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OPP II Exam 1 > Neurovascular Entrapment Syndromes > Flashcards

Neurovascular Entrapment Syndromes Flashcards

1
Q

brachial plexus structure

A 
5 ventral rami - C5-T1
3 trunks
6 divisions (3 ant, 3 post)
3 cords
5 peripheral nerves
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2
Q

digits 4 and 5 innervation

A

ulnar nerve

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3
Q

digits 1 to 3 palm

A

median nerve

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4
Q

digits 1 to 3 back of hand

A

radial nerve

-also back of arm to above elvow

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5
Q

axillary nerve

A

side of shoulder

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6
Q

sympathetics to upper extremity

A

T2-6

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7
Q

major joints

A

start proximal, move distal

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8
Q

bounds of thoracic outlet

A

spinal column
first ribs
sternum
clavicle

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9
Q

structures in thoracic outlet

A

brachial plexus
subclavian artery
subclavian vein

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10
Q

causes of thoracic outlet syndrome

A 
scalene tension
cervical rib
SD
pec minor
tumor
whiplash
fractured clavicle
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11
Q

compression locations for TOS

A

scalenes - anterior and middle
pec minor - rib and pec minor
costoclavicular articulation - clavicle and first rib

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12
Q

Sx of TOS

A

neurologic and vascular

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13
Q

brachial plexus compression

A

numbness
parasthesias
muscle weakness

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14
Q

subclavian artery compression

A

distal thromboembolism
arm pain with exertion - claudication
acute arterial thrombosis

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15
Q

subclavian vein compression

A

DVT

extremity swelling

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16
Q

claudication

A

pain with exertion

17
Q

adsons test

A

arm extended, abducted, ext rotated

-feel pulse

18
Q

roos test

A

arms up, open/close hands

19
Q

spurlings maneuver

A

cervical compression test

20
Q

hyperabduction test

A

abduct, extend arm

  • deep breath
  • feel pulse
21
Q

Tx for TOS

A 
PT
NSAIDs
steroids
muscle block
surgical decompression
22
Q

OMT for TOS

A

SD of ribs, clavicle, sibsons fascia, C-spine, T-spine, etc.

23
Q

ulnar nerve entrapment

A

compression of ulnar nerve (C7,8 T1)

24
Q

areas of compression with UNE

A

epicondylar groove
cubital tunnel
guyons canal

25
Q

tardy ulnar palsy

A

entrapment in epicondylar groove

aching pain medial elbow, migrates distal
numb 4/5 digits
produced with elbow flexion
motor symptoms less common
-possible claw hand, loss of dexterity
26
Q

cubital tunnel syndrome

A

compression of ulnar nerve between 2 heads of flexor carpi ulnaris

  • hypertonicity of muscles
  • numb 4/5 digits
  • produced with elbow flexion
  • motor symptoms less comon

Sx same as tardy ulnar palsy
-difference is where impingement is

27
Q

guyons canal neuropathy

A

damage to ulnar nerve between pisohamate ligament anteriorly and flexor retinaculum posteriorly

hand weakness, atrophy intrinsic hand muscles

  • loss dexterity
  • variable sensory loss
  • clawing of digits 4/5
28
Q

tests for ulnar nerve entrapment

A 
tinels - tap on elbow and wrist
elbow flexion - max for 1 minute
pressure test - through all 3
flexion and pressure (combo)
palpation for local nerve tenderness and thickening
29
Q

Tx for ulnar nerve entrapment

A 
OMT
don't lean on elbows
limit flexion at night
NSAIDs
PT
steroid injection
medial epicondylectomy
cubital tunnel release surgery
ulnar nerve transposition surgery
30
Q

carpal tunnel syndrome

A

THE most common mononeuropathy

compression of median nerve

31
Q

median nerve

A

C6-8 T1

32
Q

carpal tunnel

A

transverse carpal ligament
carpal bones
median nerve and flexor tendons

33
Q

Sx of carpal tunnel

A

pain, paresthsia, numbness in 1st three digits

  • weak grip strength
  • hand pain at night
  • thenar atrophy and sensory loss
34
Q

aromatase inhibitor use

A

risk factor for carpal tunnel

35
Q

carpal tunnel syndrome tests

A

tinels**
phalens (reverse prayer)** correlates with severty
prayer sign
carpal compression

36
Q

confirmation of carpal tunnel

A

EMG

37
Q

Tx for carpal tunnel

A 
cock up splint
NSAIDs
steroid
yoga/stretch
PT
nerve/tendon gliding exercise
ultra sound therapy
ergonomic key board
surgical decompression
38
Q

double crush syndrome

A

compression at one point not significant to cause Sx

  • multiple compression sites have cumulative effect leading to impaired neuronal signaling
  • when in doubt, check entire length of nerve and its nerve roots

OPP II Exam 1 (7 decks)

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