Compression Neuropathies Flashcards
What is a neuropathy?
Nerve damage or dysfunction that results in numbness, tingling, weakness and pain
What are 3 systemic causes of a neuropathy?
Pregnancy
Hypothyroidism
Diabetes
Besides systemic causes, what category is the next main cause of neuropathies?
Compression – biomechanical forces
What are the pathological changes associated with a compression neuropathy?
- Ischemia
- Thickened epineurium and Thinned myelin
- MT closure and axon degeneration
Describe the setup of a nerve until the endoneurium
Axon
- -> myelin
- -> endoneurium
A group of axons = _____ ; which are then covered by?
Fascicles are covered by Perineurium
Describe what the Epineurium surrounds?
Fascicles + blood vessels and connective tissue
1st degree nerve injury
Neuropraxia
Neuropraxia involves damage to the?
Myelin sheath only
2nd degree nerve injury
Axonotmesis
Axonotmesis involves damage to the?
Axon only
3rd, 4th, and 5th degree nerve injuries are all labeled as?
Neurotmesis
3rd degree Neurotmesis
Damage to the axon, myelin and endoneurium
4th degree Neurotmesis
Damage to axon, myelin, endoneurium and perineurium
5th degree Neurotmesis
Damage to axon, myelin, endoneurium, perineurium and Epineurium
What are the 5 models?
Biomechanical Neurologic Resp.-Circ. Metabolic Behavioral
C5
Biceps and lateral arm
C6
Brachioradialis
Wrist extension and Elbow flexion
Radial forearm and thumb/index fingers
C7
Triceps
Wrist flexion, Elbow/Finger Extension
Middle finger
C8
Finger flexion
Ulnar forearm and pinky
T1
Finger abduction
Medial arm
What usually causes a cervical nerve compression?
Secondary to cervical disc disease
– bulging/herniation
When a cervical disc ruptures, what direction does it usually go?
Posterior-laterally
Cervical nerve compressions are usually compressed at the nerve root. What does that cause?
Radiculopathy
==> pain down nerve distribution
What are 3 tests for Cervical Nerve compressions?
Spurling
Adson
Hoffmann
Spurling test
Extend and rotate head TOWARD symptomatic side
Adson test
Elevate chin and rotate head TOWARD symptomatic side while breathing in
–> obliterated radial pulse on that side
Hoffmann test
Snap middle finger
–> flexion of thumb and index finger
Adson test can identify?
Thoracic outlet syndrome
Hoffmann test can identify?
Cervical myelopathy