MONONEUROPATHIES Flashcards
What nerve is involved in carpal tunnel syndrome?
Median nerve
What conditions is carpal tunnel syndrome associated with?
Hypothyroidism Pregnancy Diabetes RA Acromegaly
What are the clinical features of carpal tunnel syndrome?
Tingling, pain and numbness in the hand
Tends to wake the patient from sleep
Exactly which parts of the hand have sensory loss in carpal tunnel syndrome?
Thumb
Index finger
Middle finger
Half of ring finger
What muscle is affected by carpal tunnel syndrome?
Abductor pollicis brevis
What techniques can be used to elicit the symptoms of carpal tunnel syndrome?
Tinel’s sign - tapping on the carpal tunnel
Phalen’s maneouvre - pushing flexed wrists together
What are the specific muscles affected by ulnar nerve compression?
Flexor carpi ulnaris
Flexor digitorum profundus to ring and little fingers
All the muscles of the hand, except for abductor pollicis brevis, opponens policis, lateral two lumbricals and part of flexor pollicis brevis.
What is the distribution of sensory loss in ulnar nerve compression?
Lateral half of ring finger
Little finger
What is the ulnar paradox?
A patient with ulnar nerve compression has ulnar claw due to lack of stimulation of the hand muscles. However, if the lesion is proximal then stimulation of the flexor digitorum profundus is also affected meaning less flexion and less clawing.
What is Saturday night palsy?
Compression of the radial nerve.
What are the features of radial nerve compression?
Wrist drop
Weakness of finger extension
What are the specific muscles affected by radial nerve compression?
Brachioradialis
Extensors of the wrist, fingers and thumb, except for extensor carpi ulnaris
What is the distribution of sensory loss in radial nerve compression?
Over the back of the hand including the anatomical snuff box
What are the features of common peroneal nerve palsy?
Foot drop
Weakness of eversion
Weakness of dorsiflexion
Sensory loss over the anterolateral border of the shin and dorsum of the foot
