discs compression px Flashcards
L3 nerve root compression
anterior thigh !!
weak ;
- hip flexion
- knee extension
- hip aDuction
L4 nerve root compression
anterior aspect of knee + medial malleolus
- weak knee extension + hip aDduction
compression of which nerve roots would result in reduced knee reflex as well as a positive femoral stretch test
L3 + L4
L5 nerve root compression
dorsum of foot! (sensory loss)
- reflexes intact
weakness in foot + big toe dorsiflexion
S1 nerve root compression
posterolateral aspect of leg + lateral aspect of foot !
weakness in PLANTAR flexion of foot
which nerve root compression would cause a reduced ankle reflex
S1
- also causes positive sciatic nerve stretch test
management of nerve root compression
analgesia + physio
- NSAIDs + PPI
if sx persist after 4-6weeks then refer for consideration of MRI
meralgia paraesthetica
paraesthesia/anaesthesia in distribution of lateral femoral cutaneous nerve
- entrapment mononeuropathy of LFCN but can be iatrogenic or from a neuroma
lateral femoral cutaneous nerve
primarily sensory nerve, no motor fibres
- originates from L2/3
where does a patient with meralgia paraesthetica experience sx
upper lateral aspect of thigh
- lateral femoral cutaneous nerve distribution
burning, tingling, numbness
deep muscle ache
usually aggravated by standing
risk factors for meralgia paraesthetica
obesity
pregnancy
tense ascites
trauma
iatrogenic - hernia repairs, spinal surgeries, abduction splint for PErthes
meralgia paraesthetica investigations
pelvic compression = sx reproduced by deep palpation just below ASIS + by extension of hip
injection of nerve with local will abolish pain
- US for diagnosis + guiding injection
