Spinal Nerves-Feld Flashcards
- What is the brachial plexus?
- What are common injuries to it?
- Definition – a network of nerves that communicates signals from the spine to innervate the upper extremity
- Common injuries – birth, trauma, tumors or inflammation
- What are two ways the brachial plexus can be injuried in birth?
- What is cervical burners?
Two ways:
* Torn nerve endings at the base of the spinal cord
* Stretched nerves of the brachial plexus
Cervical burners:
* Brachial plexus in the neck and shoulder are stretched or compressed (squeezed together) after an impact
What is the clinical presentation of brachial plexus injury?
- Loss of sensation in upper extremity
- Weakness on strength testing–may be total (limp arm)
What is the diagnpstic pathway for brachial plexus injury?
Diagnostic pathway may include x-ray to check for fractures impinging plexus, Electromyography/Nerve conduction studies, MRI
What do you use to confirm diagnosis of brachial plexus injury?
MRI
Thoracic outlet syndrome:
* Patho?
* Symptoms depend on what?
* Symptoms?
* When does it worsen?
* What can servere or long term compression of vessels cause?
- Patho – compression of vessels and nerves
- Symptoms depend on whether it is vessel, nerve or a combination
- Symptoms – pain, pins and needles sensation, cold hand/fingers
- WORSEN when arm is lifted
- Can be moderate/severe pain
- Severe or long-term compression of vessels may lead to clotting
What would a patient have on evaluation with thoraic outlet syndrome ?
What is the Roos test?
What is the adson’s test?
What is the wright test?
What is treatment of Thoraic outlet?
- Physical therapy
- Surgery if needed – common etiology is the presence of an extra rib, requires removal.
Fibular (Peroneal) Nerve Injury:
* Can occur via what?
* Occurs when?
* Most common clinical presentation is what?
* Other physical exam findings are what?
- Can occur via trauma, with knee and hip surgery, with knee dislocation.
- Occurs when peroneal nerve is entrapped – most commonly around the femoral head, but may occur in calf, ankle or foot
- Most common clinical presentation of injury is FOOT Drop
- Other physical exam findings include weakness of ankle dorsiflexion, great toe extension, foot eversion and sensory loss
What is this?
Foot drop
What is the diagnosis and treatment of foot drop?
Nerve Conduction Velocity (NCV) and Electromyography tests (EMG) -> FUNCTION
* MRI and CT may be used to confirm compression of the nerve-> HOW MUCH IS COMPRESSED
* Treatment includes bracing, shoe inserts, surgical if an entrapment or compression can be released
Sciatica:
* Patho?
* Epidemiology?
* Incidences increase with what?
- Patho – sciatic nerve is compressed by herniated disk or bony overgrowth
- Epidemiology–very common– 40% of people will experience
- Incidence increases with age, but occurs most commonly in ages 30-50.
What are the axillary nerve injury causes?
What is the axillary nerve injury presentation?
- Innervates the deltoid and teres minor muscles
- The deltoid assists in a variety of movements
- Injury to the nerve typically presents with other brachial plexopathies
- Pain in area of deltoid and anterior shoulder
What is the diagnosis and treatment of axillary nerve injury
