Compression Neuropathy Lecture Flashcards
What is compression neuropathy?
process whereby a nerve becomes entrapped as it passes through a narrow tunnel or passage
Sunderland classification of nerve injury
What usually is the cause of cervical nerve root compression?
2° to cervical disc disease (i.e. disc bulging or herniation)
What is a bulging disc? herniated disc?
a. compressed evenly without significant damage to cartilage rings
b. Some tearing of the cartilage rings
i. Protrusion: only a few cartilage rings are torn; no leakage of central material
ii. Extrusion: cartilage rings have torn in a small area, nucleus pulposus is able to flow out of the disc space
How does the disc most commonly herniate?
posterior laterally –> causes radiculopathy
What is justified in most cases of cubital tunnel syndrome? what is the exception?
operative decompression –> prevent nerve damage
not needed in very mild cases
What nerves are at risk in peripheral UE?
Radial nerve
Median nerve
Ulnar nerve
Musculocutaneous
Axillary
What sensation does the radial nerve supply?
majority of dorsum of hand (via posterior interossesous
motor to triceps, anconeus, wrist extensors
What are names for paresthetica in superficial radial nerve?
Wartenber’s syndrome or Handcuff Neuropathy
caused by compression, edema, surgical injury
What four sites can trap the median nerve?
Ligament of Struthers
Pronator Syndrome
Anterior Osseous Syndrome
Carpal Tunnel Syndrome
What is pronator syndrome?
What tests are done to test for carpal tunnel syndrome?
How do we treat carpal tunnel?
Where can the ulnar nerve have entrapment?
Cubital Tunnel
Guyon’s Canal
What are the two parts of the ulnar nerve, and what are their functions?
Thoracic Outlet Syndrome Flow Chart
What nerves are at risk to become entrapped in the LE?
Common Fibular n. (L4-S2)
Deep Fibular n. (L4-S2)
Posterior Tibial n. (L4-S2)
Lateral Femoral Cutaneous n. (L2-3)
What are sx of common fibular n. compression? tx?
Sx: pain along proximal third of lateral leg, foot drop with a slapping gait, sx exacerbated during plantarflexion & inversion of the foot
Tx: posterior fibular head HVLA or ME, ME on gastroc/soleus, biceps femoris
How do we treat anterior tarsal tunnel syndrome?
- Remove compressive forces
- Myofascial release of extensor retinaculum
- Traction tug of talonavicular joint
- Hiss whip for navicular, cuneiforms, 1st and 2nd metatarsal
What is a unique sx of lateral femoral cutaneous n compression?
trophic skin changes (later on)
(+) Tinel’s sign 1cm medial and inferior to the ASIS
What is the etiology of tarsal tunnel syndrome?
What is spinal disc disease?
can develop chronic back pain
weak back ligaments (predispose to further injury; accelerated OA)
What mainly causes sciatica?
sacroiliac ligament weakness
