WEEK 3 - Neuropathy Flashcards
Carpal tunnel, Radiculopathy, Diabetic Neuropathy
What is the most common peripheral neuropathy?
diabetic neuropathy
what is the most inherited peripheral neuropathy?
Charcot-Marie-Tooth Disease
there are 90 known causes of neuropathy true or false?
false
<100
______ refers to “pinching” or “irritation” of a spinal nerve root.
radiculopathy
what are the most frequently impacted cervical radiculopathies?
C6 spinal nerve root
C7 spinal nerve root
C8 spinal nerve root
what are the most frequently impacted Lumbar radiculopathies?
L4 spinal nerve root
L5 spinal nerve root
S1 spinal nerve root
________ may be caused by radiculopathy involving any of the following nerve roots (L4,L5,S1,S2)
Sciatica
what are the causes of radiculopathy
narrowing of vertebral bodies:
- spinal stenosis;
- from DDD
- Bone spurs
- Osteophytes
- Disc Bulge/ Herniation
from:
- inner fluid
- disc bulge
- herniation irritates
nerve root - Spondylolisthesis
- slipping of top vertebrae forward on lower vertebrea
Retrolisthesis:
- slipping of top vertebrea posteriorly onto lower vertebrea
- tumour
-
what are some symptoms of radiculopathy?
- pain often radiating through limb
- paresthesia (pins/needles)
- numbness
- weakness or heaviness
- muscle spasm
how do u asses for radiculopathy?
clinical:
- dermatomal
- myotome weakness
- hyporeflexia or areflexia
neuroimaging
- X-Ray, CT, MRI
Nerve conduction test + EMG
what are the treatments for radiculopathy?
modalities:
- TENS
- Acupuncture
- heat
- massage
Physiotherapy/ chiro
- traction
- joint manipulation (MOBS)
Exercises:
- posture correction
- stretching
- muscle imbalance correction
- improved movement mechanics
what are some medications for radiculopathy?
- NSAIDS
- Neuropathic pain (Gabapentin, SSRIs)
- epidural steroid injections
- selective nerve blocks
- muscle relaxants for muscle spasms
what is treatment for radiculopathy?
decompression surgery
what are the types of decompression surgery ?
disectomy + fusion (remove entire disc, put implant in and bone’s fuse together
microdisectomy (make tiny cut in back of spinal and only remove damaged disc)
foraminoplasty
fusion/fixation
carpal tunnel syndrom is due to _____ ________ inflammation
not talking about median nerve
flexor tendon inflammation
what is the lifetime risk for carpal tunnel?
more common in what gender
does > age mean > risk?
~10%
woman
yes
what spinal nerve roots enter the carpal tunnel?
C6
C7
C8
T1
What are some carpal tunnel risk factors?
- family history
- trauma
- pregnancy
- stress
- other diseases (RA or Hypothyrodism)
what are the sensory symptoms of carpal tunnel syndrome?
- parasthesia: numbness + pain along median nerve
- severe pain at night
- burning, aching, numbness & tingling
where does the median nerve supply what digit’s?
palm side of
thumb, index, middle, & half of ring finger
*can be unilateral or bilateral
what are some motor symptoms of carpal tunnel syndrome?
muscle weakness
hand stiffness + clumsiness
observable Thenar eminence atrophy
the median nerve primarily supplies _______ muscles
thenar muscles
how to diagnose carpal Tunnel syndrome
EMG, nerve conduction velocity
US
MRI (looking for compression)
what are sensory tests for testing carpal tunnel syndrome
tinel’s test:
- tapping of hand + forearm over median nerve
positive: if felt
- tingling
- numbness
- shock
phalens test:
- holding arms out + flexing wrists for min
positive if:
- tingling
- numbness
- pain
