Neural Tissue Injury

Question 1

Treatment plan for peripheral nerve injury

Answer 1

1. treat the interface
   
   • unload the nerve
   • progress by adding tension to the nerve
2. slide the nerve within its interface
3. place (increasing) tension on the nerve
4. address psychosocial aspects: minimise stress/anxiety; maximise things that relax/enjoy
5. strengthen the upper limb

Question 2

Primary mechanical functions of the nervous system

Answer 2

1. tension
2. sliding
3. compression

Question 3

Pathogenesis/pathophysiology of nerve pathology

Answer 3

caused by mechanical irritation or excessive pressure

1. mechanical irritation (e.g. musc tear) -> bleeding and swelling -> inflammation -> nociception triggered -> mechanosensitivity pain
2. excessive pressure -> reduced venous return -> pressure increase -> hypoxia -> nociceptors triggered -> mechanosensitivity pain

Question 4

C4 motor function

Answer 4

scapula elevation (upper trapezius)

Question 5

C5 motor function

Answer 5

GH abduction (deltoid)

Question 6

C6 motor function

Answer 6

elbow flexion (Biceps)

Question 7

C7 motor function

Answer 7

elbow extension (triceps)

Question 8

C8 motor function

Answer 8

thumb extension or finger flexion

Question 9

T1 motor function

Answer 9

DIP flexion; finger abduction and adduction

Question 10

median nerve motor function test

Answer 10

pinch grip test

Question 11

ulnar nerve motor function test

Answer 11

Wartenberg’s sign (5th digit adduction)

Question 12

radial nerve motor function test

Answer 12

wrist extension

Question 13

median nerve supplies which areas

Answer 13

anterior compartment of the forearm

lateral palmar hand and fingers

Question 14

palpation points of the median nerve

Answer 14

1. mid-portion of the medial upper arm
2. at the elbow between biceps tendon and brachial artery
3. at the wrist with the carpal tunnel compression

Question 15

Where can entrapment of the posterior interosseous nerve occur?

Answer 15

1. fibrous bands in front of the radial head
2. recurrent radial vessels
3. arcade of Frohse
4. tendinous margin of the ECRB muscle

Question 16

palpation points of the radial nerve

Answer 16

1. axilla
2. humerus
3. supinator
4. radius
5. ASB

Question 17

ulnar nerve distribution

Answer 17

FCU and 1/2 of FDP

medial hand and finger muscles

Question 18

Pathology types (name) of the ulnar nerve

Answer 18

1. cubital tunnel syndrome
2. ulnar canal syndrome
3. handlebar palsy

Question 19

palpation points of the ulnar nerve

Answer 19

1. humerus: medial arm, posterior to the median nerve
2. cubital tunnel
3. proximal medial forearm
4. medial anterior wrist
5. Guyon’s canal: between pisiform and hook of hamate