Peripheral Nerve Injury Flashcards
1
Q
Wall layer that covers a nerve fascicles
A
Perineurium
2
Q
Wall layer that covers a nerve fiber
A
Endoneurium
3
Q
Wall layer that covers a spinal nerve
A
Epineurium
4
Q
Three classifications under Seddon
A
Neuropraxia, Axonotmesis, Neurotmesis
5
Q
Seddon: (+) Wallerian Degeneration
A
Axonotmesis and Neurotmesis
6
Q
Seddon: (+) Complete transaction of neuron
A
Neurotmesis
7
Q
Good rate of nerve regeneration
A
1-2 mm per day
8
Q
Seddon: (+) Conduction block
A
Neuropraxia
9
Q
Healing time of Neuropraxia
A
1-2 months (3-4 weeks)
10
Q
Seddon: (+) Axonal injury
A
Axonotmesis
11
Q
Seddon: (+) Compression
A
Neuropraxia
12
Q
Sunderland V
A
Axon + Endo + Peri + Epi
13
Q
Seddon: (+) Gunshot wound
A
Neurotmesis
14
Q
Sunderland: Axon + Endoneurium
A
III
15
Q
Sunderland: IV
A
Axon + Endo + Peri
16
Q
Nerves commonly affected in Neuropraxia
A
Thick myelinated motor nerve
17
Q
Sunderland: Conduction Block
A
I
18
Q
Nerves commonly affected in Neurotmesis
A
Any
19
Q
Seddon: (+) Severe compression
A
Axonotmesis
20
Q
Prognosis of Axonotmesis
A
Good
21
Q
True or False: There is a (+) atrophy with Neuropraxia injuries
A
False
22
Q
Sunderland II
A
Axon
23
Q
Nerves commonly affected in Axonotmesis
A
Myelinated motor and sensory nerve
24
Q
True or False: Surrounding structures are affected in Axonotmesis
A
False
25
Brachial Plexus comes from what nerve roots?
ANTERIOR rami of C5-T1 (VEMDAS)
26
Nerve Innervation: Serratus Anterior
Long Thoracic Nerve (C5-7)
27
Nerve Innervation: Supraspinatus and Infraspinatus
Suprascapular Nerve (Upper Trunk)
28
Largest nerve in the brachial plexus
Radial Nerve
29
Medial Pectoral Nerve innervates what muscles?
Pectoralis Major and Minor
30
Nerve Innervation: Subscapularis Muscle
Upper and Lower Subscapular Nerve (Posterior Cord)
31
Lower Subscapular Nerve innervates what muscles?
Subscapularis and Teres Major
32
Nerve root of Axillary Nerve
C5-6
33
Nerve Innervation: Rhomboids
Dorsal Scapular Nerve
34
"External Respiratory Nerve of Bell"
Long Thoracic Nerve
35
Nerve Innervation: Pectoralis Major Muscle
Lateral Pectoral Nerve (Lateral Cord)
36
Musculocutaneous Nerve innervates what muscles?
BiCoBra: Biceps Brachii, Coracobrahialis, Brachioradialis
37
Nerve root of Levator Scapulae
C3-4
38
Sensory Innervation: Posterior forearm
Musculocutaneous, Radial and Medial Cutaneous of FA
39
Sensory Innervation: Superolateral Arm
Axillary Nerve
40
Sensory Innervation: Medial arm
Medial Cutaneous of Arm Nerve
41
Sensory Innervation: Lateral FA
Musculocutaneous Nerve
42
Sensory Innervation: Posterior Arm
Radial Nerve
43
Cause of Musculocutaneous nerve injury
Fracture and Dislocation
44
What atrophy happens if there is a (+) entrapment of the musculocutaneous nerve at the arm?
Flatness of Anterior arm
45
What weakness can be observed if there is a (+) entrapment of the musculocutaneous nerve at the arm?
BiCoBra: Weakness of Shoulder and Elbow flexion + FA supination
46
What area usually has a diminished sensation if there is a (+) entrapment of the musculocutaneous nerve at the arm?
Lateral FA sensory affectation
47
Two causes of musculocutaneous nerve entrapment in the forearm
Musculocutaneous nerve tunnel syndrome and Hyperextension of elbow
48
Musculocutaneous nerve tunnel syndrome is secondary to what structure?
Distal biceps tendon
49
What kind of sport causes musculocutaneous nerve entrapment in the forearm?
Backhand sports (hyperextension of the elbow)
50
What kind of neuropathy does musculocutaneous nerve entrapment in the forearm have?
Pure sensory neuropathy
51
Another name of Axillary Nerve
Circumflex Nerve
52
Two causes of axillary nerve entrapment
Anterior shoulder dislocation and Proximal Humeral Fracture
53
Site of Proximal Humeral Fracture
Quadrangular Space
54
3 clinical manifestations of axillary nerve entrapment
(+) Weakness of Teres Minor & Deltoids, (+) Atrophy, (+) Sensory loss of the superolateral arm
55
What atrophy happens if there is a (+) entrapment of the axillary nerve?
Square Shoulder Deformity
56
Two sites of Suprascapular nerve entrapment
Suprascapular ntoch and spinoglenoid notch
57
If there is a (+) suprascapular notch entrapment, what are the muscles affected?
Supraspinatus and Infraspinatus
58
If there is a (+) spinoglenoid notch entrapment, what are the muscles affected?
Infraspinatus
59
What area usually has a diminished sensation if there is a (+) entrapment of the suprascapular nerve?
AC and GH joint
60
If there is axillary nerve entrapment, what muscles would compensate for the weakness of shoulder ABER?
Supraspinatus and Infraspinatus
61
"Open Book" Winging
Medial Winging
62
Winging: Lesion of Dorsal Scapular Nerve
Posterior Winging
63
"Sliding Door" Winging
Lateral Winging
64
Synergistic action of SA and Traps
Upward Rotation of Scapula (lateral)
65
Winging: (+) Radial Neck Dissection
Lateral Winging
66
The same action of Traps and Rhomboids in the scapula
Retraction
67
Winging: Middle scalene hypertrophy
Posterior Winging
68
Winging: (+) Radial Mastectomy
Medial WInging
69
Winging: (+) Overhead activities
Posterior Winging
70
Winging: (+) Neck Surgery
Lateral Winging
71
Winging: (+) Back Pack Palsy
Medial WInging
72
9 muscles that are innervated by PIN
ECRB, Supinator, Extensor Digitiminimi, Extensor Indicis, Extensor Digitorum, Extensor Pollicis Brevis, Ext Pollicis Longus, Abductor Pollicis Longus
73
2 branches of radial nerve that branched out under spiral groove
Superficial and Deep Branch
74
4 sensory branches of radial nerve
Posterior arm, Lateral inferior arm, Posterior forearm and Superficial branch
75
Two muscles innervated by the radial nerve after its passes through the spiral groove
ECRL and Brachioradialis
76
The superficial branch of the radial nerve innervates what area of the arm?
Dorsum of the hand
77
What is the nerve palsy that occurs due to the entrapment of radial nerve in the level of axilla?
Crutch Palsy
78
The most common site of radial nerve entrapment
Spiral Groove
79
Site of radial entrapment: (+) Cheralgia Paresthetica
At the wrist
80
Site of radial entrapment: (+) Saturday night Palsy
Spiral Groove
81
Site of radial entrapment: (+) Supinator Syndrome
Radial Tunnel
82
Spared muscles in Spiral Groove Entrapment
Triceps and Anconeus
83
Pure motor neuropathy of radial nerve
Radial Tunnel Syndrome
84
Spared muscles in Radial Tunnel Syndrome
Triceps, Anconeus, ECRL, Brachioradialis
85
Two causes of Radial Tunnel Syndrome
Supinator Syndrome and Vascular Leash of Henry
86
The most common site of radial entrapment in the radial tunnel
Arcade of Froshe
87
Pure sensory neuropathy of radial nerve
Cheralgia Paresthetica / Wartenburg disease
88
Another name of Cheralgia Paresthetica
Wartenburg disease or syndrome
89
Four causes of Cheralgia Paresthetica
Tight bracelet, Tight wristwatch, scaphoid fracture, handcuff neuropathy
90
Three muscles innervated by AIN
FDP (lateral 2), Pronator Quadratus, FPL
91
Four muscles innervated by the Median nerve at the elbow
Pronator Teres, FCR, Palmaris Longus, FDS
92
Four muscles innervated by the Median nerve at the carpal tunnel
Lumbricals, Opponens Pollicis, Abductor Pollicis, Flexor Pollicis Brevis
93
A sensory branch of Median Nerve
Superficial Palmar Branch
94
Area innervated by Superficial Palmar Branch of Median Nerve
Thenar Area
95
Ligament attached to the medial epicondyle to the supracondylar process of the humerus
Ligament of Struthers
96
What is the specific site in the supracondylar process where the Ligament of Struthers is attached?
Avian Spur
97
What is the name of the median entrapment above the elbow?
Supracondylar syndrome
98
Three causes of median entrapment at the elbow?
Pronator teres syndrome, screwdrivers palsy and bicipital aponeurosis
99
Does screwdrivers palsy occur due to repetitive movements?
Yes, because. of the repetitive pronation and supination
100
Other two names of Bicipital Aponeurosis
Lacertus Fibrosus and Grace Dieu Fascia
101
What is the spared muscle in the median entrapment at the elbow?
Pronator Teres (but weak if loaded)
102
Pure motor neuropathy of median nerve
AIN/ Kiloh Nevin Syndrome
103
What is the abnormal muscle formed by FPL?
Gantzer Muscle
104
Two causes of AIN entrapment at the elbow?
Pronator Teres and Gantzer Muscle
105
Sign of (+) Kiloh Nevin Syndrome
(-) Ok sign
106
A special test of AIN neuropathy
Pinch Grip Test
107
The most common entrapment of the nerve in the shoulder
Axillary Nerve
108
The most common site of median nerve entrapment
Carpal Tunnel
109
Four contents of carpal tunnel
4 tendons of FDP, 4 tendons of FDS, 1 tendon of FPL, and 1 median nerve
110
What is the gender predominantly affected by CTS
Females
111
True or False: Bilateral hand affectation is more prevalent than unilateral in patients with CTS
True
112
Four systemic cause of CTS
Pregnancy, Obesity, Arthritis, Endocrine Problem
113
Four traumatic cause of CTS
Lunate Dislocation, Repetitive Typing, Piano Playing, Usage of vibrating equipments
114
What is spared in the CTS?
Superficial Palmar Branch (thenar area)
115
True or False: There is a weakness of finger flexors in CTS
False
116
Three sensory branches of the ulnar nerve
Palmar Cutaneous, Dorsal Cutaneous, Superficial Branch
117
What are the two muscles innervated by the ulnar nerve as it passes through the cubital tunnel?
FCU and FDP (median 2)
118
What are the muscles innervated by the ulnar nerve as it passes through the tunnel of Guyon?
Palmaris Brevis
119
Seven muscles innervated by a deep branch of the ulnar nerve
Interossei, Lumbricals, Flexor Digitiminimi, Abductor Digitiminimi, Opponens Digitiminimi, Adductor Pollics, Flexor Pollis Brevis
120
Three dually innervated muscles of the hand
Lumbricals, FDP and Flexor Pollicis Brevis
121
2 innervations of Flexor Digitorum Profundus
AIN and Deep branch of Ulnar Nerve
122
The most common site of ulnar nerve entrapment
Cubital Tunnel (at elbow)
123
Four causes of Cubital Tunnel Syndrome
Trauma on posterior elbow, cubitus valgus, Osborne ligament (FCU), anomalous epitrochelais anconeus muscle
124
What is the gender predominantly affected by Cubital Tunnel Syndrome?
Male due to old age
125
Three risk factors of Cubital Tunnel Syndrome
Tardy ulnar palsy, gripping activity, smoking
126
What activity causes Tardy ulnar palsy?
Elbow Flexion
127
What are the two muscles spared in the entrapment of the ulnar nerve in the tunnel of Guyon?
FCU and FDP
128
The tunnel fo Guyon is formed by what structures?
Pisiform, Hamate, and Pisohamate Ligament
129
Two causes of entrapment of the ulnar nerve in the tunnel of Guyon?
Handlebar's Palsy and Jackhammer's Palsy
130
Who is most likely predisposed in Handlebar's Palsy?
Bikers, Riders, Cyclist
131
What area usually has a diminished sensation if there is a (+) entrapment of the ulnar nerve at the tunnel of Guyon?
Palmar Aspect of fingers
132
Sensory innervation: Lateral palm of the hand
Median Nerve
133
Sensory innervation: Lateral dorsum of the hand
Radial Nerve
134
Sensory innervation: Medial aspect of the hand
Ulnar Nerve
135
Sensory innervation: Lateral tips of the dorsum of the hand
Median Nerve
136
Two special tests for interossei
Egawa and Wartenburg
137
Special test for adductor pollicis
Froments
138
Carpal bone affected in Radial Nerve Entrapment
Scaphoid
139
Carpal bone affected in Median Nerve Entrapment
Lunate
140
Carpal bone affected in Ulnar Nerve Entrapment
Pisiform and Hamate
141
Hand Injury: (+) Active Papal Sign
Median Nerve
142
Deformity present in Median Injury of the Hand
Ape Hand or Simian Hand
143
Hand Injury: (+) Guttering stick palsy
Ulnar Nerve
144
Deformity present in Ulnar Injury of the Hand
Bowler's Thumb
145
Hand Injury: (+) Hypothenar Muscle
Ulnar Nerve
146
Hand Injury: (-) Precision Grips
Median Nerve
147
Hand Injury: (-) Power Grips
Ulnar Nerve
148
Hand Injury: (+) Thenar Muscle
Median Nerve
149
Hand Injury: (+) Passive Papal Sign
Ulnar Nerve
150
The ligament that causes Median Nerve Entrapment
Ligament of Struthers
151
The ligament that causes Ulnar Nerve Entrapment
Osborne's Ligament
152
The abnormal muscle that causes Median Nerve Entrapment
Gantzer Muscle (FPL)
153
The abnormal muscle that causes Ulnar Nerve Entrapment
Anomalous epitrochelais anconeus muscle
154
"Anterior Crural Nerve"
Femoral Nerve
155
Nerve that is activated during cremasteric reflex
Genitofemoral Nerve (L1-2)
156
What is the continuation of the external oblique muscles to the inguinal ligament?
External Oblique Aponeurosis
157
What nerve is usually entrapement due to the External Oblique Aponeurosis?
Ilioinguinal Nerve
158
What type of sports injury is predominantly causes the Ilioinguinal Nerve entrapment
Hockey Groin Injury
159
What syndrome occurs due to the LFCN entrapment?
Meralgia Paresthetica
160
Another name of Meralgia Paresthetica
Bernhardt-Roth Syndrome
161
5 risk factors of Meralgia Paresthetica
Male, Obese, Tight Clothing, Seatbelt and Pregnancy
162
What area usually has a diminished sensation if there is a (+) Meralgia Paresthetica?
Lateral Thigh
163
The largest nerve in the lumbar plexus
Femoral Nerve
164
The largest nerve in the sacral plexus
Sciatic Nerve
165
Roots of nerve to piriformis
Posterior S1-2
166
Sensory Innervation: Posterior Thigh
PFCN
167
Femoral nerve supplies sensation in what area of the thigh?
Anterior and Inferior Medial part of the thigh
168
Sensory Innervation: Superior Medial Thigh
Genitofemoral
169
Sensory Innervation: Anterolateral of leg
SPN
170
Deep peroneal nerve supplies sensation in what area of the for?
1st web space of the foot
171
Sensory Innervation: Posteromedial of leg
Saphenous Nerve
172
Sensory Innervation: Middle Medial Thigh
Obturator Nerve
173
What are the nerves that provide sensory innervation in the sole of the foot?
Medial and Lateral Plantar Nerve, Sural Nerve, Saphenous Nerve, Calcaneal Nerve
174
Sensory Innervation: Posterolateral of leg
Sural Nerve
175
What nerve supplies the outstep of the foot?
Sural Nerve
176
What nerve supplies the instep of the foot?
Saphenous Nerve
177
Two pure sensory branches of the sciatic nerve
Sural Nerve and Calcaneal branch of tibial nerve
178
Muscle innervated by Inferior Gluteal Nerve
Gluteus Maximus
179
Cause of Inferior Gluteal Nerve entrapment
Posterior Hip Arthroplasty
180
(+) Gluteus Maximus Gait
Posterior Leaning (Hyperextension)
181
Muscles innervated by Superior Gluteal Nerve
Gluteus Minimus and Medius + TFL
182
"Uncompensated" Trendelenburg
Trendelenburg Sign / Pelvic Drop
183
"Compensated" Trendelenburg
Trendelenburg Gait / Leaning
184
The direction of Trendelenburg Sign or Pelvic Drop
Contralateral
185
The direction of Trendelenburg Gait or Leaning
Ipsilateral
186
3 compensatory mechanism of (+) Trendelenburg
C/L Pelvic Drop, C/L Cane, I/L leaning
187
Where would you put a briefcase if the patient has (+) Trendelenburg gait
Ipsilateral (not compensatory mechanism)
188
(+) Right gmed and gmin weakness, where is the location of the pelvic drop?
Left pelvic drop
189
(+) Right gmed and gmin weakness, where is the location of the trunk lean?
Right trunk lean
190
Cause of Obturator Nerve entrapment
Obstetric Palsy (Child Birth)
191
3 causes of Femoral Nerve entrapment
Anterior Hip Dislocation, Hip Fracture, and Child Birth
192
What muscle is the first to atrophy in femoral nerve entrapment?
Quadriceps muscle
193
(+) Quadriceps Gait
Forward Lurch
194
6 muscles innervated by DPN
Peroneus Tertius, TA, EHL, EDL, EHB, EDB
195
2 muscles innervated by SPN
Peroneus Longus and Brevis
196
Innervation of Shorthead of Hamstrings
CPN
197
Innervation of true hamstrings
Tibial Nerve
198
7 muscles innervated by the tibial nerve
Popliteus, TP, Gastrocs, Soleus, Plantaris, FHL, FDL
199
4 muscles innervated by MPN
FAF1: Flexor Hallucis Brevis, Abductor Hallucis Brevis, FDB, 1st Lumbricals
200
5 muscles innervated by LPN
FAIL AQ: Flexor DM, Abductor DM, Interossei, Lumbricals, Adductor Hallucis, Quadratus Plantae
201
Most common entrapment in the hip region
Sciatic Nerve at Hip
202
Most common tunnel syndrome in the body
CTS
203
Most common entrapment in the LE
CPN at Fibular Head
204
5 causes of sciatic entrapment in the hip
Posterior hip dislocation, Injection palsy, Fat wallet syndrome, toilet seat fracture, piriformis syndrome
205
What atrophy is seen in sciatic entrapment in the hip?
Spindle Leg atrophy
206
What are the 2 signs seen in sciatic entrapment in the hip?
Sign of pace and nagel and Sign of Freiberg
207
Sign: (+) pain and weakness in active ABER of hip
Sign of pace and nagel
208
Sign: (+) pain in passive IR of extended hip
Sign of Freiberg
209
7 causes of CPN entrapment at Fibular Head
Crossed-leg sitting, side-lying, leg ER at supine, Indian sitting, Guitarist Posture, Prolonged squatting, Strawberry picker's palsy
210
4 gait deviations present in CPN entrapment at Fibular Head
Weak DF: (+) Foot drop (swing), (+) Foot slap (stance), (+) Steppage gait (increase hip and knee flexion), and (-) heel strike
211
2 causes of DPN entrapment
Fracture or Trauma
212
Sensory loss present in DPN entrapment
Sensory affectation in the 1st dorsal space
213
3 syndrome that causes weakness of EDB and EHB
Anterior compartment syndrome, anterior tarsal tunnel, ski boots palsy
214
Two sites of tibial nerve entrapment
Popliteal fossa and tarsal tunnel
215
2 causes of tibial nerve entrapment at the popliteal fossa
Baker's cyst and too long wheelchair seat depth
216
3 gait deviations present in tibial nerve entrapment at popliteal fossa
Weak PF: (-) push-off, (+) decrease step length of the opposite foot, (+) calcaneal gait
217
Cause of tibial nerve entrapment at the tarsal tunnel
Lesion at porta pedis
218
What nerve is affected in tibial nerve entrapment at the tarsal tunnel?
MPN and LPN (foot intrinsics)
219
2 causes of medial plantar nerve entrapment
Jogger's foot and runners with flat feet (overpronation of the foot)
220
The most common site of pain present in medial plantar nerve entrapment
Medial sole
221
What is the pure sensory neuropathy occurs due to the entrapment of the 3rd-4th metatarsal?
Interdigital neuroma
222
Other name of interdigital neuroma
Morton's Neuroma
223
What is the gender predominantly affected in interdigital neuroma?
Female
224
Cause of interdigital neuroma
usage of poorly fitting high-heeled shoes
