midterm Flashcards
motor loss =
flaccidity
weakness =
paresis
sensory loss =
anesthesia
sensory impairment =
paresthesia
pain =
dysesthesia
first degree nerve lesion
neuropraxia
no structural damage
local demyelination of nerve fibers
weeks-month recovery
loss of motor function but sesnory and autonomic fibers are unaffected
good prognosis
second degree nerve lesion
axonotmesis
prolonged, severe compression
degeneration of axons distal to injury
sensory, motor, autonomic losses occur
endoneurial tube intact
good prognosis
third degree nerve lesion
neurotmesis
severance of all or part of nerve trunk
endoneurial tube not intact
sensory,motor,autonomic losses
prognosis is poor
inflammation of nerve
neuritis
constant dull pain
abnormal sympathetic reflex resulting in arterial spasm =
reflex sympathetic dystrophy AKA complex regional pain syndrome
tumor composed of nerve cells
neuromas
nerve pain
neuralgia
recurrent attacks of sudden, excrutiating pain along distribution of affected nerve
what nerves are commonly affected with neuralgia
trigeminal and intercostal
3 divisions of CN V - trigeminal
opthalmic
maxillary
mandibular
severe pain syndrome =
causalgia
sudden onset of intense persistent , burning pain
avoid tractioning until…
the nerve has fully regenerated
no hydro therapy until..
autonomic and vasomotor control has returned
complete radial nerve injury =
C5-T1
wrist drop
flaccid extensors
injury proximal to elbow = sensory and motor affected
injury distal to elbow= sensory or motor
complete ulnar nerve injury =
C8-T1
claw hand
mm wasting at thenar eminence
oath hand/ benedict
complete median nerve injury =
C5-T1
ape hand
loss of thenar flexors, opponens pollicis
rapidly progressing inflammatory disease results in demyelination of peripheral nerves =
guillan barre syndrome
caused mainly by vacciness
sciatic nerve innervates what mm’s
semitendinosus
semimembranosus
long head biceps femoris
1/2 adductor magnus
mm’s innervated by common peroneal nerve (8)
extensor digitorum longus
peroneus longus
tib ant
extensor hallucis longus
peroneus brevis
peroneus tertius
extensor digitorum brevis
extensor hallucis brevis
mms innervated by tibial
gastroc
soleus
plantaris
popliteus
tib post
flex digitorum longus
flex hallucis longus
intrinsic mms
flexor digitorum brevis
flexor hallucis brevis
abductor hallucis
adductor hallucis
lumbricals
interossei
complete sciatic nerve lesion =
foot drop
paralysis of dorsiflexors and evertors cause foot to hang in plantar flexion and inversion
person must lift leg high to walk, placing toe down first
steppage gait
loss of intrinsic foot mms w tibial nerve lesion =
claw toe
hyperextension at MTP and flexion of IP
what portion of leg carries the bulk of autonomic fibers
tibial portion
lesions involving tibial nerve =
severe trophic changes and edema in sole of foot and toes
what can occur with sciatic nerve lesions involving the tibial branch
causalgia
where is altered sensation experienced with the peroneal division
lateral and anterior surface of lower leg and foot , medial malleous
erbs paralysis
injury to UPPER brachial plexus C5/C6 nerve roots
presentation of erb’s
waiters tip
shoulder adducted and internally rotated
elbow extended
forearm pronated
wrist and fingers flexed
klumpke’s paralysis
injury involving LOWER brachial plexus
C8/T1 nerve roots
claw hand
horners syndrome
combination of median and ulnar lesion
horner’s syndrome
manifests on affected side
- constriction of pupil
- drooping of eyelid
- loss of sweating to face and neck
- recession of eyeball into orbit
where does guillan barre typically begin
weakness in legs and ascends to trunk and arms
with radial nerve lesion where would the fracture be
spiral radial groove
dislocation of head of radius, humeroradial and radioulnar joints
w median nerve lesion where would the fracture be
elbow, wrist, carpal bones
dislocations of elbow, wrist, carpal bones (lunate, scaphoid)
what are the thenar mms
abductor pollicis brevis
opponens pollicis
flexor pollicis brevis
w ulnar nevre lesion where would the fracture be
medial epicondyle , mid forearm or wrist (colles)
dislocation of elbow
hypothenar mms
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi
positive fromens sign affects what mm’s ability to maintain firm grip on an object
flexor pollicis longus
SH depression, abd to 90, elbow flexion, supination, wrist and finger ext, sh ext rotation
ULTT IV
nerve fibres that travel from CNS to mms are known as
efferent
area of isolated supply for median nerve
tips of 2nd and 3rd digits
dermatome over deltoids
C5
dermatome: buttock, posterior/lateral thigh, lateral leg, dorsum of foot, medial half of sole, 1,2,3 toes
L5
commoon fracture sites for sciatic
pelvis, femur, tibia, fibular head, ankle
dislocations at hip, knee, ankle
compression from piriformis
where does the sciatic nerve split
popliteal fossa
path of sciatic N
leaves sacral plexus
through greater sciatic foramen, under piriformis
between ischial tuberosity and greater trochanter
deep and follows adductor magnus down leg
SH =depression and abduction to 110
elbow = extension
forearm = supination
wrist = extension
fingers and thumb = extension
cervical spine - contralateral side flexion
ULTT1
median and anterior interosseous
SH = depression and abd to 10
elbow = ext
forearm = supination
wrist = ext
fingers and thumb = ext
shoulder = lateral rotation
cervical = contralateral
ULTT2
median N
musculocutaneus
axillary
SH = depression, abd to 10
elbow = ext
forearm = pronation
wrist = flexion and ulnar deviation
fingers and thumb = flexion
shoulder = med rotation
cervical - contra side flexion
ULTT3
radial
SH = depression, abd to 90
elbow = flexion
forearm = supination
wrist = ext and radial deviation
fingers and thumb = extension
shoulder = lateral rotation
cervical = contra side flexion
ULTT4
ulnar
when the neck is extended, rotated and laterally flexed
erbs
falling from a height and grab onto something to catch fall causes traction as the body weight stretches the C8/T1 nerve roots
klumpkes
median and ulnar lesion
claw hand
wasting of forearm mm’s
what is a positive test for tinels
paresthesia, or tingling along the disruption of a nerve
common for carpal tunnel
locations for tinels test
brachial plexus
ulnar nerve
saphenous
common peroneal
deep peroneal
posterior tibial
what do afferent/ sensory neurons convery
sensory stimuli from the skin and deeper structures to the CNS
epineurium around fascicles
endoneurium surrounds individual fibers
somatic efferent fibers=
motor neurons
with intercostal neuralgia where is pain especially intense
where the cutaneus branches emerge at the spine, at the lateral axillary line and at sternum
person tries to make a fist and cannot do it bc only the 4th and 5th digits can be flexed
oath hand
thumb lying in same plane as the rest of the hand - loss of opposition
ape
median nerve altered sensation
thumb, index, middle and 1/2 of 4th digit of flexor surface, distal 2/3 of palm
where does anesthesia occur w median nerve lesion In the fingers
DIP jt of 1st and 2nd digits
where does anesthesia occur w radial lesion in the hand
web between the thumb and second digit
where does alterered sensation occur w median nerve lesion
posterior arm, forarm and hand, thumb, index, middle, 1/2 ring finger, excluding fingertips
5th digit hyperextended and abducted at MCP jt and flexed at IP jt
4th digit hyperextended at MCP w varying amounts of flexion at IP
claw hand
loss of adductor pollicis =
positive froments sign
alterered sensation experienced 5th digit, medial half of ring finger, palmar and dorsal
ulnar nerve
what does the tibial nerve divide into
medial and lateral plantar nerves
what is formed from the tibial and common peroneal nerve
sural nerve
where is anesthesia experienced on dorsal surface of the foot at web space between great toe and second digit =
peroneal nerve lesion
related conditions to sciatic
lumbar spine conditions
piriformis syndrome
acute disc herniation
degenerative disc disease
