Final Flashcards
Compression neuropathies
Ok
Biomechanical causes compression neuropathy
Space occupying-herniated disc, cyst
Degenerative causes-foraminal stenosis
Post traumatic-fracture, hematoma, compression from equipment
Mechanical-muscle spasm, pinching from external or positional forces
Systemic causes
Pregnancy, hypothyroid, diabetes
Epineureum
Fascicles, blood vessels, CT
Perineureum
Contain axons
Pathological changes
Microvascuar compression->ischemia
Thickened epineurium
Myeli thinning
Microtubules closure
Axonal degeneration
Neuropraxia nerve injuries
Focal damage of myelin fibers around axon
Least severe, days o weeks improve
Axonotmesis
Some disruption/injury to the axon itself
Myelin sheath remains intact
Regeneration is possible but months without a fill recovery
Neurotmesis
Disruption of axon and endometrium
Recover with axonal regeneration, surgery, may be no improvement
Know your dermatomes!
Want to know where the lesion is
Where will lesion be on MRI why am i ordering MRI-i think there is pinching that we will want to do something about
Person has this deficit
It’s this nerve root
Herpes in dermatome pattern
Herpes
Pain in 1 derm
Nerve
Pain down buttand leg
Not dermatomal -nothing down side of leg
Cervical nerve compression: bulging disc
Evenly bulging out gain weight lose height
Cervical comrpession: herniated disc
Protrusion-only a few cartilage rings are torn , no leakage of central material
Extrusion-cartilagerings have in a small area, nucleus purposes is able to flow out of the disc space
Most commonly the cervical disc ruptures __-___ causing compression of the nerve root as it exits the intervertebral foramen
Posterior laterally
What does cervical nerve root compression cause
Radiculopathy-pain caused y compression of the spinal nerve that radiates int he distribution of the defined nerve root
Spurring test
Extend and rotate the neck toward symptomatic side and look forexacerbation of radicularpain
CERVICAL RADICULOPATHY indicative of
Adson test
Elicited by having the patient elevate the chin and rotate the head toward the affected side while inspiring deeply; look for obliteration of radial pulse on affected side
Thoracic outlet syndrome
Hoffman test
Elicited by firmly grasping the middle finger and quickly snapping or flipping the dorsal surface, look for a quick flexion of both the thumb and index finger
Cervical myelopathy (cervical stenosis)
Purpling
High SPECIFICITY hold. Head down
Cervical compression
Comrpession test
Just push down
Cervical spine c2 what nerve root looking at
C3 bc go above vertebral body nerve root