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MSK 2 > LE Neurological Conditions - Diagnostic Manual > Flashcards

LE Neurological Conditions - Diagnostic Manual Flashcards

1
Q

outcome measures for LE neuropathies

A

PSFS
LEFS
ODI

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2
Q

femoral neuropathy will have _____ deficits

A

sensory and motor

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3
Q

motor deficits associated with femoral neuropathy

A

weakness in:
hip flexion
knee extension

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4
Q

sensory loss associated with femoral neuropathy

A

anterior and medial thigh
medial lower leg

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5
Q

entrapment locations of femoral nerve

A

retroperiotneal space
crossing deep to inguinal ligament

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6
Q

what can cause femoral nerve injury

A

surgery or procedures at femoral triangle
- vascular catheterization
- anterior approach hip replacement
trauma / space occupying pathology

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7
Q

range of motion finding associated with femoral neuropathy

A

limited hip flexion and/or knee flexion AROM
- limited by weakness

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8
Q

muscle performance finding associated with femoral neuropathy

A

weakness in hip flexion

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9
Q

explain what entrapment location will impair hip flexion

A

above inguinal ligament in retroperitoneal space

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10
Q

explain entrapment location that will not impair hip flexion

A

below the inguinal ligament

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11
Q

palpation finding associated with femoral neuropathy

A

sensory deficit comparison bilaterally
- anterior thigh
- medial thigh
- medial lower leg

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12
Q

joint mobility finding associated with femoral neuropathy

A

normal

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13
Q

special tests associated with femoral neuropathy

A

femoral nerve tension test

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14
Q

interventions related to femoral neuropathy

A

removal/limiting of inciting factors
nerve mobility exercises
manual therapy
restore normal muscle function
prevent paresis
improve blood circulation to affected tissues

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15
Q

how to restore normal muscle function

A

therapeutic exercise
NMES

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16
Q

neuropathy of lateral femoral cutaneous nerve is also called

A

meralgia parasthetica

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17
Q

sensory deficits associated with meralgia parastethetica

A

pain, paresthesia, numbness and tactile hypersensitivity isolated in anterior thigh

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18
Q

explain the commonality of lateral femoral cutaneous neuropathy

A

second most common LE neuropathy

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19
Q

potential causes of lateral femoral cutaneous neuropathy

A

compression of nerve via external forces
– weight / large abdomen (pregnancy)
ascites in liver failure
acute compression from seatbelt in MVA
complication following hip surgery

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20
Q

range of motion finding associated with lateral femoral cutaneous neuropathy

A

normal

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21
Q

muscle performance finding associated with lateral femoral cutaneous neuropathy

A

normal

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22
Q

palpation finding associated with lateral femoral cutaneous neuropathy

A

anterolateral thigh pain, paresthesia, numbness and tactile hypersensitivity

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23
Q

joint mobility finding associated with lateral femoral cutaneous neuropathy

A

normal

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24
Q

special test associated with lateral femoral cutaneous neuropathy

A

femoral nerve tension test

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25
interventions associated with lateral femoral cutaneous neuropathy
patient education postural re-training trunk ROM and aerobic exercises nerve mobility exercises manual therapy
26
what would patient education look like for those with lateral femoral cutaneous neuropathy
activity modification / reduction of aggravating factors loose clothing / belts diet/weight loss
27
medical interventions related to lateral femoral cutaneous neuropathy
corticosteroid injection surgical decompression
28
piriformis syndrome is synonymous with
sciatic nerve entrapment
29
explain how piriformis syndrome presents
sensory-like symptoms in absence of true sensory or motor deficits
30
if there is laceration/damage to sciatic nerve, what motor loss may occur
loss of foot musculature action
31
explain subjective reporting of piriformis syndrome
symptoms worsen with sitting on involved side, driving, and crossing of involved leg
32
what is the "wallet sign"
sitting on involved butt cheek and having symptoms flare up - piriformis syndrome of sciatic nerve
33
what tests/actions would increase the likelihood of symptoms to reproduce in those with piriformis syndrome
SLR with dorsiflexion piriformis stretch palpation/provocation of piriformis
34
ROM finding associated with piriformis syndrome
normal -- increased symptoms may occur with hip ADD and IR
35
muscle performance finding associated with piriformis syndrome
normal -- may have increased symptoms with resisted hip ER
36
palpation finding associated with piriformis syndrome
provocation of symptoms over piriformis
37
joint mobility finding associated with piriformis syndrome
normal
38
special tests related to piriformis syndrome
straight leg raise
39
physical therapy interventions related to piriformis syndrome
activity modification entrapment reduction strengthening motor coordination training
40
explain activity modification/pt education in those with piriformis syndrome
avoid laying on involved leg (adducts and IR involved hip naturally) crossing symptomatic leg avoid aggressive/prolonged stretching
41
imaging related to piriformis syndrome
MRI for identification of compression cause - if not responding to conservative management
42
what is the most common LE neuropathy
fibular
43
what can cause fibular nerve neuropathy
trauma to lateral knee/leg ganglionic cyst prolonged immobilization / habitual cross-leg sitting
44
where is the common fibular nerve located? if lesioned here, what deficits are seen?
at fibular head - foot drop - numbness of lateral lower leg / dorsum of foot - characteristic steppage gait
45
why does foot drop occur
weakness of ankle dorsiflexion and foot eversion
46
into what and where does the common fibular nerve branch
past the fibular head, branches into superficial fibular nerve deep fibular nerve
47
explain the branching of superficial fibular nerve
medial / lateral cutaneous branches
48
what is the area of sensation associated with deep fibular nerve
web space between toes 1 and 2 dorsally
49
ROM finding associated with fibular nerve entrapment
reduced ankle dorsiflexion / foot eversion AROM
50
muscle performance finding associated with fibular nerve entrapment
reduced ankle dorsiflexion / foot eversion
51
palpation finding associated with fibular nerve entrapment
likely sensory deficits of lateral lower leg/dorsum of foot
52
joint mobility finding associated with fibular nerve entrapment
normal
53
special tests associated with fibular nerve entrapment
SLR with fib nerve bias
54
physical therapy interventions associated with fibular nerve entrapment
pt education reduction of entrapment fibular nerve mobilization NMES for significant weakness
55
what random factor may attribute to a more distal fibular nerve compression
tight shoes -- loosen the laces homeslice
56
how to reduce entrapment of common fibular nerve
superior tibiofibular jt mobilization fibular head soft tissue mobilization
57
posterior tibial neuropathy is also known as
tarsal tunnel syndrome
58
explain symptom findings associated with tarsal tunnel syndrome
pain, sensory loss and paresthesia over: - medial ankle and heel - sole of foot - toes
59
sensory deficit present in lesion of medial plantar branch of tibial nerve
plantar foot of digits 1-3
60
sensory deficits present in lesion of lateral plantar branch of tibial nerve
plantar foot of lateral half of digit 4 and all of digit 5
61
what accessory symptoms may be associated with tarsal tunnel syndrome
cramping in the foot weakness of toe flexion/abduction
62
what actions may aggravate tarsal tunnel syndrome
standing walking running
63
ROM finding associated with tarsal tunnel syndrome
deficit in toe flexion/abduction AROM -- if significant or long term compression
64
muscle performance finding associated with tarsal tunnel syndrome
atrophy of plantar foot muscles -- if significant or long term compression
65
palpation/neurological finding associated with tarsal tunnel syndrome
notable sensory deficits in tibial nerve distribution
66
joint mobility finding associated with tarsal tunnel syndrome
normal
67
special tests associated with tarsal tunnel syndrome
tinel test triple compression test
68
PT interventions associated with tarsal tunnel syndrome
pt education -- footwear with adequate support -- unloading of tissue entrapment reduction therapeutic exercise
69
how to unload irritable tissues in those with tarsal tunnel syndrome
taping rocker-bottom footwear orthotics
70
therapeutic exercises for those with tarsal tunnel syndrome would focus on
proximal chain - increased pronation that may cause compression at tarsal tunnel
71
medical interventions associated with tarsal tunnel syndrome
microsurgical decompression - if muscle weakness and atrophy are present
72
what can cause morton's neuromas
entrapment of the common plantar digital nerves and repetitive traction
73
subjective reporting associated with morton's neuroma
sharp, burning localized pain to second or third web/metatarsal interspace - level of metatarsal heads may radiate into toes feeling like there is a pebble in the shoe worse when walking
74
what is an odd subjective report associated with morton's neuroma
patient feeling the need to remove shoes and massage the area
75
what are some common examination findings associated with morton's neuroma
cutaneous sensation decreased in distal distribution "lateral squeeze test" is often positive with palpable/painful click
76
ROM finding associated with Morton's Neuroma
no true ROM loss but could be limited due to pain
77
muscle performance finding associated with Morton's Neuroma
normal
78
special tests associated with Morton's Neuroma
squeeze test
79
PT interventions related to Morton's Neuroma
pt edcuation unloading irritable tissue entrapment reduction therapeutic exercise
80
how to unload irritable tissue for those with Morton's Neuroma
rocker-bottom footwear - shoes with wide toe-boxes orthotics
81
medical interventions associated with Morton's Neuromas
corticosteroid injection surgical excision

MSK 2 (37 decks)

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