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12. Neurology > Mononeuropathies > Flashcards

Mononeuropathies Flashcards

1
Q

What is the normal function of the radial nerve?

Motor: 3
Sensory: 1

A

Motor:

  • Wrist extension
  • Finger extension
  • Brachioradialis

Sensory:
-Radial half of dorsum

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2
Q

What can cause radial nerve mononeuropathy? (3)

A

Entrapment in spiral groove (humerus)
Trauma
Saturday night palsy

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3
Q

Describe the clinical features of radial nerve palsy. (7)

A

Wrist drop
Finger drop
NO pain

Weakness in:

  • Wrist extension
  • Finger extension
  • Elbow flexion in mid-pronation

Sensory change in:
-Radial half of dorsum

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4
Q

What is the normal function of the ulnar nerve?

Motor: 3
Sensory: 2

A 
MOTOR:
Wrist flexion
Intrinsic hand muscles, e.g.
-Finger abduction
-Thumb adduction

SENSORY:
Ulnar side:
-1.5 fingers on palm
-2.5 fingers on dorsum

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5
Q

What can cause ulnar nerve mononeuropathy?

A

Entrapment in ulnar groove (by medial epicondyle)

Elbow trauma

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6
Q

Describe the clinical features of ulnar nerve mononeuropathy. (7)

A

History of elbow trauma
Weak grip

Motor weakness in:

  • Index finger abduction
  • Little finger abduction
  • Wrist flexion
  • Thumb adduction

Sensory change in:
-Ulnar side (1.5 fingers on palm, 2.5 fingers on dorsum)

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7
Q

Describe the normal function of the median nerve.

Motor: 4
Sensory: 2

A 
MOTOR:
LOAF muscles:
-Flexion at MCPs
-Thumb opposition
-Thumb abduction
-Thumb flexion

SENSORY:
Radial side:
-3.5 fingers on palm
-Fingertips 2 and 3 on dorsum

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8
Q

What can cause a median nerve mononeuropathy? (2)

A

Carpal tunnel syndrome (entrapment in carpal tunnel)

Trauma

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9
Q

Describe the clinical features of a median nerve mononeuropathy. (6)

A

Intermittent night pain
Numbness and tingling
Symptoms relieved by shaking hand
Weak grip

Positive tests:

  • Tinel’s sign
  • Phalen’s test
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10
Q

What is Tinel’s sign?

What does it indicate?

A

Tingling in the median nerve distribution elicited by tapping over the median nerve

Median nerve palsy

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11
Q

What is Phalen’s test?

What is a positive result?

What does it indicate?

A

Forced wrist flexion: press dorsal sides of hands together for 30-60 seconds

Positive: tingling in the median nerve distribution; indicates median nerve palsy

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12
Q

What is the normal function of the anterior interosseos nerve?

Motor: 2
Sensory: 1

A

MOTOR:
Flexion at MCP joints
Thumb flexion

SENSORY:
None

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13
Q

What can cause an anterior interosseous nerve palsy?

A

Forearm trauma

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14
Q

Describe the clinical features of an anterior interosseous nerve palsy. (5)

A

Pain
Weak grip of keys
NO sensory change

Positive tests:

  • Tinel’s sign
  • Phalen’s test
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15
Q

What is the normal function of the femoral nerve?

Motor: 3
Sensory: 1

A

MOTOR:
Quadriceps (knee extension)
Iliopsoas (hip flexion)
Adductor magnus (hip adduction)

SENSORY:
Lateral side of shin

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16
Q

What can cause a femoral nerve mononeuropathy? (2)

A

Trauma

Haemorrhage

17
Q

Describe the clinical features of a femoral nerve mononeuropathy. (4)

A

Motor weakness in:

  • Knee extension
  • Hip flexion
  • Hip adduction

Sensory change in:
-Lateral side of shin

18
Q

What is the normal function of the common peroneal nerve?

Motor: 2
Sensory: 1

A 
MOTOR: 
Tibialis anterior (ankle dorsiflexion)
Extensor hallucis longus (big toe extension)

SENSORY:
Lateral shin around the knee

19
Q

What can cause a common peroneal nerve mononeuropathy? (3)

A

Entrapment (fibular head)
Knee trauma
Knee surgery

20
Q

Describe the clinical features of a common peroneal nerve mononeuropathy.

A

History of:

  • Trauma
  • Surgery
  • External compression

Acute onset
Foot drop
Sensory disturbance
NO pain

Weakness in:

  • Foot dorsiflexion
  • Great toe extension
21
Q

How do you differentiate between a common peronoeal nerve mononeuropathy and an L5 palsy? (2)

A

Both have weakness in foot dorsiflexion, BUT L5 ALSO HAS:

  • Weakness in foot inversion
  • Sensory change in medial shin
22
Q

Define mononeuritis multiplex.

A

Simultaneous or sequential development of neuropathies in 2 or more nerves

23
Q

List 6 causes of mononeuritis multiplex.

A 
Diabetes mellitus
Vasculitis
Rheumatoid disease
Infections (e.g. hep C, HIV)
Sarcoidosis
Lymphoma
24
Q

What are the 3 important nerves in the thigh, arising from the lumbar plexus?

What are their spinal nerve roots?

A 
Femoral nerve (L2, 3, 4)
Obturator nerve (L2, 3, 4)
Lumbosacral trunk (L4, 5)
25
Q

Which important lower limb nerve comes from the sacral plexus, NOT the lumbar plexus?

What is its spinal nerve roots?

A

Sciatic nerve (L4, 5, S1, 2, 3)

26
Q

What are the clinical features of:

a) Obturator nerve palsy? (1)
b) Sciatic nerve palsy? (1)

A

OBTURATOR PALSY:
Weakness in leg adduction

SCIATIC PALSY:
Weakness in knee flexion (hamstrings)

12. Neurology (13 decks)

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