Peripheral N injuries Flashcards
Deep fibular Nueropathy
Signs and sxs:
- motor: weak EHL, tib ant, EDL
- present with drop foot
- sensory: dorsal web space btw first and second toes
Ulnar N
nerve roots and cord comes off of
C8-T1, medial cord
cubital tunnel syndrome
Nerve: Ulnar N
Site of compression: Cubital tunnel - between both heads of FCU
MOI: prolonged elbow flexion, fractures, spurs, arthritis
Signs and sxs:
- sensory ( first): sensory and pain of palmar and dorsal innervation of ulnar N - 4th/5th digits and hypothenar
- motor (later): weak hypothenars, FDP 3,4, addP, interossei
Special tests: +Froment’s, +Tinels, +elbow flexion test, +Wartenburgs sign
femoral neuropathy
Site of compression: Inguinal ligament, iliopsoas tendon
Signs/sxs
-motor: weak quads, psoas, iliacus, pectineus, sartorius
- sensory: anteromedial thigh
radiculopathy
- usually follows dermatomal pattern, sensory sxs are most reliable
- compression at N root
- motor, sensory, pain, altered reflexes
- possiblle neck pain with arm pain: arm pain>neck pain
Compression under Ligament of Struthers
- median N
- ligament of struthers: proximal to elbow (distal humerus)
- motor and sensory loss in whole distribution
- pronator teres IS AFFECTED
mononeuropathy
- disturbance of single nerve ex radial N
- doesntly follow derm pattern
- usually combo of motor, sensory, and reflex deficits
Tibial N neuropathy:
Site of compression: popliteal region
Signs and sxs:
-motor: weak PFs, weak inversion
- medial longitudinal arch cant be maintained- flat feet
- sensory: heel, plantar surface of foot (besides medial border), plantar surface of toes
- DTR affected: achilles
Common peroneal N neuropathy
Signs and sxs: see sxs of deep and superficial peroneal N neuropathies
High radial N injury
MOI: humerus spinal groove fx, fx of humerus shaft
Site of compression: mid- arm
Nerve: radial
Signs and sxs:
- motor: weak anconeus, wrist extensors (wrist drop), thumb extensor weakness, (triceps are spared)
- sensory: post forearm, post thumb, 2.5 digits
Wartenberg’s syndrome
Nerve: superficial sensory branch of Radial Nerve
Site of compression: chieralgia paresthetica - compression of superficial sensory branch under brachialis and ECRL tendons
MOI: trauma, handcuffs, right watch
Signs/ SXS:
-sensory only - lose sensory distribution and pain of dorsal 3.5 digits
- pain with wrist flexion and ulnar deviation
Special test: +Tinels at wrist
5 P’s of compartment syndrome
pain, pallor, paresthesia, pulselessness, paralysis
saphenous neuropathy
Site of compression: btw vastus medialis and adductor magnus
Signs and sxs:
- sensory only: from medial knee, medial leg, to medial malleolus
- pain with resisted knee flexion or resisted hip adduction
Radial N
N roots and where comes off brachial plexus
C5-T1
posterior cord
Guyon’s canal syndrome
nerve: Ulnar N
Site of compression: Guyon’s canal between hook of hamate and transverse carpal ligament
MOI: heavy gripping, twisting, activities involving pressure
Signs and SXS:
- decreased sensory of PALMAR Ulnar N distribution only, with pain
- weak interossei, weak AddP, weak hypothenars
Special tests:
+Froment’s, +Wartenburg sign, +Tinels sign at wrist