 23

What is the neuropathy that compresses the deep fibular nerve?

Answer 23

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