Comp. Nero Flashcards by Sara Bigelow

What is neuropathy?

functional or pathological change in the peripheral NS

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4 Biomechanical Causes of Neuropathy

Space Ocupying lesions (cust/herniated disc)
Degenerative (stenosing age)
Post Traumatic (Fracture/hematoma/equipment compression)
Mechanical (muscle spams/external force)

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3 systemic causes of Neuropathy

Diabetes
Pregnancy
Hypothyroidism

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5 pathological changes in Neuropathy

-Microvascular compression ->ischemia
• Thickened epineurium
• Myelin thinning distortion
• Microtubule closure
• Axonal degeneration

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Where are 3 places for radial N. entrapment?

High on Humorerus
Radial tunnel
at the wrist

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Associted symptoms of Radial N entrapment

Wrist drop
Pain on L. epicondyle
pain with resisted supination
weakness of elbow flexion

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Associated symptoms of Medial N. entrapment

achy pain mid/proximal forearm
pain with resisted pronation
cramping in finger

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Anterior Interosseous syn.
What test with?
Trt?

Median N. entrapment
Ok Sign
Splint the elbow

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Club cast and dull pain associated with

Weakness of the long flexor muscle of the thumb

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Symptoms of Ulnar N. entrapment

Paraesthesia 4/5th digits
Medial elbow pain radiated to hand, dec strength
- Tinneal sign at elbow
symptoms reproduced with elbow extension flexion and wrist extension

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What is cubital tunnel syn.?

Ulnar N entrapment at the elbow

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Medial N. Entrapment Sym.

Note: MOST COMMONLY COMPRESSED Nerve!

Nighttime numbness of lateral 3 ½ digits, tingling, wrist pain, dropping things, thenar atrophy

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How do you test for MEdian N entrapment?

gold-standard EMG

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Sympt. of Thoracic Outlet Syn.

Weakness, paresthesia of medial arm, forearm, and

hand exacerbated by overhead activities

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What are the four tests to determine Thoracic Outlet Syn?

Military/Costoclavicular maneuver
Wright’s HyperABduction Test
EAST Test/Roos Test
Adson Test

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Sympt. OF Maralgia Paresthetica

Numbness or burning pain on anterolateral thigh
Hyperesthesia to the point of not putting anything in pockets
Trophic skin changes later on
(+) Tinnel’s sign 1cm medial and inferior to the ASIS

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Innervation of Common Fibular N. and motion

L4-S2

plantar flexion and inversion of the foot.

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How can you cause Common fibular N. entrapment?

Leg gets hooked over a rail
Spend a prolonged time squating
Ankle Sprains or Trauma to Fibular Head

What is Tarsal Tunnel Syn?

Compression of posterior tibial nerve in the tarsal tunnel behind the medial malleolus with the overlying flexor
retinaculum

What does P. Tibial N. innervate?

motor to the plantar muscles of the foot and sensation to plantar aspect of the foot and toes

Sym. of P. Tibial N Entrapment

-Pain on plantar surface of foot
• Not very specific, on plantar aspect of the foot
• Vague burning
• Tingling
• Numbness
• Gait seldom affected

OMM trt for Tarsal N entrapment?

Myofascial release

• HVLA

ANTERIOR TARSAL TUNNEL SYNDROME is due to compression of what N.?

Deep fibular nerve (L4-S2) compressed at the inferior extensor retinaculum

What are symptoms of Anterior Tarsal Tunnel Syn.?

-Pain over dorsomedial aspect of foot and worse at rest

• Weakness of extensor digitorum brevis

Three types of injury of Nerves

Neuropraxia (1st degree ) Axometesis (2nd Degree) Neuromesis (3rd to 5th)

With Neuroesis (3 to 5th degree) What occurs

Axon Damage plus CT coverings begin to damaged in successive order around the Nerve -Cannot fully recover b/c loss to the CT

Axometesis what occurs

Disruption to Axon itself (in the name), can have full recovery

Neuropraxia

- Damaged the Myelin sheath surrounding the Axon - fully reversible - shortest duration of days to weeks

C5 associated with what reflex, Motor, Sensation

Reflex: Biceps Motor: Deltoid and Biceps Sensation: Lateral Arm

C6 associated with what reflex, Motor, Sensation

Reflex: Brachioradialis Motor: Wrist extension and Elbow flexion Sensation: Radial forearm Thumb and index finger

C7 associated with what reflex, Motor, Sensation

Reflex: Triceps Motor: Wrist flexion, Elbow extension Finger extension Sensation: Middle Finger

C8 associated with what Motor and Sensation

Motor: Finger flexion Sensation: Ulnar forearm, Small finger

T1 associated with what Motor and Sensation

Motor: Finger ABDuction Sensation: Medial Arm

What is Handcuff Neuropathy?

Superficial Radial N entrapment aka Chairalgia prostetia aka Wartenburg's Syndrome

What is the sensory distribution for the Superficial Radial N.?

The Dorsum of hand, First through middle fingers

What is the Gold standard for diagnosing Carpal Tunnel Syndrome?

EMG

L1/L2 Motor and Sensation

Motor: Hip Flexion Sensation: Inguinal crease (L1),anterior thigh (L2)

L2, L3 Motor and Sensation

Motor: Knee Extension Sensation: anterior thigh just above knee (L3); Antrio thigh (L2)

L4 Reflex, Motor, Sensation

Reflex: Patellar Motor: Ankle dorsiflexion Sensation: Medial leg and foot

L5 , Motor, Sensation

Motor: Extensor hallucis longus m. Sensation: Lateral leg, foot dorsum

S1 Reflex, Motor, Sensation

Reflex: Achilles Motor: Ankle Plantar Flexion SensationL: Lateral foot, plantar foot

Symptoms of Common Fibular N. Entrapment

- Pain along proximal third of lateral leg - Foot drop with a slapping gait - Sx exacerbated during plantarflexion & inversion of the foot

Sciatica is ____ NOT a _____ ... | Most often caused by?

A symptom NOT a cause | Most often caused by WEAKNESS of the Sacroiliac ligament

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