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REHAB > Peripheral nerve injury > Flashcards

Peripheral nerve injury Flashcards

1
Q

The peripheral nervous system is made up of ____ Cranial nerves and ___ Spinal nerves

A

12

31

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2
Q

In the cervical and lumbar regions, the spinal nerves intemingle to create _______ which form individual peripheral nerves

A

Plexus

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3
Q

The basic neural structure consists of : (3)

A

Neuron
Associated axons
Nerve fiber

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4
Q

An axon invested solely by a schwann cell wrapping around it several times is known as

A

Myelinated fiber

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5
Q

Most common cause of localized injury yo a single nerve ( mononeuropathy)

A

Trauma

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6
Q

focal conduction block without axonal damage

Seddon Classification
Sunderland Classification

A

Neuropraxia

First degree

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7
Q

Axon damage with wallerian degeneration, supporting structures are intact

Seddon Classification
Sunderland Classification

A

Axonotmesis

Second degree

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8
Q

Damage to axon and endoneurium

Seddon Classification
Sunderland Classification

A

Neurotmesis

Third degree

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9
Q

Damage to perineurium and endoneurium

Subderland class

A

Fourth degree

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10
Q

Damage to axon and all supporting structures

Sunderland class

A

Fifth degree

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11
Q

At the area of the injury, the axon distal to the site of injury is the one that undergo degeneration

A

Wallerian degeneration

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12
Q

Transitory localized conduction block with no development of signs of denervation

A

Neuropraxia
Ex. Numbness of hand after holding an ice
Recovery within days or weeks

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13
Q

Describes lesions that cause axonal interruption in which the connective tissue and schwann cell basement membrane remain intact

A

Axonotmesis

- complete loss of motor, sensory, and sympathetic functions in the autonomous distribution of the injured nerve

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14
Q

Damage to the axon and connective tissue or COMPLETE transection of the nerve

A

Neurotmesis

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15
Q

Hyperirritable sensation

A

Dysesthesias

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16
Q

Can be used to study the pattern of denervation and later re-innervation

A

Electromyogram

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17
Q

Can ascertain the site and nature of injury

A

Nerve conduction velocity

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18
Q

Long thoracic nerve root

A

C5,6,7

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19
Q

Winging of scapula is an action of

A

Long thoracic nerve

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20
Q

Supraclavicular nerve
Root
Muscle
motion

A

C5,6
Supraspinatus
Shoulder abduction

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21
Q

Axillary

Root
Muscle
motion
Sensation

A

C5,6
Deltoid
Arm abduction
Lateral arm below shoulder

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22
Q

Musculocutaneous

Root
Muscle
motion
Sensation

A

C5,6,7
Biceps and brachialis
Elbow flexion
Lateral forearm

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23
Q

Radial

Root
Muscle
motion
Sensation

A

C5-T1
Extensor carpi, radialis longus and brevis

Extension of elbow and wrist
Post lat arm and dorsum of hand

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24
Q

Median nerve

Root
Muscle
motion
Sensation

A

C5-T1
Pronator teres and quadratus, flexor carpi radialis, flexors of fingers

Flexion of wrist and fingers
Radial palm, palmar surface, tips of lateral 3 1/2 fingers

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25
Q

Ulnar

Root
Muscle
motion
Sensation

A

C8-T1
Inteossei and lumbricals and adductir pollices
Movement of medial 2 fingers
Ulnar and dorsal palm and medial 1/2 fingers

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26
Q

Passes under the bicipital aponeurosis before entering antecubital fossa medial to biceps tendon

A

Median nerve

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27
Q

_______ crosses over the median nerve

A

Ligament of struthers

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28
Q

Supplies medial portion of medial portion of FDO, FPL, pronator quadratus

A

Anterior Interosseous Syndrome

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29
Q

After exiting the tunnel, the median nerve supplies the:

4

A

1st and 2nd lumbricals
Opponens pollicis
Abductir pollicis brevis
Cutaneous to the skin of the 1st to the lateral portion of the 4th finger

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30
Q

Anterior interosseous nerve can be compressed at the fibrous arch formed by : (2)

A

Flexor digitorum superficialis

Pronator teres

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31
Q

(+) aching pain in forearm but no sensory loss

A

Anterior interosseous syndrome

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32
Q

(+) pain and parasthesia jn the 1st 3 fingers of the hands, mimicking carpal tunnel syndrome

A

Pronator teres syndome

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33
Q

(+) involvement of skin over thenar eminence which is usually spared in CTS

A

Pronator teres syndrome

34
Q

Pain may be provoked by resisted flexion, pronation and finger flexion

A

Pronator teres syndrome

35
Q

Tenderness over the area entrapment

A

Tinel’s sign

36
Q

EMG shows denervation potentials in all muscles supplied by median nerve except PT

A

PT syndrome

37
Q

Median nerve is compressed within the carpal canal, approx _____ beyond the distal wrist crease

A

1-2cm

38
Q

Cause has been assoc with repetitive hand and wrist movement or use of vibratory tools

A

Carpal tunnel syndrome

39
Q

Often assoc with DM, hypothyroidism and rheumatoid arthritis as well as obesity and pregnancy

A

Carpal tunnel syndrome

40
Q

Numbness and pain along the median nerve distribution, radiating to the forearm

A

Carpal tunnel syndrome

41
Q

Signs on carpal tunnel syndorme (3)

A

Tinel’s sign 1-2 cm distal to wrist crease
Atrophy to thenar eminence
Phalen’s sign

42
Q

Courses along the medial aspect of the upper arm in close proximity to the median nerve

A

Ulnar nerve

43
Q

Proximal to the elbow it runs superficially in the groove made by the medial epicondyle and the olecranon

A

Ulnar nerve

44
Q

It innervates the distal 3rd of the palmar and dorsal aspects of the medial hand

A

Ulnar nerve

45
Q

The ulnar nerve enters the _______ in the wrist between the hook of hamate and pisiform

A

Guyon’s canal

46
Q

Symptoms:
Difficulty eating and dressing
Loss of dexterity and grip strength

A

Ulnar neuropathy at elbow

47
Q

Signs:
Pos tinel’s sign in the retriepicondylar region
CLAWING OF THE HAND

A

Ulnar neuropathy

48
Q

Compression within the guyon’s canal

Altered sensation in the 4th and 5th digits

A

Ulnar neuropathy at the wrist

49
Q

Weakness of all ulnar innervated hand muscles

A

Ulnar neuropathy at the wrist

50
Q

Largest terminal branch of brachial plexus

A

Radial nerve

51
Q

Supplies triceps then winds around the spinal groove of the humerus

A

Radial nerve

52
Q

Enters forearm between biceps and brachioradialis muscles and divide into PIN and superficial radial nerve at the elbow

A

Radial nerve

53
Q

Posterior interosseous nerve courses around the neck of the radius thru the _____ which is made up of the proximal border of supinator

A

Arcade of frohse

54
Q

Supply sensation to dorsolateral position of the hand and 1st 3 digits

A

Radial nerve

55
Q

From fracture of the humerus
External compression from tourniquets
Honeymooner’s palsy
Saturday night palsy

A

Radial nerve injury at the spiral groove

56
Q 
S/s 
Wrist drop 
Inability to extend fingers
Abn sensation in lateral aspect of dorsumof the hand and dorsum of digits 1-4
Diminished or absent BR reflex
A

Radial nerve injury at the spiral groove

57
Q

Radial nerve injury at the spiral groove
Surgical exploration is warranted with no recovery within _____

Tendon transfer when no functional recovery in ______

A

8-10 weeks

1 year

58
Q

Post interosseous neuropathy

Common is entrapment at the

A

Arcade of frohse

59
Q

AKA supinator syndrome

A

Posterior interosseous neuropathy

60
Q

Weakness seen in finger extensor and ECU

BR and radial wrist extensors are spared

A

Post inter neuropathy

61
Q

Largest nerve jn the body

A

Sciatic nerve

62
Q

Sciatic nerve consists of

A

Tibia and common peroneal

63
Q

Freq injured by gunshot or stab wounds or intramuscular injection of drugs

A

Sciatic nerve

64
Q

Represents a sciatic neuritis due to compression between bony edge of the notch and piriformis muscle

A

Piriformis syndrome

65
Q

Pain in the low back and in the leg along the course of the nerve

A

Sciatica

66
Q

Runs with tibial nerve in the posterior thigh as part of the sciatic nerve

A

Common peroneal neuropathy

67
Q

Lesions of the peroneal nerve often occur at the ________from the compression during surgery, prolonged bed rest, improperly placed casts or splints

A

Fibular head

68
Q

Foot drop

A

Peroneal mononeuropathy

69
Q

Sensation is diminished in lower 2/3 of the lateral leg and dorsum of foot

A

Peroneal mononeuropathy

70
Q

It innervates all the hamstring muscles except the short head of the biceps femoris

A

Tibial nerve

71
Q

Partially innervates the adductor magnus.

At the ankle it passes through within the popliteal fossa it gives off the SURAL SENSORY NERVE

A

Tibial nerve

72
Q

Maybe injured by penetrating wounds in the popliteal fossa and in the leg, fractures and dislocations about the knee, knee surgeries and compression from swelling within the post muscle compartments

A

Proximal tibial neuropathy

73
Q

Loss of ankle jerk and plantar reflex

A

Proximal tibial neuropathy

74
Q

Compression of the posterior tibial branch at the medial malleolus

A

Tarsal tunnel syndrome

75
Q

Supplies the psoas muscle in the pelvis

A

Femoral nerve

76
Q

Travles between the psoas and iliacus then pass under the inguinal ligament

A

Femoral nerve

77
Q

Unilateral thigh weakness and numbness of the anterior thigh and leg

A

Femoral nerve neuropathy

78
Q

Present with sensation of knee buckling, difficulty negotiations stairs if nerve is affected within pelvis hip flexion

A

Femoral nerve neuropathy

79
Q

Purely sensory arising from l2-l3 nerve roots coursing around the pelvic brim to exif under the inguinal ligament just medial to the ASID

A

Lateral femoral cutaneous nerve

80
Q

Mononeuropathy is known as

A

Meralgia paresthetica

81
Q

Exterbal sources of compression :
Heavy tool belts
Habitually leaning against a table or wearing waist bands
Surgery

A

Meralgia paresthetica

REHAB (3 decks)

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