UE nerve issues Flashcards
Sensory changes
Burning tingling, prickling pins and needles numbness, hyperalgesia allodynia
Motor changes
cramps, weakness or paralysis
fibrillations, fasciculations
Autonomic
Hypohidrosis
Edema
Cardiovascular dysregulation
B&B dysfunction
trophic changes
Smooth, shiny skin muscle atrophy
mononeuropathy
Trauma or non-traumatic
polyNeuropathy
metabolic
Nutritional
Hereditary
immnunologically mediated
infectious disease
Paraneoplastic
Test item cluster for ruling down radiculopathy or myelopathy
rotation less than 60° ipsilateral
Spurling A
Upper limb tension test A
Distraction test
Dorsal scapular nerve
C4 5
levator scapula
rhomboids
Long thoracic
C5 7
serratus anterior
Suprascapular nerve
C4-6
infraspinatus
supraspinatus
Thracodorsal nerve
C6-8
latissimus dorsi
Upper subscapular nerve
C5-6
Subscapularis
Lower subscapular nerve
C5-6
Subscapularis
teres major
thoracic outlet syndrome
neck pain with arm symptoms N/T in UE
weakness in arm/hand
intermittent variable symptoms
vascular, prolonged or repetitive activities
Neurologic repetitive or traumatic
Aggravated by overhead reaching activities
examination items for thoracic outlet syndrome
Supraclavicular region tender may reproduce upper extremity symptoms
Tinels over the region
positive adsons or 90° ABER wright test
ULTT
Associated data from cervical mobility, first reability, clavicular mobility, flexibility of scalene and pec minor
Stinger burner
Neurapraxia in upper trunk of brachioplexus
Burning tingling stinging in upper extremity
mechanism of injury, typically traumatic from below to shoulder with contralateral side bending of neck
PE- symptoms similar to erb’s palsy upper trunk affected- scapular elevators, external rotators, biceps triceps
Typically, transient resolving with time
Erbs palsy
affects C5-6 roots or upper trunk
Most commonly from birth trauma
Ranges from neuroptaxia to neurotmesis
Posture- shoulder extension, internal rotation, and slight abduction
No active abduction or external rotation
Elbow affected in about half of patients
klumpkes palsy
affects lower trunk or C7-T1
May have associated Horner syndrome
Sensory deficit in medial arm forearm hand
traction injury through scapula with arm elevated
Claw hand from unopposed extensor digitorum
Suprascapular nerve lesion
trauma traction or compression to suprascapular nerve
Often mistaken for rotator cuff tear
deep burning worse with horizontal adduction
Tender over suprascapular notch
Motor weakness of supra and infraspinatus
Axillary nerve lesion
May result from shoulder dislocation
Sensory deficit in axillary patch
Motor deficit in teres minor and deltoid
Long thoracic nerve lesion
Idiopathic or palpation or trauma to posterior triangle region
Scapular winging may cause aching
Secondary shoulder symptoms
dorsal scapular nerve lesion
Idiopathic or with palpation, trauma and posterior triangular region
Deficits with scapular elevation, and control
Secondary shoulder symptoms
Radial nerve dysfunction arm lesion
crutch palsy, Saturday night palsy
Damage at radial or spiral groove of humerus
posterior interosseous syndrome
compression of PIN after arcade of frohse
Radial tunnel syndrome
Tissue symptomatic, not true neuro
wartenbergs syndrome
Superficial radial nerve entrapment
cubital tunnel syndrome
Caused by compression immobilization or trauma
Sensory deficits in entire ulnar distribution of hand
motor loss hypothenar musculature, FCU usually spared
guyons canal syndrome
more common in cyclist and racket sports
Sensory deficits limited to volar hand dorsal branch spared
Varied presentation
froments sign
pronator teres syndrome
pain and tenderness over PT
Sensory changes in median distribution of hand
Motor loss in median nerve distribution distal to pronator teres
anterior interosseous syndrome
Pain proximal forearm
No sensory changes
FPL, FDP, PQ motor loss, median spared
OK sign
carpal tunnel syndrome
most common compression neuropathy
Pain and paresthesias median nerve distribution
With use and nocturnally
May radiate proximately
sensory deficits spared in thenar eminence - palmar cutaneous branch
thenar wasting, gripping weakness
tines
phalens
carpal tunnel syndrome, CPR
Age greater than 45
Symptoms severity scale 1.9
Wrist ratio index greater than .67
Decreased Median sensory thumb
hand shaking improves symptoms
