Peripheral nerve compression and entrapment neuropathies Flashcards
5 diseases associated with carpel tunnel syndrome
Hypothyrodisim DM Pregnancy Rheumatoid arthritis Acromegaly
What is the main muscle to test in suspected carpal tunnel?
Abductor pollicis brevis
Which intrinsic muscles are supplied by the median nerve?
1st lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
Where is the ulnar nerve usually compressed?
In the olecranon groove
Muscles supplied by the ulnar nerve
Flexor carpi ulnaris
FDP to ring and little finger
All the small muscles of the hand excluding LOAF
What muscles does the radial nerve supply?
Triceps Brachioradialis Supinator Wrist & finger extensors Abductor pollicis longus
Where does compression of the radial nerve usually take place?
Against the humerus
How does a radial nerve compression present?
Wrist drop, loss of finger extension and loss of sensation over the anatomical snuff box
Superficial branch of the peroneal nerve motor supply to -
ankle evertors
Superficial branch of the peroneal nerve sensory supply to -
skin on the lateral side of the lower leg
Deep branch of the peroneal nerve motor supply to -
Toe and ankle dorsiflexors
Deep branch of the peroneal nerve sensory supply to -
1st webspace of the foot
L3 nerve root compression
Sensory loss over ant thigh
Weak quads
Reduced knee reflex
+ve femoral stretch
L4 nerve root compression
Sensory loss over ant knee
Weak quads
Reduced knee reflex
+ve femoral stretch
L5 nerve root compression
sensory loss on dorsum of foot
weakness in foot and big toe dorsiflex
reflexes INTACT
positive sciatic stretch test
S1 nerve root compression
Sensory loss over posterolateral aspect of foot
Weakness of plantar flex
reduced ankle reflex
+ve sciatic stretch test
Femoral nerve lesion presentation
Weak knee extension
loss of patella reflex
numbness over ant thigh and medial thigh and lower leg
Sciatic nerve lesion
weakness in knee flexion and foot movements
pain and numbness from gluts to ankle
Obturator nerve lesion
numb over medial thigh
weak hip adduction
How is femoral nerve injured
hip and pelvic fractures
how is obturator nerve injure
ant hip dislocation
how is lat cut nerve of the thigh injured
compression of nerve near ASIS
tibial nerve injury usually due to ?
rare - popliteal lacerations
+ve trendelenburg sign often due to lesion of which nerve
superior gluteal nerve
radiculopathy =
conduction block in the axons of a spinal nerve or its roots
Causes of spinal nerve compression
Disc prolapse Degenerative disease of the spine Trauma Malingancy Infection - osteomyelitis
Red flags for CES
Urinary incontinence / retention
Bowel incontinence
Saddle anaesthesia
Red flags for infection causing radiculopathy
Immunosuppression
IVDU
fever (unexplained)
Red flags for fracture causing radiculopathy
Steroid use
Trauma
Osteoporosis
Red flag for malignancy causing radiculopathy
past hx of malignancy
> 50
First line pain relief in radiculopathy
2nd line
Amytriptyline
Gabapentin
Treatment for muscle spasms in radiculopathy
benzodiazepines e.g. diazepam
Gold standard test for cervical myelopathy
Cervical MR
