Nerve palsies Flashcards
Presentation of common peroneal nerve palsy
FOOT DROP
-weakness of foot dorsiflexion
-weakness of foot eversion
-weakness of extensor hallucis longus
-sensory loss over the dorsum of the foot and lower lateral part of the leg
-wasting of the anterior tibial and peroneal muscles
what injury commonly causes common peroneal nerve palsy
injury to the neck of the fibula
What are some risk factors for carpal tunnel syndrome
obesity
pregnancy
hypothyroidism
how does carpal tunnel syndrome present?
pain and numbness in the lateral 3.5 fingers
wasting of the thenar eminence
symptoms are worse at night
what two tests can be done for carpal tunnel syndrome
phalens test
tinels test
what nerve is damaged in cubital tunnel syndrome
ulnar nerve
how does cubital tunnel syndrome (ulnar nerve palsy) present?
- claw hand
- numbness and tingling in the medial 1.5 fingers
- hand weakness due to wasting of the intrinsic hand muscles and hypothenar eminence
What is another name for radial nerve pasly
saturday night palsy
what can cause saturday night palsy (radial nerver damage)
compression to the axilla- crutches, sleeping with arm over chair
how does radial nerve palsy present?
wrist drop
loss of sensation in the dorsal aspect of the hand
what can cause axillary nerve mononeuropathy?
shoulder dislocation, proximal humerus fracture
how does axillary nerve injury present?
weakness in shoulder abduction
sensory loss over the deltoid area
how does tibial nerve palsy mononeuropathy present?
burning pain and numbness over the sole of the foot
what does damage to the long thoracic nerve cause?
scapula winging
What does damage to the lateral femoral cutaneous nerve cause and what can cause it
causes- obesity, tight clothing, pregnancy
presentation- numbness and tingling over the anterolateral thigh
How would a C5 radiculopathy present?
weakness in shoulder abduction
sensory loss over lateral arm (deltoid area)
loss of the brachial reflex
how would a C6 radiculopathy present?
weakness in elbow flexion and wrist extension
sensory loss over the lateral forearm, thumb and index finger
diminised brachioradialis reflex
how would C7 radiculopathy present?
weakness in elbow extension and wrist flexion
sensory loss over the middle finger
diminished triceps reflex
What nerve root supplies the nipple?
T4
what nerve root supplies the umbilicus
T10
How would a T1 radiculopathy present?
weakness in finger adduction and abduction
sensory loss over medial arm and elbow area
how would an L4 radiculopathy present?
weakness in knee extension
sensory loss over the anterior thigh and medial shin
diminished patellar reflex
how would an L5 radiculopathy present?
weak dorsiflexion (foot drop), toe extension and foot inversion
sensory loss over the lateral thigh, lateral calf and dorsum of the foot
how would an S1 radiculopathy present?
weakness in plantar flexion and toe flexion
sensory loss over posterior calf, lateral foot and sole of foot
loss of archilles tendon reflex
How does cauda equina present ?
lower back pain
bilateral radicular pain
saddle anaesthesia
bowel and bladder disturbance
causes of cauda equina
lumbar disc herniation
neoplasms
abscesses
iatrogenic
investigation of cauda equina
whole spine MRI
management of cauda equina
surgical decompression within 48 hours
dexamethasone can be given if suspected neoplasia
What spinal levels of disc herniation commonly cause cauda equina?
L4-L5 and L5-S1
first line management of lower back pain?
NSAIDS and PPI
