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PHTH 545 > Peripheral nerve injury > Flashcards

Peripheral nerve injury Flashcards

1
Q

What are the 3 types of nerve injuries?

A
  1. neuropraxia
  2. axonotmesis
  3. neurotmesis
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2
Q

______ = segmental demyelination, transient disruption, fast recovery with good prognosis

A

neuropraxia

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3
Q

______ = loss of axon continuity, prolonged disruption, longer recovery with fair prognosis

A

axonotmesis

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4
Q

______ = completely severed, recovery only possible with surgery with variable prognosis

A

neurotmesis

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5
Q

What are 4 ways to injure a nerve?

A
  1. compression
  2. traction
  3. avulsion
  4. laceration
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6
Q

What are 4 S & S of a peripheral nerve injury?

A
  1. altered/absent sensatin in nerve distribution
  2. decreased strength in muscles innervated by that nerve
  3. diminished reflex
  4. sympathetic changes
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7
Q

Scapular ______ in common in long thoracic n. injury

A

winging

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8
Q

Long thoracic nerve roots?

A

C5-7

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9
Q

Median nerve roots?

A

C5-T1

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10
Q

Where are common places for median n to get impinged?

A
  1. between pronator heads

2. carpal tunnel

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11
Q

S & S of median nerve palsy?

A

loss of dexterity in thumb and thenar wasting

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12
Q

Where are common sites for ulnar n to get impinged?

A
  1. cubital tunnel
  2. tunnel of guyon
  3. FCU
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13
Q

S & S of ulnar n palsy?

A

lose adduction strength in thumb; add and abd control of fingers; pt may complain of feeling clumsy

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14
Q

Radial n roots?

A

C5-T1

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15
Q

Axillary n roots?

A

C5-6

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16
Q

Where can radial n get impinged?

A

with crutches, radial head #, humeral head #, and beneath supinator

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17
Q

S & S of radial n palsy?

A

loss of use of triceps, wrist extensors and weaker supination

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18
Q

How can axillary n get injured?

A

humeral head #

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19
Q

Test for axillay n health?

A

test abduction, ER

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20
Q

Nerve roots of lateral cutaneous n ?

A

L2-3

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21
Q

Is lateral cutaneous n sensory, motor or both?

A

sensory

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22
Q

Sensory distribution of lateral cutaneous n ?

A

lateral thigh

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23
Q

What is impingement of the lateral cutaneous nerve called?

A

meralgia paresthetica

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24
Q

What are 3 causes of meralgia paresthetica?

A
  1. obesity
  2. pregnancy
  3. tight pants
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25
Q

Obturator n roots?

A

L2-4

26
Q

Motor innervations of obturator n?

A

innervates medial compartment of thigh (obturator)

27
Q

Sensory innervations of obturator n?

A

cutaneous branch innervates skin of the medial thigh

28
Q

Femoral n roots?

A

L2-4

29
Q

Motor innervations of femoral n?

A

anterior thigh muscles that flex hip joint (pectineus, iliac, sartorius) and extend knee (quads)

30
Q

Sensory innervations of femoral n?

A

Supplies cutaneous branches to the anteromedial thigh (anterior cutaneous branches of the femoral n) and the medial side of the leg and foot (saphenous n)

31
Q

Sciatic n roots?

A

L4-S3

32
Q

Motor innervations of sciatic n ?

A

muscles of the post thigh and the hamstring portion of the adductor magnus. indirectly innervates the muscles of leg and foot

33
Q

Sensory innervations of sciatic n?

A

no directly sensory functions, indirectly innervates (via terminal branches) the skin of lateral leg, heel, and both the dorsal and plantar surfaces of the foot

34
Q

____ n = damaged in injuries to tarsal tunnel

A

tibial

35
Q

Injury to nerve root = _______

A

radiculopathy

36
Q

Injury to periperhal nerve = _______ _________

A

peripheral neuropathy

37
Q

Damage to _____ ____ = fatiguable weakness

A

nerve root

38
Q

Damage to _______ ____ = muscle will test weak from the beginning

A

peripheral nerve

39
Q

Suprascapular n roots?

A

C5-6

40
Q

What 3 management strategies must occur in the recovery phase of nerve injuries ?

A
  1. motor retraining
  2. desensitization
  3. discriminative sensory re-education
41
Q

What two management strategies occur in the chronic phase of nerve injuries?

A
  1. compensatory function

2. preventive care

42
Q

______ = group of disorders that involve compression of 1+ neuromuscular elements as they traverse the thoracic outlet

A

TOS

43
Q

What are the 5 possible types of TOS?

A
  1. arterial
  2. venous
  3. traumatic neuromuscular
  4. true neurogenic
  5. symptomatic
44
Q

What are 3 key impingement areas in TOS?

A
  1. scalene triangle
  2. costoclavicular space
  3. axillary interval
45
Q

What are the 2 possible causes of TOS?

A
  1. congenital abnormalities

2. trauma

46
Q

Arterial TOS is caused by compression of the ________ artery

A

subclavian

47
Q

Most common cause of arterial TOS?

A

cervical rib

48
Q

Pathology of venous TOS = venous thrombosis involving _____-______ veins

A

sub-axillary

49
Q

_____ ______ TOS = lower plexus is stretched and angulated by presence of fibrous band from 1st rib to a cervical rib or a large transverse process on C7

A

true neurological

50
Q

What nerve roots will be effected in true neurological TOS?

A

C8 & T1

51
Q

______ ______ TOS = rare and usually following a clavicular #

A

traumatic neuromuscular

52
Q

______ TOS = more common in females, frequently bilateral

A

symptomatic

53
Q

Symptomatic TOS = likely compression or traction injury of _______ ______ within the thoracic outlet

A

brachial plexus

54
Q

Injury to the brachial plexus, seen in symptomatic TOS, results in what 3 things?

A
  1. scalene muscle fibrosis
  2. scar tissue
  3. muscle imbalance
55
Q

Lower plexus type symptomatic TOS clinical features?

A

pain in neck or supraclavicular region and radiates along medial arm, forearm and hand

56
Q

Upper plexus type symptomatic TOS clinical features?

A

pain in shoulder region and radiates into ipsilateral head and neck, upper thorax and proximal arm

57
Q

What are 6 special tests for TOS?

A
  1. allen’s
  2. adson’s
  3. ROOS test or elevated arm stress test
  4. hyperabduction test
  5. costoclaivculr maneuver
  6. supraclavicular pressure
58
Q

Pulse alteration of paresthesias are ________ when interpreting TOS tests

A

unreliable

59
Q

Low false-positive rates when a positive outcome is followed by _____ after the test

A

pain

60
Q

How long does the ROOS test last for?

A

3 mins

61
Q

When there is decreased strength in shoulder girdle muscles on symptomatic side, especially upper and middle traps, substitution or increased recruitment of ____, _____ _____ and ____ ______ also occurs; leading to what 3 positions of the scapula?

A

rhomboids, levator scap, pec minor; downward rotation; depression; anterior tilt

62
Q

What are 6 steps in the conservative treatment of symptomatic TOS?

A
  1. decrease compression
  2. increase extensibility of tight tissue
  3. mobilize restricted joints
  4. strengthen weak muscles
  5. postural re-education
  6. re-educate breathing patterns

PHTH 545 (23 decks)

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