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Physical Disabilities > FINAL PERIPHERAL NERVE SENSORY DEFICITS > Flashcards

FINAL PERIPHERAL NERVE SENSORY DEFICITS Flashcards

1
Q

Branchial plexus gives birth to what nerves?

A

RN, MN, UN, Axillary, and Musculocutaneous nerve

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2
Q

What is Endoneurium?

A

Electrically insulates individual nerve fibers.

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3
Q

What is Perineurium?

A

The sheath that serves as a diffusion barrier (allows blood flow, keeps toxin away from nerve fibers)

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4
Q

What is Epineurium?

A

Outer cover

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5
Q

What is Mesoneurium?

A

The slippery surface that limits friction

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6
Q

What prolonged stretch/compression on a nerve will lead to if circulation is restored?

A

Edema within CT covering. The swelling will lead to nerve pathology.

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7
Q

What are mechanisms of nerve injuries?

A 
Compression or entrapment 
Traction
Avulsion
Laceration
Burn
Chemical
Ischemic
Radiation
Injection Injuries
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8
Q

What are motor symptoms of nerve injury?

A

Weakness
Venous/lymphatic issues
Atrophy
Muscle/joint fibrosis

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9
Q

What are sensory symptoms of nerve injury?

A 
Paresthesia 
Altered vibratiory perception
Abnormal discrimination 
Decreased functional use 
Increased risk of burn.
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10
Q

What are autonomic symptoms of nerve injury?

A

Vasomotor - skin temperature, edema, color
Sudomotor - Sweat patterns
Pilomotor - Absence of goosebumps
Trophic - Nail and hair changes, slowed skin healing and slow bone growth in kids.

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11
Q

C5 motor screen wil perform what action?

A

Shoulder abd

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12
Q

C6 motor screen wil perform what action?

A

Elbow flexion and wrist extension

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13
Q

C7 motor screen wil perform what action?

A

Elbow extension, wrist flexion

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14
Q

C8 motor screen wil perform what action?

A

Digital flexion

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15
Q

T1 motor screen wil perform what action?

A

Digital abd/add.

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16
Q

C5 sensory screen wil result in feeling what part of the body?

A

Skin over deltoid

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17
Q

C6 sensory screen wil result in feeling what part of the body?

A

Tip of thumb, radial wrist

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18
Q

C7 sensory screen wil result in feeling what part of the body?

A

Tip of middle finger

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19
Q

C8 sensory screen wil result in feeling what part of the body?

A

Tip of SF, and ulnar wrist

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20
Q

T1 sensory screen wil result in feeling what part of the body?

A

Medial elbow

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21
Q

In complete nerve injury what are medical treatments

A

Surgery

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22
Q

Mononeuropathy is?

A

Damge to singe nerve

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23
Q

Miltiple monooneuropathy is?

A

multi-focal asymmetrical involvement of multiple nerves

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24
Q

Double crush syndrome?

A

One -nerve, multiple site of pathology

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25
Polyneuropathy
B/L extremity damage to two or more PN due to metabolic changes
26
Peripheral polyneuropathy
often hands and feet, in smokers, alcoholism, autoimmune disease
27
What is neuropraxia?
Compression and loss of blood flow to a nerve = sensory and motor los. Recovery weeks to months (Staruday night palsy, or sutternlands type 1)
28
Axonotmesis ?
Severe compression, axon distal to compression degenerate. Endoneurial tubes remain, good recovery (Sunderland type 2).
29
Sunderland Type 3 is?
destruction of endoneurial tubes
30
Sunderland type 4?
Destruction of perineurium Singifican internal scarring impairing function Nerve graft probably required
31
Sunderland type 5 and 6
Physiologic disruption of entire nerve or section of nerve Requires surgery With complete severed PN will see loss of sensation, motor control and reflexes.
32
Wallerian Degeneration ?
Breakdwon of the axon distal to site of injury. Starts 48 -96 hrs after injury and concludes 3 wks after injury. During this process there is deterioration of myelin and distal axons become disorganized.
33
When is primary nerve repain happen?
within first wk of injury
34
When does secondary nerve repain happen?
Wekks or more after injury
35
Nerve grafting is necessary when?
When primary repair on the cut ends can not occur due to tension on the nerve.
36
What is autograft?
Harvested from sensory nerves
37
What is allograft ?
Cadavers
38
What is conduits ?
Commercially available tubes to brige gap
39
Neurolysis ?
Free nerve from surrounding tissue
40
Nerve decompression
Remove nerve from impigement by moving nerve or cutting tissue Tendon transfer
41
What is neuropraxia?
A conduction block, no anatomical disruption. All components attached
42
What is axonotmesis?
Disruption of axons and myelin sheaths, but endoneurial tubes are intact
43
What is Neurotmesis?
Complete severance or serious disorganization -- No spontaneous recovery
44
Nerver regeneration is happening (scale)
1-4mm per day (after 3 weeks of Wallerian degeneration) (about 1 in per month).
45
What factors influence regeneration?
``` Age Amount of scare tissue How high the injury Delayed reconstruction Severity of injury Inaccurate alignment of fascicles during surgery Neuroma development. ```
46
What are nerve recovery function ?
``` Pain temperature Touch Propriception Motor ```
47
What are patterns of sensory recovery?
``` pain perception vibration of 30 cps moving touch constant touch vibration 256 cps ```
48
RN compression sites; High radial nerve injury
Crutch palsy - compression at axilla, motor and sensory involvement. Saturday night palsy - compression of the RN at midhumerous, motor and sensory involvement (triceps OK). Humeral shaft fx
49
What presentation will high radial nerve injury have?
Triceps works! Weakness - wrist ext, supination, thumb ext, MP ext Paresthesia - dorsum of the hand
50
Posterior Interosseous nerve palsy (PIN) Numerous compression areas will result in?
Primary motor involvement | Weakness - wrist ext, MP ext, thumb ext
51
Radial Tunnel will result in?
PIN compression Pain 3-5 cm distal to LE Deep burning, aching including at rest No weakness or sensory involvement
52
Superficail radial sensory nerve (RSN) palsy will result in?
Wartensbergs Syndrome Sensory involvement only Wrist watch, handcuffs, splint or from with ECRL and branchioradialis
53
What are RN orthosis ?
TO stabilize wrist | MCP extension assist
54
Categories of Compression of the MN are?
Pronator syndrome Anterior interousseous syndrome Carpal tunnel syndrome
55
What is pronator syndrom?
Compression between the 2 heads of the pronator, at the ligament of struthers, lacertus fibrosis, hypertrophy of the pronator trees or at the arch of the FDS
56
Where would pain be with pronator syndrom?
Proximal volar forearm Sensory involvement Report of hand weakness
57
Anterior Interousses sundrom will present as?
Compression of deep motor branch at the pronator trees Paralysis of FPL and FDP to index No sensory symptoms, forearm pain present
58
What are compression sites of the UN?
Cubital tunnel | Guyon's canal
59
Cubital tunnel what is it?
At the elbow cause by trauma sustain elbow flexion, cubitus valgus deformity, fx, Sensory symptoms include pain, motor weakness Test - Elbow flexion test TX - Elbow pad, splint, injection, ulnar nerve transposition
60
Guyons Canal?
Pain , sensory symptoms and/or motor weakness AKA - handle bar palsy Test - compression to canal Tx - padded glove, injection, surgery
61
Ulnar Nerve Orthosis?
Prevent RF/SF from clawing | Put MPs in flexion
62
What are therapeutic management of Nerve injuries ?
``` Orthosis - protect nerves PROM - prevent join contracrues Education - on injury, healing, ergonomics and protection of insensate areas Nerve gliding Pain management Desensitization Sensory re-education ```
63
Nerve Glides are?
gentel glides! that help limit adhesions after surgery, increase blood flow, help decrease neural symptoms and protective muscle guarding. DUE not stretch or lengthen the nerve. Should not produce nerve symptoms
64
Protective Reeducation is about ?
Educating pt on compensatory techniques for sensory protection Education about injury and re-injury Skin-checks Avoidance of cold temps
65
Descriminative Sensory Reeducation
Sensory retruns from proximal to distal Two phases; Eraly phase - starts when protective sensation Late phase - when moving/constant touch is 256 cps is perceived at fingertips with good localization
66
Desensitization benefits?
Systematic process used to reeducat the nervous system Requires frequent sessions with various tactile stim throughout day The mote frequently the pt participates the sooner they get better
67
Pain management is about?
``` Education Occupational based interventions Ultrasound TENS Iontophoresis Manual therapy NOT IF PT HAS SENSORY LOSS Superficial heat Fluidotherapy Paraffin Cold ```

Physical Disabilities (12 decks)

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