Peripheral N Injuries & ULTTs

Question 1

Radiculopathy vs Mononeuropathy: what structure is involved?

Answer 1

Radiculopathy: N root compressed.
Mononeuropathy: single nerve disrupted.

Question 2

Radiculopathy vs Mononeuropathy: common symptoms

Answer 2

Radiculopathy: follows dermatomes & myotomes.
Mononeuropathy: does NOT follow dermatomes & myotomes.

Question 3

Median N entrapment sites/syndromes

Answer 3

1. Ligament of Struthers (prox to elbow).
2. Pronator Syndrome (pronator teres).
3. AIN Syndrome (pronator teres).
4. Carpal Tunnel Syndrome (transverse carpal ligament).

Question 4

Ligament of Struthers compression: key sxs

Answer 4

-Pronator Teres mm affected.
-Motor + sensory loss.

Question 5

Pronator Syndrome: motor loss (list the muscles)

Answer 5

-FPL
-APB
-FDP
-Opponens Pollicis
-Pronator Quadratus
*Pronator Teres spared.

Question 6

Pronator Syndrome: P! reproduced with…

Answer 6

Resisted flex + pronation

Question 7

Pronator Syndrome: sensory loss

Answer 7

-Digits 1-3
-Thenar
-Fingertips

Question 8

AIN Syndrome: key sxs

Answer 8

-Pure motor.
-No sensory loss, but P! in forearm.

Question 9

AIN Syndrome: motor loss (list the muscles)

Answer 9

-FPL
-FDP
-Pronator Quadratus

Question 10

Kiloh-Nevin Sign

Answer 10

Unable to make OK sign.
Indicates AIN Syndrome.

Question 11

Carpal Tunnel Syndrome: motor loss (list the muscles)

Answer 11

-APB
-Opponens Pollicis
-FPB
*Thenar atrophy

Question 12

Carpal Tunnel Syndrome: P! reproduced with…

Answer 12

Prolonged wrist flexion

Question 13

Carpal Tunnel Syndrome: sensory loss

Answer 13

-Digits 1-3
*Thenar spared.

Question 14

Radial N entrapment sites/syndromes

Answer 14

1. Crutch Palsy (axilla injury).
2. High Radial N Injury (humerus fx).
3. Radial Tunnel Syndrome (PIN in radial tunnel).
4. PIN Syndrome (PIN compressed by supinator).
5. Wartenberg’s Syndrome (superficial branch by ECRL + brachialis)

Question 15

Crutch Palsy: motor loss

Answer 15

Weak:
-Elbow extension
-Wrist extension
-Digit extension
-Supination

Question 16

Crutch Palsy: sensory loss

Answer 16

-Posterior/lateral arm, forearm, & wrist.
-Posterior thumb.
-Radial 2.5 digits (index, middle, half of ring).

Question 17

High Radial N Injury: motor loss

Answer 17

-Wrist drop
-Weak thumb extension
*Triceps spared.

Question 18

High Radial N Injury: sensory loss

Answer 18

-Posterior/lateral forearm & wrist.
-Posterior thumb.
-Radial 2.5 digits (index, middle, half of ring).

Question 19

Radial Tunnel Syndrome: pain locations & key sxs

Answer 19

-No sensory loss.
-No motor loss (but may have weakness d/t pain-limited).
Pain:
-Radial tunnel (5cm distal to lateral epi).
-Radial aspect of proximal forearm.

Question 20

Radial Tunnel Syndrome: P! aggravated by…

Answer 20

-Resisted supination.
-Resisted finger extension.
-Positioning in elbow extension, pronation, wrist flexion.

Question 21

PIN Syndrome: key sxs

Answer 21

-Pure motor.
-P! in lateral elbow & forearm.
-Wrist extensor weakness.
-Dropped fingers & thumb.

Question 22

Wartenberg’s Syndrome: MOI

Answer 22

Tight watch, handcuffs

Question 23

Wartenberg’s Syndrome: key sxs & pain locations

Answer 23

-No motor loss.
-Pain/Sensory loss: dorsal hand, radial side.

Question 24

Wartenberg’s Syndrome: P! aggravated by…

Answer 24

Flexion + UD

Question 25

Ulnar N entrapment sites/syndromes

Answer 25

1. Cubital Tunnel Syndrome (FCU).
2. Guyon’s Canal (hook of hamate + transverse carpal ligament).

Question 26

Cubital Tunnel Syndrome: MOI

Answer 26

-Prolonged elbow flexion.
-Fractures, bone spurs, arthritis.

Question 27

Cubital Tunnel Syndrome: sensory loss

Answer 27

*Occurs early, before motor symptoms.
-Digits 4+5 (dorsal & palmar).
-Hypothenar.

Question 28

Cubital Tunnel Syndrome: motor loss

Answer 28

*Occurs later.
-FDP
-Hypothenar
-Ulnar interossei
-Adductor Pollicis

Question 29

Guyon’s Canal Syndrome: MOI

Answer 29

Heavy gripping

Question 30

Guyon’s Canal Syndrome: sensory loss

Answer 30

-Digits 4+5 (palmar only).
-Hypothenar.

Question 31

Guyon’s Canal Syndrome: motor loss

Answer 31

-Hypothenar
-Ulnar interossei
-Adductor Pollicis

Question 32

ULTT: what indicates positive?

Answer 32

Reproduction of sxs.
>10deg difference in ROM btwn affected vs unaffected sides.

Question 33

ULTT: how does cervical side bending affect symptoms?

Answer 33

Normal with nerve tension:
-SB toward = relief.
-SB away = worsens.
Impaired neurodynamics:
-Either direction may increase, decrease, or no change in symptoms.

Question 34

ULTT A: nerve & steps

Answer 34

Median.
1. Shoulder abducted 90.
2. Supinate.
3. Shoulder ER.
4. Elbow ext.
*Maintain wrist ext throughout.

Question 35

ULTT B: nerve & steps

Answer 35

Radial.
1. Elbow extended.
2. Pronate forearm & IR shoulder.
3. Flex wrist & fingers.
4. Abduct shoulder.

Question 36

ULTT C: nerve & steps

Answer 36

Ulnar.
1. Shoulder abducted 90.
2. Pronate forearm & ER shoulder.
3. Ext wrist & fingers.
4. Flex elbow.