Compression neuropathy

Question 1

Neuropathy

Answer 1

functional or pathological changes in peripheral nervous system

Question 2

Compression neuropathy

Answer 2

process in which a nerve becomes entrapped as it passes through a narrow tunnel or passage

Question 3

Biomechanical causes of compression neuropathy

Answer 3

space occupying lesions, post-traumatic, degenerative, mechanical

Question 4

Systemic causes of neuropathy

Answer 4

pregnancy, hypothyroidism, diabetes

Question 5

Epineurium contains…

Answer 5

fascicles, blood vessels, and connective tissue

Question 6

Fascicles of a nerve are covered by

Answer 6

perineurium and contain groups of axons

Question 7

Axons are covered in

Answer 7

myelin sheath and endoneurium

Question 8

Pathological changes of a neuron that may cause neuropathy

Answer 8

thickened epineurium, microvascular compression, myelin thinning, microtubule closure, axonal degeneration

Question 9

First degree nerve injury

Answer 9

neuropraxia, involves focal damage to myelin fibers around axon

Question 10

Second degree nerve injury

Answer 10

axonotmesis, some disruption to axon

Question 11

Third degree nerve injury

Answer 11

neurotmesis, disruption of axon and endoneurium

Question 12

Fourth degree nerve injury

Answer 12

neurotmesis, disruption of axon, endoneurium and perineurium

Question 13

Fifth degree nerve injury

Answer 13

neurotmesis, disruption of axon, endoneurium, perineurium, and epineurium

Question 14

5 models of osteopathic medicine

Answer 14

biomechanical, resp/circulatory, metabolic, neurologic, behavioral

Question 15

Cervical nerve root compression usually occurs secondary to…

Answer 15

cervical disc disease

Question 16

Bulging disk

Answer 16

compressed evenly without significant damage to cartilage rings

Question 17

Herniated disc

Answer 17

some tearing of cartilage rings, can protrude or extrude

Question 18

Discs most commonly rupture which direction

Answer 18

posterior-laterally

Question 19

Spurling test

Answer 19

extend and rotate neck toward symptomatic side

Question 20

Adson test

Answer 20

have patient elevate chin and rotate toward affected side while inspiring, look for obliteration of radial pulse

Question 21

Hoffmann test

Answer 21

firmly grasp middle finger and quickly snap the dorsal surface, look for quick flexion of thumb and index finger

Question 22

General treatment options for cervical radiculopathy

Answer 22

modification of activity, anti-inflammatories, PT, OMM, surgical release

Question 23

Nerves at risk for UE neuropathy

Answer 23

radial, median, ulnar, musculocutaneous and axillary

Question 24

Function of Radial N.

Answer 24

motor to triceps brachii, anconeus, wrist extensors, sensation of dorsum of hand

Question 25

Sites of radial nerve entrapment

Answer 25

high on humerus, radial tunnel, at wrist

Question 26

Sx of radial n. entrapment on humerus

Answer 26

wrist drop, weakness of elbow flexion, diminished tricep reflex

Question 27

Sx of radial n. entrapment in radial tunnel

Answer 27

pain and tenderness 5cm distal to lateral epicondyle, wrist drop

Question 28

Cheiralgia paresthetica

Answer 28

compression of SRN, numbness and tingling

Question 29

Sites of median n. entrapment

Answer 29

Ligament of struthers, pronator syndrome, anterior osseous syndrome, carpal tunnel syndrome

Question 30

Functions of median n.

Answer 30

forearm flexion and pronation, wrist flexion and radial deviation, thumb abduction and opposition, index and middle finger abduction and flexion

Question 31

Pronator syndrome

Answer 31

occurs as median n. passes between superficial and deep pronator teres m., seen in repetitive pronation

Question 32

Sx of pronator syndrome

Answer 32

achy pain in mid/proximal forearm, aggravated by repetitive lifting

Question 33

Anterior interosseous syndrome

Answer 33

deep motor branch of median n. injured due to trauma, cat pressure, soft tissue masses, fibrous bands

Question 34

Test for anterior interosseous syndrome

Answer 34

"OK" sign

Question 35

Carpal tunnel syndrome

Answer 35

most common compression syndrome, under flexor retinaculum

Question 36

Special tests for carpal tunnel syndrome

Answer 36

phalen's and tinel's

Question 37

Sites of ulnar n. entrapment

Answer 37

cubital tunnel, guyon's canal

Question 38

Function of ulnar n.

Answer 38

innervates skin and muscles of ulnar side of forearm and hand, motor for interosseous and adductor pollicis, sensory to ring and pinky finger

Question 39

Cubital tunnel formed by...

Answer 39

medial epicondyle, medial trochlea, olecranon, ulnar collateral ligament

Question 40

Cubital tunnel syndrome

Answer 40

parasthesia to 4th and 5th digits, medial elbow pain radiating to hand with decreased muscle strength, tinel's sign at elbow

Question 41

Sites of compression in thoracic outlet syndrome

Answer 41

scalene triangle, costoclavicular passage, pec minor attachment at coracoid process

Question 42

Sxs of thoracic outlet syndrome

Answer 42

weakness, paresthesia of medial arm, forearm, and hand

Question 43

Special tests for thoracic outlet syndrome

Answer 43

military/costoclavicular maneuver, EAST test, Wright's Hyperabduction, Adson's test

Question 44

LE nerves at risk for compression neuropathy

Answer 44

common fibular n., deep fibular n., posterior tibial n., lateral femoral cutaneous n.

Question 45

Meralgia paresthetica

Answer 45

compression of lateral femoral cutaneous n. under inguinal canal

Question 46

Sxs of meralgia paresthetics

Answer 46

numbness or burning pain on anterolateral thigh, hyperasthesia, trophic skin changes

Question 47

Deep fibular n. innervates...

Answer 47

tibialis anterior m., extensor digitorum longus/brevis, extensor hallicus longus

Question 48

Superficial fibular n. innervates...

Answer 48

fibularis longus and brevis

Question 49

Nerve roots of common fibular nerve

Answer 49

L4-S2

Question 50

Location of common fibular n. compression

Answer 50

nerve winds around fibular neck and enters tunnel

Question 51

Sx of common fibular n. compression

Answer 51

foot drop, pain along proximal third to lateral leg, pain exacerbated during plantarflexion and inversion of foot

Question 52

Anterior tarsal syndrome

Answer 52

compression of deep fibular nerve at inferior extensor retinaculum

Question 53

Sxs of anterior tarsal syndrome

Answer 53

pain over dorsomedial foot and worse at rest, weakness of extensor digitorum brevis

Question 54

Tarsal tunnel syndrome

Answer 54

compression of posterior tibial n. in tarsal tunnel behind medial malleolus with overlying retinaculum

Question 55

Posterior tibial n. function

Answer 55

motor to plantar muscles and sensation to plantar aspect of foot and toes

Question 56

Sxs of tarsal tunnel syndrome

Answer 56

pain on plantar surface of foot, vague burning, tingling, numbness

Question 57

Sxs of initial disc herniation

Answer 57

extremely painful acutely, disc slowly shrivels away but should resolve

Question 58

Sciatica

Answer 58

pain from lower back felt along distribution of sciatic n., usually due to SI ligament weakness