compression neuropathies Flashcards
signs and symptoms of a upper radiculopathy
pain in the neck that radiates down the arm to a specific region in the hand
numbness and weakness along a specific distribution
UE radiciulopathy is usually caused by a nerve impingement at the level of the cervical spine - what are the most common causes
disc degeneration
disc herniation
degenerative arthritis
test for UE radiculopathy
neck compression/spurlings test
spurling test
rotate and side bend head toward affected side
extend head
add compression
**pain radiating down the arm or tingling is positive
*if contralateral arm has symptoms may be due to contralateral scalene causing impingement
UE plexopathy symptoms
intermittent numbness and tingling
pain not consistent with 1 nerve root
generalized weakness
UE plexopathy aka
thoracic outlet syndrome
tests for UE plexopathy/thoracic outlet syndrome
roos east test (general)
adsons (scalene)
adsons (1st and 2nd rib)
clavicle (military brace)
pectoralis minor (wrights hyperabduction)
adsons test
monitor radial pulse
**test for scalene compression causing plexopathy
extend and slightly abduct patient arm, have them inhale look at their hand and hold their breath
breath and return to neutral
inhale and look other direction and hold breath
***loss of pulse/reproduction of symptoms (while looking at hand is a rib/clavicle problem), looking away is a scalene problem
military brace
supinate, extend and abduct patients arm behind them while monitoring the radial pulse
apply infraclavicular force at the shoulder
**obliteration of pulse is positive
wright hyperabduction
test for pectoralis minor causing plexopathy
monitor radial pulse and abduct , externally rotate arm, flex elbow to 45 degrees and hold for 1 mint
then repeat with hyperabduction (arm by the ear)
**positive is obliteration of pulse
cubital tunnel
numbness and tingling of the median forearm to the 4th and 5th digit
-ulnar nerve
(tinel test, froments sign)
froments sign is _ nerve entrapment and the _ must contract
ulnar
flexor pollicis longus
pronator teres mononueropathy
median nerve palsy
pain in anterior proximal forearm
numbness and tingling in forearm
radiates to wrist and first 3 digits
(weakness in grip strength)
medican nerve assessment test
OK sign
weakness of index finger DIP and thumb IP
weak flexor digitorum profundis and flexor policies longus
medical epicondyle CS
F PRO Add
wrist pain, intermittent during the day, dull achey, numbness/tingling in the first 3 digits of the hand
night pain radiating proximally
carpa; tunnel
carpal tunnel tets
tines sign , phalanx test
what is the most commonly affected LE nerve roots
L5-S1
L5-S1 is most commonly affected by?
herniated disc
L5-S1 mononeuropathy symptoms
pain down 1 leg that will involve the posterolateral leg from butt to leg/ankle/foot
always look for red flags!!!!- weight loss, fever, chills, loss of bowel control
SLR
IT band
neurologic
mechanical
15-30: IT band tightness
30-60- lumbar L4-S1 herniation , lumbosacral radiculopathy, sciatica
> 70 mechanical low back pain
resisted SLR=
femoral acetabular impingement and SCFE
lower pole L5 CS
F IR Add
upper pole L5
E add ER
high ilium sacroiliac
E EBD ER
what is piriformis syndrome
peripheral neuritis of the sciatic nerve caused by any condition of the piriformis muscle
need to rule out sciatica
piriformis syndrome symptoms
pain sitting, standing, or laying longer than 15 minutes
pain and tingling down the gluteal region stopping above the knee
contralateral SI pain
antalgic gait
piriformis specialty test
FAIR
piriformis counterstain
F ABD ER
neuralgia parsthetica
lateral femoral cutaneous nerve entrapment under the inguinal ligmament
numbness/tingling on anterolateral thigh
hyperesthesia cant put anything into pockets
trophic skin changes
where is tines sign for neuralgia prosthetics
1 cm medial and inferior to ASIS
common fibular nerve
L4-S2
foot drop
fibular nerve winds around fibular neck- compression here
**saturday night palsy
tarsal tunnel
posterior tibial nerve compression in the tarsal tunnel behind the medial malleolus by the flexor retinaculum
pain in plantar foot, burning, tingling, numbness
