Peripheral Nerve entrapment and condition Flashcards
Median N
Carpal tunnel and pronator teres syndrome
Carpal tunnel syndrome site
Under flexor retinaculum
Cause of carpal tunnel syndrome
Obesity
Fluid retention due to pregnancy
Hypothyroidism
RA
Presents with numbness and tingling of the first 3 digits, thenar atrophy, nocturnal pain, weak opponent pollicis (ape hand appearance)
Carpal tunnel
Carpal tunnel tests
Tinnels
Phalens
Grip strength with dynamometer
Carpal tunnel treatment
Adjust
Cock up splint
Natural diuretic vitamin B6
Pronator teres syndrome site
Between head of pronator trees at the elbow
Pronator teres nerve
Anterior interosseous nerve
Presents with pain & paresthesia on the VOLAR (palm) aspect of forearm, lateral palm, lateral digits
Pronator teres syndrome
Caused by hypertonicity of the muscle by things such as occupation (carpenters and mechanics)
Pronator teres syndrome
Pain with pronation, wrist flexion, thenar atrophy
Pronator teres syndrome
Test for pronator teres syndrome
Pinch grip test
Treatment for pronator trees syndrome
Trigger point therapy, stretch
Ulnar nerve entrapment site
Tunnel of Guyon (under hook of hamate) Cubital tunnel (elbow)
Caused by direct trauma or repetitive micro trauma. Presents with pain, tingling, and numbness in the last 2 digits and weakness of adductor pollicis (Claw hand deformity), Hypothenar atrophy
Ulnar N entrapment
Claw hand deformity; weakness of adductor pollicis
Ulnar N
Klumpke’s paralysis (Lower brachial plexus)
Ape hand deformity; weak opponen pollicis
Median N (carpal tunnel syndrome)
Cubital tunnel entrapment will present with weak wrist flexion on the ulnar side
Ulnar N entrapment
Lower Brachial Plexus entrapment c8-t1
Klumpke’s paralysis
Palsy of the lower brachial plexus from childbirth
Creates a claw hand deformity with flexion of the wrist
Klumpke’s paralysis
Wrist drop
Erbs Palsy (waiters tip deformity)
Saturday night palsy
Crutch paralysis
Radial N entrapment
Unable to extend elbow and wrist
Wrist drop
Adduction, internal rotation, flexion of the wrist
Erb’s palsy
Waiters tip deformity
Presents with loss of triceps reflex. Caused by trauma, lead poisoning, pressure from crutches
Radial N entrapment
Decreased sensation in posterior arm, forearm, and posterolateral 3.5 fingers
Radial N entrapment
LTN entrapment
Scapular (medial) winging
The result of numerous causes including trauma, iatrogenic, and idiopathic processes that most often result in nerve injury and paralysis of serratus anterior
LTN entrapment
DSN entrapment
Flaring of the scapula
Lateral Femoral Cutaneous N entrapment
MEralgia paresthetic
Meralgia paresthetica location/ site
over the pelvic brim under the inguinal ligament
Meralgia Paresthetic Nerve Roots
L2 and L3 Nerve Roots
Caused by external pressure, obesity, and tight jeans. Presents with burning synesthesia on anterolateral thigh.
Meralgia Paresthetica
Meralgia Paresthetica treatment
Advice weight loss and loose clothing
Sciatica site
Pelvis, hip, popliteal fossa
Caused by trauma, traction, wallet pressure, piriformis and muscle spasm.
Sciatica
Patient presents with sensory pain in posterior buttock, thigh, leg down to the floor. Weak knee flexion and decreased achilles reflex
Sciatica
Differential diagnosis with facet
Sciatica
Tibial N entrapment
Tarsal Tunnel Syndrom (Medial plantar N)
Presents with burning paresthesia, decreased sensation on soles of feet and weak muscles of the foot, aggravated by walking or standing
Tarsal tunnel syndrome
Tarsal tunnel syndrome treatment
Adjust
Orthotic support to keep foot in slight inversion
Morton’s neuroma (inter metatarsal neuroma) Site
Between 3rd and 4th metatarsal
Presents with pain in toes and dorsum of the foot
Morton’s neuroma
Test for Morton’s neuroma
Morton’s squeeze
Treatment for Morton’s neuroma
Surgery may be needed
Common Peroneal N entrapment site
Fibular head
Presents with pain in the lateral aspect of the leg, weak peroneal muscle, FOOT DROP. Caused by trauma
Common peroneal N entrapment
Common Peroneal N entrapment (foot drop) patient management
Adjust
Refer if fracture is present
Deep Peroneal N entrapment
Anterior Compartment Syndrome
Can affect any and all four muscles of that compartment; tibialis anterior, extensor hallucinating longus, extensor digitorum longus, peroneus tertius.
Ant. Compartment SYndrome
Symptoms of ant. Compartment syndrome is similar to
Charcot Marie Tooth
A deformity in which the fingertip is curled in and cannot straighten itself. This deformity results from injury, which either damages the tendon or tears the tendon from the bone
Mallet finger
Hyperflexion of DIP and Hyper-extension of PIP
Swan neck deformity
Swan neck deformity is associated with which condition
RA
Hyper-extension of DIP and hyper flexion of PIP
Boutonnierres Deformity
Boutonierres associated with which condition
OA
An abnormal thickening underneath the skin of the palm and fingers. Causes the last 2 digits to cure into the palm. Later on the middle finger may be involved
Dupuytren’s contracture
A finger becomes locked in a flexed position. The finger locks when one of the tendons that flex the finger becomes inflammed and swollen. To straighten the finger, a person must force the swollen area into the sheath producing a popping or snapping
Trigger Finger
Inflammation of the extensor pollicis braves and the abductor pollicis longus tendons on the side of the wrist at the base of the thumb. Can be brought on by simple strain injury
De Quervain tenosynovitis
Dequevain test and treatment
Finkelstein’s test
Treated by bracing the thumb and wrist
