Nerve Problems: Median, Ulnar, Radial, Axillary, Common Peroneal, Radiculopathies

Question 1

Common peroneal nerve
-presentation and why
How would this differ from a sciatic nerve lesion

Answer 1

Fibula neck => foot drop

• weak foot dorsiflex, eversion
• sensory loss of dorsum, lower lateral leg

Sciatic => common peroneal signs +

• weak knee flexion
• sensory loss below knee
• KNEE JERK PRESENT

Question 2

Median nerve patterns of damage

• wrist, pathology, diagnosis and management
• elbow
• AIN

Answer 2

Wrist - carpal tunnel

• motor LOAF weakness
• lateral 2.5 finger sensory loss
• Tinel’s, Phalen’s test => wrist splinting, SC CS, surgical decompression

Elbow

• ulnar deviation
• weak wrist flexion, pronation

AIN - branches off below elbow
-no thumb, index flexion, not ok

Question 3

Ulnar nerve patterns of damage

• distal and proximal lesions
• pathology, diagnosis, management

Answer 3

Claw hand

• wasting, paralysis of hypothenar, lat lumbricals
• medial 1.5 finger sensory loss

Claw hand more severe in distal ulnar lesions than proximal ulnar lesions
-innervation of FDP

Cubital tunnel

• Tinel
• Avoid compressing tunnel, splinting, NSAIDs/CS, surgery

Question 4

Radial nerve patterns of damage

-causes

Answer 4

Wrist drop

• Sunday night, Honeymoon, Crutch palsy, humeral shaft #
• sensory loss of dorsal lateral
• tricep paralysis

Question 5

Axillary nerve pattern of damage

-causes

Answer 5

Shoulder dislocation, clavicle fracture, humeral neck fracture

• sensory loss of regimental badge
• weak shoulder abduction

Question 6

Radiculopathy

• presentation
• diagnosis
• management

Answer 6

Symptoms caused by compression of nerve at spine root
-disc degeneration
-spinal cord mets
Presentation
-sharp pain, numbness, weakness in spinal root affected

Lumbar (sciatica) - lower limbs
-Straight leg raise - recreate leg pain
Cervical - upper limbs
-Spurling test - neck mv to recreate pain

Pain relief
Gentle mv