Nerve palsies

Question 1

Presentation of common peroneal nerve palsy

Answer 1

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

Question 2

what injury commonly causes common peroneal nerve palsy

Answer 2

injury to the neck of the fibula

Question 3

What are some risk factors for carpal tunnel syndrome

Answer 3

obesity
pregnancy
hypothyroidism

Question 4

how does carpal tunnel syndrome present?

Answer 4

pain and numbness in the lateral 3.5 fingers
wasting of the thenar eminence
symptoms are worse at night

Question 5

what two tests can be done for carpal tunnel syndrome

Answer 5

phalens test
tinels test

Question 6

what nerve is damaged in cubital tunnel syndrome

Answer 6

ulnar nerve

Question 7

how does cubital tunnel syndrome (ulnar nerve palsy) present?

Answer 7

• claw hand
• numbness and tingling in the medial 1.5 fingers
• hand weakness due to wasting of the intrinsic hand muscles and hypothenar eminence

Question 8

What is another name for radial nerve pasly

Answer 8

saturday night palsy

Question 9

what can cause saturday night palsy (radial nerver damage)

Answer 9

compression to the axilla- crutches, sleeping with arm over chair

Question 10

how does radial nerve palsy present?

Answer 10

wrist drop
loss of sensation in the dorsal aspect of the hand

Question 11

what can cause axillary nerve mononeuropathy?

Answer 11

shoulder dislocation, proximal humerus fracture

Question 12

how does axillary nerve injury present?

Answer 12

weakness in shoulder abduction
sensory loss over the deltoid area

Question 13

how does tibial nerve palsy mononeuropathy present?

Answer 13

burning pain and numbness over the sole of the foot

Question 14

what does damage to the long thoracic nerve cause?

Answer 14

scapula winging

Question 15

What does damage to the lateral femoral cutaneous nerve cause and what can cause it

Answer 15

causes- obesity, tight clothing, pregnancy
presentation- numbness and tingling over the anterolateral thigh

Question 16

How would a C5 radiculopathy present?

Answer 16

weakness in shoulder abduction
sensory loss over lateral arm (deltoid area)
loss of the brachial reflex

Question 17

how would a C6 radiculopathy present?

Answer 17

weakness in elbow flexion and wrist extension
sensory loss over the lateral forearm, thumb and index finger
diminised brachioradialis reflex

Question 18

how would C7 radiculopathy present?

Answer 18

weakness in elbow extension and wrist flexion
sensory loss over the middle finger
diminished triceps reflex

Question 19

What nerve root supplies the nipple?

Answer 19

T4

Question 20

what nerve root supplies the umbilicus

Answer 20

T10

Question 21

How would a T1 radiculopathy present?

Answer 21

weakness in finger adduction and abduction
sensory loss over medial arm and elbow area

Question 22

how would an L4 radiculopathy present?

Answer 22

weakness in knee extension
sensory loss over the anterior thigh and medial shin
diminished patellar reflex

Question 23

how would an L5 radiculopathy present?

Answer 23

weak dorsiflexion (foot drop), toe extension and foot inversion
sensory loss over the lateral thigh, lateral calf and dorsum of the foot

Question 24

how would an S1 radiculopathy present?

Answer 24

weakness in plantar flexion and toe flexion
sensory loss over posterior calf, lateral foot and sole of foot
loss of archilles tendon reflex

Question 25

How does cauda equina present ?

Answer 25

lower back pain
bilateral radicular pain
saddle anaesthesia
bowel and bladder disturbance

Question 26

causes of cauda equina

Answer 26

lumbar disc herniation
neoplasms
abscesses
iatrogenic

Question 27

investigation of cauda equina

Answer 27

whole spine MRI

Question 28

management of cauda equina

Answer 28

surgical decompression within 48 hours
dexamethasone can be given if suspected neoplasia

Question 29

What spinal levels of disc herniation commonly cause cauda equina?

Answer 29

L4-L5 and L5-S1

Question 30

first line management of lower back pain?

Answer 30

NSAIDS and PPI