Root and entrapment neuropathy syndromes

Question 1

C5: sensory deficit?

Answer 1

pain in lateral shoulder; sensory loss over deltoid

Question 2

C5: motor deficit

Answer 2

paresis of deltoid, supraspinatus, and biceps

Question 3

C5: reflex deficit

Answer 3

impaired biceps reflex

Question 4

C6: sensory deficit

Answer 4

radial side of arm to thumb

Question 5

C6: motor deficit

Answer 5

paresis of biceps and brachioradialis

Question 6

C6: reflex deficit

Answer 6

impaired/loss of biceps reflex

Question 7

C7: sensory defiict

Answer 7

b/w 2nd and 4th finger

Question 8

C7: motor deficit

Answer 8

triceps, wrist extensors and flexors, pec major

Question 9

C7 reflex deficit

Answer 9

impaired/lost triceps reflex

Question 10

L3 sensory def

Answer 10

usually none; lateral area if any

Question 11

L3 motor def

Answer 11

quadriceps and anterior tibial paresis; adductor may be affected (differentiates from femoral neuropathy)

Question 12

L3 reflex def

Answer 12

loss of knee jerk; loss or impaired adductor reflex

Question 13

L4 sensory def

Answer 13

medial leg below knee to medial malleolus

Question 14

L4 motor def

Answer 14

quadriceps and anterior tibial muscles; inversion of foot

Question 15

L4 reflex def

Answer 15

dec. knee jerk

Question 16

L5 sensory def

Answer 16

dorsum of foot to great toe

Question 17

L5 motor def

Answer 17

extensor hallucis longus and externsor digitorum longus

Question 18

L5 reflex def

Answer 18

none

Question 19

S1 sensory def

Answer 19

lateral border of foot

Question 20

S1 motor def

Answer 20

plantar flexion and eversion of foot

Question 21

S1 reflex def

Answer 21

dec or absent ankle jerk

Question 22

median nerve neuropathy clinically

Answer 22

numb/tingling first 4 digits; occ entire hand; may awake from sleep w/ symptoms; worse w/ exercise

Question 23

median nerve neuropathy exam

Answer 23

weak/atrophy thenar muscle, esp abdcutor pollicis brevis; dec sensation in first 4 fingers; tinel/phalen sign

Question 24

ulnar neuropathy clincally

Answer 24

paresthesia/pain in 5th digit and medial 4th; can involve median forearm/elbow; diff spreading fingers

Question 25

ulnar neuropathy exam

Answer 25

weakness in first dorsal interosseus, abductor digiti minimi; atrophy; claw hand

Question 26

radial neuropathy clinically

Answer 26

weakness of radial-innervated muscles; sensory loss on dorsum of hand

Question 27

radial neuropathy exam

Answer 27

weak: triceps, brachioradialis, supinator, wrist and finger extensors; triceps affected by axillary compression but spared by spiral groove compression; weak wrist extensors -> wrist drop

Question 28

etiology of radial neuropathy

Answer 28

compression at level of axilla (ie w/ crutches), spiral groove (sat night palsy), forearm

Question 29

meralgia paresthetica

Answer 29

lateral cutaneous nerve of thigh; burning sensation/variable loss of sensation over anterolateral thigh

Question 30

femoral neuropathy clinically

Answer 30

leg weakness on attempting to stand/walk; pain in anterior thigh

Question 31

femoral neuropathy exam

Answer 31

weak quads; absent/dec patellar reflex; sensory loss over anterior thigh; w/ saphenous involvement: medial leg/foot sesnory loss; adductors INTACT (differs from L2-L3 radiculopathy)

Question 32

femoral neuropathy cause

Answer 32

trauma from sx, stretch injury (prolonged lithotomy position in childbirth), DM/inflamm

Question 33

peroneal neuropathy clincally

Answer 33

foot drop w/ minimal sensory complaints

Question 34

peroneal neuropathy exam

Answer 34

weak of extensor hallicus longus, tib anterior (foot dorsiflexion) and peroneal muscles (foot eversion); mild sensory loss over dorsal foot

Question 35

peroneal neuropathy cause

Answer 35

entrapment of peroneal nerve b/w neck of fibula and insertion of peroneus longus muscle; usually due to trauma and compression