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OS 3 Exam 1 > Compression Neuropathy > Flashcards

Compression Neuropathy Flashcards

1
Q

involves focal damage of myelin fibers around axon

A

1st degree - neuropraxia

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2
Q
  • some disruption/injury to the axon itself

- myelin sheath remains intact

A

2nd degree - axonotmesis

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3
Q

disruption of axon and:

  • endoneurium
  • endoneurium + perineurium
  • endoneurium + perineurium + epineurium
A

3rd-5th degree - neurotmesis

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4
Q

what is the nerve root of deltoid and biceps muscles?

A

C5 - sensation to lateral arm

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5
Q

what is the nerve root of wrist extension and elbow flexion?

A

C6 - sensation to radial forearm, thumb and index finger

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6
Q

what is the nerve root of wrist flexion, elbow extension, and finger extension?

A

C7 - sensation to middle finger

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7
Q

what is the nerve root of finger flexion?

A

C8 - sensation to ulnar forearm and small finger

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8
Q

what is the nerve root of finger abduction?

A

T1 - sensation to medial arm

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9
Q

disk is compressed evenly without significant damage to cartilage rings

A

bulging disk

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10
Q

some tearing of the cartilage rings, with only a few cartilage rings torn
- NO leakage of central material

A

protrusion

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11
Q

some tearing of the cartilage rings, nucleus pulposus is able to flow out of the disc space

A

extrusion

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12
Q

what nerve root would be affected if C5 disk is herniated?

A

C6

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13
Q

what nerve root would be affected if T1 disk is herniated?

A

T1

- T1 and below, pedicle and nerve root numbers match

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14
Q

what nerve provides motor function to triceps brachii, aconeus, and the wrist extensors?
- sensation to majority of top (dorsum of the hand)

A

radial nerve

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15
Q

what are the three sites of radial nerve entrapment?

A
  1. high on the humerus
  2. radial tunnel
  3. at the wrist
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16
Q

wrist drop, weakness of elbow flexion (brachioradialis), possible tricep involvement, tricep reflex may be dinished, pain/numbness

A

high on the humerus (radial n)

- dx: function usually returns in 4-5 months

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17
Q

pain and tenderness 5 cm distal to lateral epicondyle

- wrist drop or pain with resisted supination

A 
radial tunnel (radial n)
- caused by repetitive rotatory movements
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18
Q

superficial branch (sensory) pinched between brachioradialis and ECRL during forearm pronation, sensation changes over posterolateral hand

A

at the wrist (radial n)

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19
Q

numbness, tingling, burning pain in superficial radial nerve distribution
- caused by compression, edema, surgical injury

A

cheiralgia paresthetica, aka “handcuff neuropathy”

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20
Q

achy pain in the mid/proximal forearm, aggravated by repeated lifting

  • dx: pain with resisted forearm pronation
  • occurs as the median nerve passes between the superficial and deep heads of pronator teres
  • ex: weight lifter
A

PRONATOR SYNDROME

- median nerve

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21
Q

trauma, or cast pressure

  • “OK” sign: pt unable to hold and resist tip to tip of thumb to index fingers
  • no sensory sx
A

ANTERIOR INTEROSSEOUS SYNDROME

  • median nerve
  • tx: elbow splint to 90 degrees in flexion for up to 12 weeks
  • ex: post-cast pressure
22
Q

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

  • common in repetitive motion jobs and pregnancy
  • dx: gold standard is EMG
  • ex: gymnast
A

CARPAL TUNNEL SYNDROME

  • median nerve
  • most common compression syndrome
  • tx: Xray if fracture concern, MRI is soft tissue injury concern, wrist splinting with 30 degree hand extension (usually at night)
23
Q

what special tests used for carpal tunnel?

A

phalen’s and tinel’s

24
Q

flex hands to 90 degrees, reproduction of sx within 60 seconds is positive sign

A

phalen’s sign

25
Q

tapping over flexor retinaculum reproduces sx (esp tingling) in first 3.5 digits

A

tinel’s sign

26
Q

paresthesia to 4-5th digits, medial elbow pain radiating to the hand with decreased intrinsic muscle strength

  • can’t turn a key in a door
  • positive tinel’s sign at elbow
A

CUBITAL TUNNEL SYNDROME

- tx: padded elbow sleeve to limit terminal elbow flexion/prove cushion

27
Q

pt has to flex thumb in order to pinch paper between 1st and 2nd digits (can’t straighten out thumb)

A

froment’s sign

28
Q

pt seated, apply extension, external rotation, abduction at the affected shoulder joint
- if pain when rotating head toward affected side -> rib 1
- if pain when rotating head away from affected side -> scalenes
(+) test = reproduction of symptoms or diminished radial pulse

A

ADSON TEST

- ** indicates impingement at thoracic outlet**

29
Q

monitor radial pulse. t affected shoulder, apply extension, abduction, have patient actively stand “at military attention”
(+) test = reproduction of symptoms or diminished radial pulse

A

MILITARY TEST

- ** indicates impingement at thoracic outlet**

30
Q

instruct patient to actively abduct bilateral shoulders to 90 degrees, externally rotate the shoulders, flex elbows and open/close hands repeatedly
(+) test = reproduction of symptoms, weakness or discoloration of the hands

A

EAST TEST

- ** indicates impingement at thoracic outlet**

31
Q

monitor radial pulse, abduct shoulder to 90, externally rotate to 90, flex the elbows to 90
- from ending position in step 1, hyperflex the affected shoulder while continuing to monitor the radial pulse
(+) test = reproduction of symptoms or diminished radial pulse

A

WRIGHT HYPERABDUCTION TEST

- ** indicates impingement at thoracic outlet d/t PECTORALIS MINOR**

32
Q

what nerve roots allow hip flexion?

A

L1-2

33
Q

what nerve roots allow knee flexion?

A

L2-3

34
Q

what nerve root allows ankle dorsiflexion?

A

L4

35
Q

what nerve root supplies extensor hallucis longus?

A

L5

36
Q

what nerve root allows ankle plantarflexion?

A

S1

37
Q

numbness or burning pain on anterolateral thigh
- hyperesthesia to the point of not putting anything in pockets
- trophic skin changes
(+) tinel’s sign 1cm medial and inferior to ASIS

A

MERALGIA PARESTHETICA

-** lateral femoral cutaneous nerve**

38
Q

pain along proximal third of lateral leg

  • foot drop with slapping gait
  • sx exacerbated during plantarflexion & inversion of the foot
A

COMMON FIBULAR NERVE COMPRESSION (L4-S2)

  • 3rd most common compression neuropathy
  • tx: posterior fibular head HVLA or MET
  • MET on gastroc/soleus, biceps femoris
39
Q

pain over dorsomedial aspect of foot & worse at rest

  • weakness of extensor digitorus brevis
  • recurrent ankle sprains, soccer players
  • prolonged plantar flexion, compression from shoes
A

ANTERIOR TARSAL TUNNEL SYNDROME (L4-S2)

  • tx: remove compressive forces
  • MFR to extensor retinaculum
  • traction tug of talonavicular joint
  • hiss whip for navicular, cuneiforms, 1-2 metatarsal
40
Q

pain on plantar surface of foot (not very specific)

  • vague burning/tingling/numbness
  • gait seldom affected
A

TARSAL TUNNEL SYNDROME

  • posterior fibular nerve
  • tx: MFR or HVLA, NSAIDs, rest, US, PT
41
Q

OK sign tests which nerve?

A

median

42
Q

Froment’s sign tests which nerve?

A

ulnar

43
Q

Hoffman’s sign tests what?

A

CNS

44
Q

spinal disk disease:

  • extremely painful acutely
  • disk slowly shrivels away in a few days-weeks
  • **most resolve without treatment within 2-6 weeks*
  • 90% back to normal activity within 1 month regardless of tx
A

initial herniation

45
Q

sharp, burning ‘hip” pain that radiates down their leg

- draws a line from right lower SI joint straight down back of leg to posterior knee

A

sciatica

- majority caused by sacroiliac ligament weakness

46
Q

pinching of the nerve root as they exit the spinal cord/cross intervertebral disc

A

radiculopathy

47
Q

compression of spinal cord itself

A

myelopathy

48
Q

damage to peripheral nerves, often causes weakness, numbness and pain, usually in hands and feet

A

neuropathy

49
Q
  • posterior pelvic tilt, flattening of the lumbar curve

- posterior translation of the tibia, laxity of the ACL and increased tension on the PCL

A

tight hamstrings

50
Q

why do the adductors need to be released before the hamstrings?

A

because a tight adductor magnus will cause limitation of full hamstring lengthening

OS 3 Exam 1 (1 decks)

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