peripheral nerve systems Flashcards
neuropraxia
segmental demyelination
transient disruption
fast recovery w good prognosis
axonotmesis
loss of axon continuity
prolonged disruption
longer recovery w fair prognosis
neurotmesis
completely severed
recovery w surgery w variable prognosis
pathology of peripheral nerve injury
compression
traction
avulsion
laceration
S/S peripheral nerve injury
altered/absent sensation in nerve distribution decreased strength of innervated mm diminished reflex sympathetic changes special tests
lateral cutaneous nerve
segments
motor or sensory
L2/3
sensory lateral thigh
tight jeans
obturator nerve segments
motor or sensory
L2-4
motor: adductors
sensory: skin of medial thigh
femoral nerve
segments
motor or sensory
L2-4
motor: anterior thigh, hip flexors and knee extensors
sensory: skin covering these mm
sciatic nerve
segments
motor or sensory
L4-S3
motor: mm of posterior thigh
sensory: none but indirectly skin of lateral leg, heal and foot
Whats two things that comes off the sciatic nerve
tibial nerve and common peroneal nerve
what effects common peroneal nerve
tight cast, so you’ll see a foot drop
acute nerve injury treatment
immobilize / unnload
splint/brace/tape
movement
education
recovery phase of nerve injury
motor training
desensitization
discriminative sensory re education
chronic phase of nerve injury management
compensatory function
preventive care
types of TOS
arterial venous traumatic neurovascular true neurogenic disputed TOS
key impingement areas in TOS
Scalene triangle
costoclavicular space
axillary interval
Etiology of TOS
congenital abnormalities
Trauma
vascular TOS arterial pathology
compression of subclavian
vascular TOS arterial ethology
bony anomaly (ie. cervical rib)
vascular TOS arterial S/S
chronic UE ischemia pain w effort cool to touch decreased cap refill decreased pulse tissue necrosis
vascular TOS venous patho
venous thrombosis involving subclavian axillary veins
When does vascular TOS venous happen
sudden onset young healthy person after UE exertion
acute occlusion
diffuse UE swelling
cyanosis
pain
chronic thrombosis
venous collateral formation
dilated veins in neck chest shoulder
True neurological TOS high or lower plexus
lower (c8-t1 nerve roots to lower trunk)
S/S true neurological TOS
C8-t1 motor /sensory changes
hand wasting
when does traumatic neuromuscular TOS happen
clavicle fracture
Disputed or Symptomatic TOS
compression or traction of brachial plexus
Disputed or Symptomatic TOS results in
scalene mm fibrosis
scar tissue
mm imbalance
lower plexus disputed TOS type
pain in neck or supraclavicular region along medial UE
upper plexus type TOS
pain in shoulder radiates to neck, thorax
symptomatic TOS clinical presentation
decreased scap mm control, strength n substation recruitment
conservative treatment TOS
decrease compression increase extensibility of tight tissue mobilize restricted joints strengthen posture education breathing education
how are arterial, venous true and neurogenic and traumatic TOS treated
surgical
injury to a nerve root vs peripheral nerve
nerve root - radiculopathy
peripheral - periperhal neuropathy
