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MSK 4 > Peripheral Nerve Injuries Of UE (2) > Flashcards

Peripheral Nerve Injuries Of UE (2) Flashcards

1
Q

What is mononeuropathy?

A

Damage to selected peripheral nerves like the median nerve (traumatic or non traumatic)

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2
Q

What is polyneuropathy?

A

Metabolic (diabetes or alcoholic)

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3
Q

What is Grade 1 neuropraxia?

A

Focal segmental demyelination (full recovery)

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4
Q

What is grade 2 axonotmesis?

A

Axon damaged with intact Endoneurium (full recovery)

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5
Q

What is grade 3 axonotmesis?

A

Axon and Endoneurium damaged with intact Perineurium (partial recovery)

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6
Q

What is grade 4 axonotmesis?

A

Axon, Endoneurium, and Perineurium damaged with intact Epineurium (no recovery, requires surgery)

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7
Q

What is grade 5 neurotmesis?

A

Complete nerve transection (no recovery, requires surgery)

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8
Q

What is a grade 6 injury?

A

Mixed nerve injury

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9
Q

How can PNI be diagnosed?

A

Using electromyography combined with nerve conduction study

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10
Q

What are some involuntary activation that occurs with PNIs?

A

Fibrillation potential and fasciculations

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11
Q

What pain occurs with PNIs?

A

Burning

Primarily distal

Projected or referred

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12
Q

Where can the median nerve be damaged?

A

Carpal tunnel (most common)

Pronator teres

Anterior interosseus

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13
Q

What are the motor loss involved with pronator teres syndrome?

A

Flexor pollicis longus

Flexor digitorum profundus (1 and 2)

Pronator quadratus

Opponens pollicis

Flexor pollicis brevis

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14
Q

What is the sensory loss involved in the pronator teres syndrome?

A

Thenar eminence and digits 1-3 (possibly 4 too)

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15
Q

What are the special tests of pronator teres syndrome?

A

+ pronator teres syndrome test

+ tinels in forearm

  • phalens
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16
Q

What is the sensory loss in anterior interosseus syndrome?

A

No sensory loss but have aching

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17
Q

What is the motor loss in anterior interosseus syndrome?

A

Flexor pollicis longus

Flexor digitorum profundus (1 and 2)

Pronator quadratus

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18
Q

What are the sensory loss of carpal tunnel syndrome?

A

Median nerve distribution except for the thenar eminence

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19
Q

What is the motor loss of carpal tunnel syndrome?

A

Atrophy of thenar muscles

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20
Q

When do patients with carpal tunnel syndrome complain of paresthesia?

A

At night or with increased use of

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21
Q

What are the special tests for carpal tunnel syndrome?

A

Pain radiating distal to proximal

Report dropping objects

+ tinels at wrist

+ phalens and reverse phalens

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22
Q

What are the provocative tests of carpal tunnel syndrome?

A

Phalens

Tinels

CCT

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23
Q

What is the clinical prediction rule of carpal tunnel syndrome?

A

Hand shaking improves symptoms

Wrist-ratio index > .67

Symptom severity score > 1.9

Diminished sensation in median sensory field 1

Age > 45

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24
Q

Where can the ulnar nerve be damaged?

A

Cubital tunnel (elbow)

Guyons canal (wrist)

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25
Q

What is the second most common peripheral nerve injury?

A

Cubital tunnel syndrome

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26
Q

What are the sensory losses of cubital tunnel syndrome?

A

Sensory deficits at the 5th digit and ulnar 1/2 of 4th digit

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27
Q

What are the motor losses of cubital tunnel syndrome?

A

Atrophy of ulnar intrinsics

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28
Q

What are special tests for cubital tunnel syndrome?

A

+ elbow flexion test

+ tinels at cubital tunnel

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29
Q

What are sensory losses of Guyans canal syndrome?

A

Limited to palm

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30
Q

If there is Guyons canal at zone 1 what do you lose?

A

Motor and sensory

31
Q

If there is Guyons canal at zone 2 what do you lose?

A

Motor only

32
Q

If there is Guyons canal at zone 3 what do you lose?

A

Sensory only

33
Q

What are special tests for Guyons canal syndrome?

A

+ phalens and reverse phalens

+ tinels at Guyons canal

+ froments sign

+ wartenbergs sign

34
Q

Where are the locations where the radial nerve is damaged?

A

Upper arm lesion

Posterior interosseus

Radial tunnel

Wartenbergs syndrome

35
Q

What is an upper arm lesion caused by?

A

Fractures or prolonged compression (crutch or Saturday night palsy)

36
Q

Where is sensory loss in an upper arm lesion if the lesion is at the spiral groove?

A

Dorsum of hand and 1st two digits (most common)

37
Q

Where is motor loss in an upper arm lesion if the lesion is at the spiral groove?

A

Weakness distal to tricep (wrist drop)

38
Q

Where is sensory loss in an upper arm lesion if the lesion is proximal to the spiral groove?

A

Posterior arm, posterior 1/3 forearm, Dorsum of hand, and web space

39
Q

Where is motor loss in an upper arm lesion if the lesion is proximal to the spiral groove?

A

Triceps

40
Q

What causes posterior interosseus syndrome?

A

Fracture or RA

41
Q

Where does posterior interosseus syndrome occur?

A

Arcade of froshe

42
Q

What are the sensory losses in posterior interosseus syndrome?

A

None

43
Q

What are the motor losses in posterior interosseus syndrome?

A

Supinator

Wrist extensors

44
Q

How does the wrist present in posterior interosseus syndrome?

A

Radial deviation with wrist extension

45
Q

What is present in radial tunnel syndrome?

A

Lateral elbow pain below epicondyle (no sensory or motor losses)

46
Q

Where does wartenbergs syndrome most commonly occur?

A

Where the nerve exits the Musculotendinous junction of the brachioradialis and ECR

47
Q

What is the sensory loss of wartenbergs syndrome?

A

Dorsal radial wrist and hand (worse with pronation, wrist/finger flexion, and ulnar deviation)

48
Q

What is motor loss to wartenbergs syndrome?

A

None

49
Q

What nerve is damaged if there is an ape hand presentation?

A

Median

50
Q

What nerve is damaged if there is a bishops (Benedict) hand?

A

Ulnar

51
Q

What nerve is damaged if there is a claw or intrinsic minus hand?

A

Combined median and ulnar

52
Q

What nerve is damaged if there is a wrist drop?

A

Radial

53
Q

Where does thoracic outlet syndrome occur?

A

Between scalenes (no venous)

1st rib and clavicle

Pec minor

54
Q

What is interventions for thoracic outlet syndrome?

A

Posture education

Stretching/strengthening to improve posture

55
Q

How does an axillary nerve injury occur?

A

Dislocation

56
Q

What are the sensory losses to axillary nerve injury?

A

Lateral deltoid (axillary patch)

57
Q

What are the motor losses to axillary nerve injury?

A

Teres minor and deltoid

58
Q

What causes a suprascapular nerve injury?

A

Direct blow or cyst

59
Q

What is a suprascapular nerve injury often mistaken for?

A

RC tear

60
Q

What are the sensory losses of a suprascapular nerve injury?

A

None

61
Q

What are the motor losses of a suprascapular nerve injury?

A

RC weakness (atrophy of Supra and Infraspinatus)

62
Q

What is a sign that someone has a suprascapular nerve injury?

A

Deep burning worse with horizontal adduction

63
Q

How can you get a long thoracic nerve injury?

A

Idiopathic or fall on your side

64
Q

What is presentation of someone with a long thoracic nerve injury?

A

Winging and aching

65
Q

What are the nerve injuries that are considered birth injuries?

A

Brachial plexus birth palsy

Klumpke

66
Q

What is affected in brachial plexus birth palsy?

A

C5-C6 roots

67
Q

What is affected in a kempke?

A

C7, C8, and T1

68
Q

What is the shoulder presentation in erbs palsy (C5-6)?

A

Extended, IR, and slightly abducted

69
Q

What may denervated muscles require?

A

Support like splinting or AAROM

70
Q

What has been shown to not be beneficial in nerve injury rehab?

A

Electrical stimulation

71
Q

What should be controlled early in nerve injuries?

A

Inflammation

72
Q

What should be prevented in nerve injuries?

A

Overstretching denervated muscles or injured nerve

Prevent joint contractures

73
Q

What type of strengthening exercises should be used for nerve injuries?

A

Low load (avoid muscle fatigue or failure)

MSK 4 (24 decks)

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