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OSIII > Compression neuropathy > Flashcards

Compression neuropathy Flashcards

1
Q

Neuropathy

A

functional or pathological changes in peripheral nervous system

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2
Q

Compression neuropathy

A

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

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3
Q

Biomechanical causes of compression neuropathy

A

space occupying lesions, post-traumatic, degenerative, mechanical

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4
Q

Systemic causes of neuropathy

A

pregnancy, hypothyroidism, diabetes

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5
Q

Epineurium contains…

A

fascicles, blood vessels, and connective tissue

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6
Q

Fascicles of a nerve are covered by

A

perineurium and contain groups of axons

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7
Q

Axons are covered in

A

myelin sheath and endoneurium

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8
Q

Pathological changes of a neuron that may cause neuropathy

A

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

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9
Q

First degree nerve injury

A

neuropraxia, involves focal damage to myelin fibers around axon

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10
Q

Second degree nerve injury

A

axonotmesis, some disruption to axon

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11
Q

Third degree nerve injury

A

neurotmesis, disruption of axon and endoneurium

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12
Q

Fourth degree nerve injury

A

neurotmesis, disruption of axon, endoneurium and perineurium

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13
Q

Fifth degree nerve injury

A

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

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14
Q

5 models of osteopathic medicine

A

biomechanical, resp/circulatory, metabolic, neurologic, behavioral

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15
Q

Cervical nerve root compression usually occurs secondary to…

A

cervical disc disease

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16
Q

Bulging disk

A

compressed evenly without significant damage to cartilage rings

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17
Q

Herniated disc

A

some tearing of cartilage rings, can protrude or extrude

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18
Q

Discs most commonly rupture which direction

A

posterior-laterally

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19
Q

Spurling test

A

extend and rotate neck toward symptomatic side

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20
Q

Adson test

A

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

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21
Q

Hoffmann test

A

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

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22
Q

General treatment options for cervical radiculopathy

A

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

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23
Q

Nerves at risk for UE neuropathy

A

radial, median, ulnar, musculocutaneous and axillary

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24
Q

Function of Radial N.

A

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

25
Q

Sites of radial nerve entrapment

A

high on humerus, radial tunnel, at wrist

26
Q

Sx of radial n. entrapment on humerus

A

wrist drop, weakness of elbow flexion, diminished tricep reflex

27
Q

Sx of radial n. entrapment in radial tunnel

A

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

28
Q

Cheiralgia paresthetica

A

compression of SRN, numbness and tingling

29
Q

Sites of median n. entrapment

A

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

30
Q

Functions of median n.

A

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

31
Q

Pronator syndrome

A

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

32
Q

Sx of pronator syndrome

A

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

33
Q

Anterior interosseous syndrome

A

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

34
Q

Test for anterior interosseous syndrome

A

“OK” sign

35
Q

Carpal tunnel syndrome

A

most common compression syndrome, under flexor retinaculum

36
Q

Special tests for carpal tunnel syndrome

A

phalen’s and tinel’s

37
Q

Sites of ulnar n. entrapment

A

cubital tunnel, guyon’s canal

38
Q

Function of ulnar n.

A

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

39
Q

Cubital tunnel formed by…

A

medial epicondyle, medial trochlea, olecranon, ulnar collateral ligament

40
Q

Cubital tunnel syndrome

A

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

41
Q

Sites of compression in thoracic outlet syndrome

A

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

42
Q

Sxs of thoracic outlet syndrome

A

weakness, paresthesia of medial arm, forearm, and hand

43
Q

Special tests for thoracic outlet syndrome

A

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

44
Q

LE nerves at risk for compression neuropathy

A

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

45
Q

Meralgia paresthetica

A

compression of lateral femoral cutaneous n. under inguinal canal

46
Q

Sxs of meralgia paresthetics

A

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

47
Q

Deep fibular n. innervates…

A

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

48
Q

Superficial fibular n. innervates…

A

fibularis longus and brevis

49
Q

Nerve roots of common fibular nerve

A

L4-S2

50
Q

Location of common fibular n. compression

A

nerve winds around fibular neck and enters tunnel

51
Q

Sx of common fibular n. compression

A

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

52
Q

Anterior tarsal syndrome

A

compression of deep fibular nerve at inferior extensor retinaculum

53
Q

Sxs of anterior tarsal syndrome

A

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

54
Q

Tarsal tunnel syndrome

A

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

55
Q

Posterior tibial n. function

A

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

56
Q

Sxs of tarsal tunnel syndrome

A

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

57
Q

Sxs of initial disc herniation

A

extremely painful acutely, disc slowly shrivels away but should resolve

58
Q

Sciatica

A

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

OSIII (11 decks)

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