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CMT > Mononeuropathies > Flashcards

Mononeuropathies Flashcards

1
Q

Carpal Tunnel Syndrome

pathophys

A

compression of the median nerve at the wrist within the carpal tunnel

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2
Q

Carpal Tunnel Syndrome

which fingers does the median nerve innervate?

2

A
  • pointer
  • middle
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3
Q

Carpal Tunnel Syndrome

Risk Factors

7

A
  1. RA
  2. myxedema
  3. amyloidosis
  4. sarcoidosis
  5. leukemia
  6. acromegaly
  7. hyperparathyroidism
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4
Q

Carpal Tunnel Syndrome

Signs/Sx

4

A
  1. pain, burning, tingling, or numbness in the fingers
  2. weakness in fingers
  3. sensations increase w/ activity
  4. to alleviate sx, they try to “shake out” their fingers
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5
Q

Carpal Tunnel Syndrome

PE findings

A
  • diminished sensation to the 1st to 3rd fingers and half the 4th
  • poor grip strength, thenar atrophy
  • pos tinel sign
  • pos phalen sign
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6
Q

Carpal Tunnel Syndrome

what is tinel sign

A

reproduction of sx w/ nerve percussion

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7
Q

Carpal Tunnel Syndrome

what is phalen sign

A

reproudction of sx w/ flexing wrist to 90deg for 60s

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8
Q

Carpal Tunnel Syndrome

dx

A
  1. US can show flattening of nerve
  2. EMG/NCV (gold standard)
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9
Q

Carpal Tunnel Syndrome

what can EMG/NCV show that US can’t

A

severity of disease

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10
Q

Carpal Tunnel Syndrome

tx

6

A
  1. splint in neutral position
  2. reduce repetitive activities
  3. NSAIDs/oral steroids
  4. physical therapy
  5. steroid injection
  6. surgical release
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11
Q

Ulnar Neuropathy

pathophys

A
  • compression of the ulnar nerve in either the elbow (cubital) or the wrist (Guyon’s)
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12
Q

Ulnar Neuropathy

which fingers are innervated by ulnar neuropathy

A

1/2 4th finger and all of the 5th finger

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13
Q

Ulnar Neuropathy

signs/sx

A
  • pain, tingling, or numbness in the ulnar nerve distribution
  • +/- weakness
  • sensations worsen w/ elbow flexion
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14
Q

Ulnar Neuropathy

PE Findings

3

A
  • diminished sensation in fingers
  • pos tinel sign
  • +/- reduced grip strength
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15
Q

Ulnar Neuropathy

dx

A
  1. US (flattening of nerve)
  2. EMG/NCV (gold standard)
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16
Q

Ulnar Neuropathy

what does EMG/NCV show that US doesn’t

A
  • severity of disease
  • where compression is occuring (elbow vs wrist)
17
Q

Ulnar Neuropathy

tx

A
  1. bracing elbow/wrist
  2. NSAIDs/oral steroids
  3. avoid pressure on the nerve
  4. surgical release w/ relocation of nerve @ elbow
18
Q

Ulnar Neuropathy

what is this typically due to if it occurs at the wrist/hand?

A

mass/tumor related

19
Q

Radial Neuropathy

pathophys

A
  • damage to radial nerve w/ humerus fracture
  • compression of radial nerve (@ axilla or wrist)
20
Q

Radial Neuropathy

signs/sx

3 components

A
  • numbness to back of hand
  • weakness w/ wrist extension & at triceps
  • all sx & PE findings are location dependent
21
Q

Radial Neuropathy

dx

A
  • EMG/NCV
22
Q

Radial Neuropathy

tx

A
  • remove compression/stop activity causing compression
23
Q

Radial Neuropathy

what should you always check if there is a humerus shaft fracture

A

check the integrity of the radial nerve status

24
Q

Tarsal Tunnel Syndrome

pathophys

A

compression of the posterior tibial nerve at the foot/ankel, could be due to nerve stretching

25
Q

Tarsal Tunnel Syndrome

signs/sx

4

A
  • pain & numbness to medial ankel & arch of foot
  • spares heel
  • occasional weakness (not often)
  • worsens after exercise/at night
26
Q

Tarsal Tunnel Syndrome

PE Findings

A
  • abnormal sensation in foot/ankle
  • +/- tenderness over posterior tibial tendons and nerve in tarsal tunnel
  • weakness (if present) is only in the foot)
27
Q

Tarsal Tunnel Syndrome

dx

A

EMG/NCV gold standard, but less accurate

28
Q

Tarsal Tunnel Syndrome

tx

2

A
  • arch supports/orthotics
  • surgical release
29
Q

Tarsal Tunnel Syndrome

often accompanied by:

A

flat feet

30
Q

Meralgia Paresthetica

pathophys

A

compression of lateral femoral cutaneous nerve

31
Q

Meralgia Paresthetica

pts at largest risk

3

A
  1. pregnant
  2. obese
  3. diabetic
32
Q

Meralgia Paresthetica

signs/sx

2

A
  • numbness to lateral thigh that does not pass the knee joint
  • unilateral
33
Q

Meralgia Paresthetica

PE Findings

A
  • no loss of motor function in areas of sensory loss
34
Q

Meralgia Paresthetica

dx

A

clinical

35
Q

Meralgia Paresthetica

tx

3

A
  1. nothing: often spontaneously resolves
  2. steroid injections
  3. surgical decompression

CMT (72 decks)

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