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Neurology > Mononeuropathies > Flashcards

Mononeuropathies Flashcards

1
Q

Name the common nerves which are affected by neuropatheis?

A 
Radial nerve
Ulnar nerve
Median nerve (and anterior interosseous nerve)
Common peroneal nerve
Femoral nerve
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2
Q

What are the main nerves given off by the brachial plexus?

A 
Musclocutaneous nerve
Axillary nerve
Median
Radial 
Ulnar
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3
Q

What is the most common cause of radial nerve palsy?

A

Saturday night palsy (pressure on the underside of the arm, causing entrapment of the nerve in the spiral groove)

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4
Q

What is the function of the radial nerve?

A 
Motor
- extends wrist and fingers
- tennis backhand 
Sensory
- area over the anatomical snuffbox
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5
Q

What are the presenting symptoms of a radial nerve palsy?

A

Wrist and finger drop

Numbness - usually painless

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6
Q

Describe the pattern of motor weakness in radial nerve palsy.

A

Wrist extension weakness - extensor carpi radialis longus
Finger extension weakness - extensor digitorum communis
Elbow flexion in mid-pronation - brachioradialis

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7
Q

What is the most common cause of ulnar nerve palsy?

A

Entrapment of the nerve at the ulnar groove (medial epicondyle of the humerus)
- caused by inflammation of lifestyle chanegs

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8
Q

What is the function of the ulnar nerve?

A 
Motor
- intrinsic muscles of the hand
- some muscles of the forearm 
Sensory
- medial aspect of the hand
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9
Q

What are the presenting symptoms of ulnar nerve palsy?

A 
History of trauma at the elbow
- repeated trauma causes permanent damage
Sensory disturbance 
Weak grip
Painless
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10
Q

Describe the pattern of motor weakness in ulnar nerve palsy.

A

Weakness in the following actions

  • index finger abduction (1st dorsal interosseus)
  • pinkie abduction (abductor digiti minimi)
  • wrist flexion (flexor carpi ulnaris)
  • thumb adduction (adductor policis)
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11
Q

What is the most common cause of medial nerve palsy?

A

Entrapment within the carpal tunnel at the wrist

- can be caused by inflammation and swelling of tendons within the tunnel

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12
Q

What is the function of the median nerve?

A

Sensory
- the most lateral 3.5 fingers on the palm
Motor
- flexors of the forearm
- LOAF (lumbricals, opponens pollicis, abductor pollicis brevis and flexor pollicis brevis)

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13
Q

What are the presenting symptoms of median nerve palsy?

A

Intermittent nocturnal pain
Numbness and tingling
Weak grip
Tinel’s sign
- lightly tapping the nerve to elicit tendernss and tingling over the wrist
Phalens test
- complete flexion of the wrist to elicit tingling and pain over the wrist

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14
Q

Which muscles display weakness in median nerve palsy?

A 
Lumbicals (1 and 2)
- flexion at the MCP joint
Opponens pollicis
- thumb opposition
Abductor pollicis brevis 
- thumb abduction
Flexor pollicis brevis
- thumb flexion
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15
Q

What is the most common cause of anterior interosseous branch nerve palsy?

A

Trauma to the forearm

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16
Q

What is the function of the anterior interosseous branch?

A

This nerve branches off the median nerve in the forearm where it travels deeper to supply

  • pronator quadratus (hand pronation)
  • flexor pollicis longus (allows OK sign)
  • lateral part of flexor digitorum profundus (thumb flexion)
17
Q

What are the presenting symptoms of anterior interosseous nerve palsy?

A

History of forarm pain
Weak grip on keys
Tinels sign
Phalens test

18
Q

Which muscles are weakened by an anterior interosseous nerve palsy?

A

Pronator quadratus - flexion at MCP joint is limited
Flexor pollicus longus - thumb flexion
Flexor digitorum profundus - thumb flexion

19
Q

Give a brief description of the function of the nerve of the upper limb.

A 
Radial nerve
- tennis backhand
- wrist and finger extension
Median nerve
- forearm flexors
- LOAF
Ulnar nerve
- intrinsic muscles of the hand
20
Q

Where is the lumbar plexus located?

A

Near iliopsoas

- damage to this muscles risks damage to the plexus

21
Q

Name the large nerves of the hip (supply the thigh).

A

Femoral nerve
Sciatic nerve
Obturator nerve

22
Q

Summarise the nerves of the thigh, and what they supply.

A 
Femoral nerve 
- found in the front of the leg
- supplies the quads (knee extension and hip flexion)
Obturator nerve 
- found medially 
- hip adduction 
Sciatic nerve
- found in the back of the leg
- supplies the hamstrings (knee flexion, allowing running)
23
Q

What is the most common cause of femoral nerve palsy?

A

Haemorrhage or trauma

24
Q

What is the function of the femoral nerve?

A 
Motor
- knee extension
- hip flexion
Sensory
- skin over the front and inner thigh, shin and arch of foot
25
Q

What are the presenting symptoms of femoral nerve palsy?

A

Weakened quadriceps
Weakened hip flexion
Numbness on medial shin

26
Q

Which muscles and actions are weakened in femoral nerve palsy?

A

Quadriceps - knee extension
Iliopsoas - hip flexion
Adductor magnus - hip adduction

27
Q

Once it has entered the lower leg, what happens to the sciatic nerve?

A

At the knee, it splits into

  • common pernoeal nerve (muscles in anterior and lateral leg compartments)
  • tibial nerve (posterior leg compartment and sole of the foot)
28
Q

Describe the pattern of distribution of the common pernoeal and tibial nerves?

A

Tibial - back of the leg
- motor: gastrocnemius and soleus muscles of the calf
Common peroneal - front of the leg
- motor: tibialis anterior and the peroneus muscles
- sensory: shin and dorsum of the foot

29
Q

What is the most common cause of common perneal nerve palsy?

A

Entrapment at the fibular head.

30
Q

What are the presenting symptoms of a common peroneal nerve palsy?

A 
History of trauma, surgery or external compression
Acute onset foot drop (plantarflexion)
- stepage gait 
Sensory disturbance 
Painless
31
Q

How can you tell the difference between common peroneal nerve palsy and L5 radiculopathy?

A

L5 radiculopathy and common peroneal nerve palsy both have sensory change down the lateral skin and foot dorsum
However L5 radiculopathy also has foot inversion

32
Q

Which muscles and movements would be weakened in common peroneal nerve palsy?

A

Tibialis anterior - ankle dorsiflexion

Extensor hallucis longus - great toe extension

33
Q

What is mononeuritis multiplex?

A

Simultaneous or sequential development of palsies of two or more nerves.

34
Q

List some common causes of mononeuritis multiplex.

A 
Diabetes
Vascilitic - Churg Strauss 
Rheumatological - RA, lupus, Sjogrens syndrome
Infective - Hep C, HIV
Sarcoidosis
Lymphoma

Neurology (13 decks)

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