Cervical Spine II Flashcards
(22 cards)
The ulnar nerve can get entrapped where
Guyons canal at wrist
Cubital tunnel at elbow
What is 2nd and 1st most common peripheral n entrapment sites?
1: CTS for median
2: cubital tunnel for ulnar
What are the medial, lateral, floor and roof of cubital tunnel?
Lateral: medial edge trochlea and olecrenon
Medial: medial epicondyle
Roof: arcuate lig/cubital tunnel retinaculum
Floor: UCL
Cubital tunnel sensation deficits
Medial arm, 5th digit, medial 1/2 of 4th digit
Cubital tunnel motor
Affects hand intricacies but spares FCU/FDP (no wrist flex weakness)
Weak hypothenar, interossei, adductor policis (lateral pinch)
Special tests for cubital tunnel syndrome
Elbow flx test (1-3m)
Lateral pinch weakness
Wartenbergs sign
ANTT
Where does ulnar n get entrapped in guyons canal
Between piriformis and hamate and splits into deep branch that goes lateral and sensation branch stays medial
Causes of ulnar n entrapment in guyons canal
Carpal ganglions
Hamate fx
Extrinsic trauma/compression
Guyons canal entrapment causes what type of sx?
Can be isolated motor or sensory or both
Sx of Guyons canal
Claw hand
What is distinguished between C8/T1 vs ulnar n
EPL innervated by radial n (c8) so will be strong in ulnar n issues
C8/T1 sensation will not affect digits like ulnar n will
Median n entrapment sites
Lig of struthers
Carpal tunnel / wrist
Pronator teres
Ant interosseous nerve
Med n entrapment at lig of struthers
Rare, only 1% of pop have this lig
Median n entrapment at pronator teres sites
- Thickened lacertus fibrosis when it connects to pronator teres
- Pronator teres hypertrophy of fibrous bands within muscle
Median n entrapment at pronator teres sx
Prox forearm pain and hand pain increased by pronation and wrist flexion. No night pain. Sensory issues radial hand and first 3.5 digits
Median n entrapment at any interroseus nerve sx
No sensory issues, weakness in FDL (pinch grip)
Median n entrapment at wrist sx
CTS
Pain at night, parasthesias in palm and first 3.5 fingers, thenar and 1 and 2 lumbricals weak (opposition)
C6/c7 vs median n problems
C6/c7 - will have reflex issues and brachioradialis (inn by radial nerve, c6) strong
Median n- sensation issues in first 3 fingers
Radial n sx
Mixed motor and sensory, dorsal sensation sx in arm and hand and radial 3 fingers
Weak supinator, wrist ext, thumb ext/abd, finger MP ext
Radial PIN sx
Most common site for radial n
No sensation loss
Weak ext, night pain
PIN entrapment sites
Fibrous bands anterior radial head
Avascular arcade
ECRB
Supinator
C6/C7 vs Pin
PIN motor only no sensation issues
