Neurology- Peripheral Nerves

Question 1

Median nerve- carpal tunnel

Answer 1

• the median nerve may be compressed as it passes between the flexor retinaculum and the carpal bones at the wrist (carpal tunnel syndrome). This is the most common entrapment neuropathy and initially produces sensory symptoms and pain in the hand

Question 2

Median nerve examination

Answer 2

• Look for wasting of the thenar eminence
• test thumb abduction with the palm flat on surface
• ask patient to put ring finger and thumb together and try and pull them apart
• test sensation over the hand (thumb to lateral half of ring finger, splitting the ring finger
• Tinals sign is elicited by tapping the distal wrist crease with a tendon hammer which may produce paraesthesia
• Phalen’s test is forced flexion of the wrist for up to 60 seconds to induce Sx

Question 3

Common features of carpal tunnel

Answer 3

Question 4

Radial nerve

Answer 4

• may be compressed as it runs through the axilla in the spinal groove of the humerus (Saturday night palsy) or may be injured during #
• Typically causes wrist drop

Question 5

Radial nerve exam

Answer 5

• test for weakness of the brachialradialis and triceps
• ## there will be weakness of wrist and finger extension

Question 6

Ulnar never

Answer 6

• the ulnar nerve is most often affected at the elbow by external compression as the nerve is superficial in some individuals and vulnerable to pressure by injury
• compression usually occurs as the nerve passes through the condylar groove behind the medial epicondyle of the humerus or pass it passes through the cubital tunnel

Question 7

Ulnar nerve exam

Answer 7

• examine the medial elbow, palpating the nerve in the ulnar groove (most common place of entrapment) note signs of trauma
• look for wasting
• test for grip by placing card between their fingers and trying to pull it out
• asses for sensory loss on the ulnar side of the hand splitting the ring finger