peripheral nerve injury

Question 1

discus median nerve injury

Answer 1

impingement c hypertrophied pronator teres

ligament of struthers
bicipital aponeurosis
FDS

Question 2

discuss radial nerve injury

Answer 2

musculospiral groove in radial neck

under ECRB
arcade of frohse
distal edge of supinator

Question 3

discuss ulnar nerve injury

Answer 3

sa cubital tunnel sa med epicondyle

bet heads of FCU

Question 4

rehab goals in protection phase for cubital tunnel syndrome

Answer 4

pt educ

rest and protection

focus on depression

maintain muscle integrity

Question 5

interventions for pt educ in cubital tunnel syndrome

Answer 5

ssx, diff gripping and tingling over little finger

encourage compliance to PT

Question 6

interventions for rest and protection in cubital tunnel syndrome

Answer 6

night splints, rolled towel or hugging a pillow during sleep to prevent elbow flexion beyond 90°

TENS, pulsed US or cryo

Question 7

interventions to focus on depression in cubital tunnel syndrome

Answer 7

discontinue sleeping c elbows flexed

leaning c elbow kc ulnar nerve gets pinched

Question 8

interventions to maintain muscle integrity in cubital tunnel syndrome

Answer 8

PROM - AAROM - AROM

Question 9

rehab goals during mod and minimum protection phase in cubital tunnel syndrome

Answer 9

improve functional strength and endurance

return to function

Question 10

interventions for improve functional strength and endurance in cubital tunnel syndrome

Answer 10

strengthening when sx subside

emphasis on gripping on ring and little fingers

discontinue immed if sx are aggravated

Question 11

interventions for return to function in cubital tunnel syndrome

Answer 11

complete cessation of sx before initiating throwing program if throwing athlete

Question 12

order of PNM

Answer 12

cervical spine - shoulder - elbow and FA - wrist - fingers

usually sx elicited at wrist, FA or elbow

Question 13

goal of PNM

Answer 13

to mobilize the nerves to desensitize and eliminate symptoms

Question 14

intervention scenario for acute phase of PNI

Answer 14

restore: regen the nerve and protect

compensate: use other UE for function

Question 15

interventions for acute phase of PNI

Answer 15

immob - only 1 mm per day of regeneration

movement - controlled ROM to avoid contractures

splinting - to protect nerve

pt educ - to not hold cold/hot and sharp kc desensitized si patient

alw check hands or skin for dryness or irritation

Question 16

interventions for recovery phase of PNI

Answer 16

motor retraining - AROM + ES

desensitization - reintroduce textures lalo if pt is hypersensitive

discriminative sesnory reeducation - sensory testing as treatment

Question 17

intervention scenario for chroninc phase of PNI

Answer 17

intervention scenario

compensate: use good UE or adaptive device

preventive: avoid atrophy via ES, checking for skin dryness and wounds, pt educ

Question 18

intervention scenario for recovery phase of PNI

Answer 18

restore: improve the sensation of the patient, correct the hypersensitivity, and reorient or re educate the patient on the proper sensations