Ch. 17 - Peripheral nerve entrapments, injuries, and tumors Flashcards Preview

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Flashcards in Ch. 17 - Peripheral nerve entrapments, injuries, and tumors Deck (15)
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Where does peripheral nerve entrapment occur most commonly?

Near joints (e.g. 2/2 bone or joint disorder, as nerve passes under tendinous arch)


Population most affected by carpal tunnel syndrome

Women 4x more than men; patients who perform unusually strenuous work with their hands


Contents of the carpal tunnel

Median nerve and flexor tendons


What systemic conditions are associated with carpal tunnel syndrome?

Pregnancy and lactation, OCP use, rheumatoid arthritis, myxedema, acromegaly


Sxs of carpal tunnel syndrome

Pain (worse at night), numbness, tingling (mostly in lateral 3 digits)


What sxs would indicate median nerve dysfunction in prolonged carpal tunnel syndrome?

Wasting of thenar muscle, weakness of abductor pollicis brevis, diminished sensation in lateral 3 digits


Carpal tunnel syndrome diagnosis

EMG - prolonged sensory latency, diminished amplitude of sensory action potentials, denervation potentials in thenar muscles


Tinel's sign

Tapping over median nerve elicits tingling/pain in lateral 3 digits of hand (but little diagnostic value in carpal tunnel syndrome)


Carpal tunnel syndrome tx

Conservative first (wrist splint), decompression surgery if refractory


How does ulnar nerve entrapment at the elbow present?

Paraesthesia and numbness in ring and little fingers of hand, wasting of hypothenar eminence and interossei muscles, weakness, 'claw hand'


Classic patient with ulnar nerve compression at wrist

Men using heavy jack hammers or wire-cutting shears, and motorcyclists (repetitive trauma over ulnar aspect of hand causing compression at pisohamate hiatus)


Thoracic outlet syndrome

Entrapment neuropathy of brachial plexus at root of neck


Major presenting features of thoracic outlet syndrome

Arm pain, motor weakness and sensory loss 2/2 compression of lower trunk of brachial plexus


Erb's palsy

Damage to upper trunk of brachial plexus


Klumpke's palsy

Damage to lower trunk of brachial plexus (C8 and T1)