Mononeuropathies Flashcards
Carpal Tunnel Syndrome
pathophys
compression of the median nerve at the wrist within the carpal tunnel
Carpal Tunnel Syndrome
which fingers does the median nerve innervate?
2
- pointer
- middle
Carpal Tunnel Syndrome
Risk Factors
7
- RA
- myxedema
- amyloidosis
- sarcoidosis
- leukemia
- acromegaly
- hyperparathyroidism
Carpal Tunnel Syndrome
Signs/Sx
4
- pain, burning, tingling, or numbness in the fingers
- weakness in fingers
- sensations increase w/ activity
- to alleviate sx, they try to “shake out” their fingers
Carpal Tunnel Syndrome
PE findings
- diminished sensation to the 1st to 3rd fingers and half the 4th
- poor grip strength, thenar atrophy
- pos tinel sign
- pos phalen sign
Carpal Tunnel Syndrome
what is tinel sign
reproduction of sx w/ nerve percussion
Carpal Tunnel Syndrome
what is phalen sign
reproudction of sx w/ flexing wrist to 90deg for 60s
Carpal Tunnel Syndrome
dx
- US can show flattening of nerve
- EMG/NCV (gold standard)
Carpal Tunnel Syndrome
what can EMG/NCV show that US can’t
severity of disease
Carpal Tunnel Syndrome
tx
6
- splint in neutral position
- reduce repetitive activities
- NSAIDs/oral steroids
- physical therapy
- steroid injection
- surgical release
Ulnar Neuropathy
pathophys
- compression of the ulnar nerve in either the elbow (cubital) or the wrist (Guyon’s)
Ulnar Neuropathy
which fingers are innervated by ulnar neuropathy
1/2 4th finger and all of the 5th finger
Ulnar Neuropathy
signs/sx
- pain, tingling, or numbness in the ulnar nerve distribution
- +/- weakness
- sensations worsen w/ elbow flexion
Ulnar Neuropathy
PE Findings
3
- diminished sensation in fingers
- pos tinel sign
- +/- reduced grip strength
Ulnar Neuropathy
dx
- US (flattening of nerve)
- EMG/NCV (gold standard)