Peripheral Nerve disorders

Question 1

What are common sites of injury to peripheral nerves

Answer 1

• nerve roots
• brachial plexus

Question 2

Peripheral nerves of Upper quarter screen and NR

Answer 2

• axillary nerve: C5-C6
• musculocutaneous nerve: C5-6
• median nerve C6-C8
• ulnar nerve: C8-T1
• radial nerve: C6-T1

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Question 3

Peripheral nerves lower quarter screen and NR

Answer 3

• femoral nerve L2-L4
• obturator nerve: L2-L4
• sciatic nerve: L4-S3
• Tibial/posterior tibial nerve: L4-S3
• Common peronal nerve: L4-S2

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Question 4

Upper quarter screen myotomes

Answer 4

• C1-C2: cervical flexion
• C3: cervical side flexion
• C4: scapular elevation
• C5: Shoulder abduction
• C6: elbow flexion and wrist extension
• C7: elbow extension and wrist flexion
• C8: thumb extension
• T1: finger abduction

Question 5

Lower quarter myotomes:

Answer 5

• L1-2: hip flexion
• L3: knee extension
• L4: ankle dorsiflexion
• L5: big toe extension
• S1: ankle eversion and plantar flexion, hip extension
• S2: knee flexion
• S3: no specific test; intrinsic foot muscles

Question 6

Morton Neuroma

Answer 6

• ball of nerves that forms a tumor
• typically between 3rd and 4th metatarsals
• burning, tingling in forefoot interspaces of toes while walking

Question 7

causes of mortons neuroma

Answer 7

• inadequate footwear
• excessive pronation
• arthritis

Question 8

Thoracic outlet syndrome types

Answer 8

• vascular TOS 5%
• neurogenic 95%

Question 9

TOS: etiology of symptoms

Answer 9

• compressive neuropathy
• faulty posutre most common
• entrapment of neural tissue from scar tissue or pressure

Question 10

Assessing Vascular TOS

Answer 10

• 3 minute elevated test
• adson test
• swelling
• discoloration of hand
• costclavicular test
• hyperabduction test
• UE claudication
• differences in BP
• skin temperature changes
• cold intolerance

Question 11

Neural TOS assessment

Answer 11

• point tenderness of C5-C6
• pressure over lateral neck elicits pain and or numbness
• pain with head turned and or tilted to opposite side
• weak biceps
• weak triceps
• weak wrist
• hypoesthesia in radial nerve distribution
• 3 minute abduction stress test

Question 12

what are comme compression/entrapment sites in TOS

Answer 12

• interscalene triangle
• costoclavicular space
• rectropectoralis minor space

Question 13

Ulnar nerve compression in tunnel of guyon

Answer 13

• claw hand
• atrophy between metacarpals
• atrophy with hypothenars
• loss of digits 4 and 5 for spherical and cylindrical power grips

Question 14

Carpal tunnel syndrome

Answer 14

• median nerve
• hand involvement without the palm
• phalens and reverse phalens

Question 15

radial nerve compression: radial groove

Answer 15

• fracture or compression. (saturday night palsy)
• triceps spared
• weakness: wrist extension
• sensory loss: dorsum of hand dorsum of fingers 1-4

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Question 16

Radial nerve: supinator syndrome

Answer 16

• posterior interosseus nerve
• weakness: finger extesnors
• spared: brachioradialis, wrist extensor
• sensation

Question 17

SI joint pain

Answer 17

• PSIS
• lower lumbar spine (L5 - 72%)
• buttocks (94%)
• posterior lateral thigh (50%)
• knee to the ankle (14%)
• lateral foot (8%)
• abdominal (2%)
• groin or pubic (14%)
• anteiror thigh (10%)