Peripheral nerve compression and entrapment neuropathies

Question 1

5 diseases associated with carpel tunnel syndrome

Answer 1

Hypothyrodisim 
DM
Pregnancy 
Rheumatoid arthritis 
Acromegaly

Question 2

What is the main muscle to test in suspected carpal tunnel?

Answer 2

Abductor pollicis brevis

Question 3

Which intrinsic muscles are supplied by the median nerve?

Answer 3

1st lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

Question 4

Where is the ulnar nerve usually compressed?

Answer 4

In the olecranon groove

Question 5

Muscles supplied by the ulnar nerve

Answer 5

Flexor carpi ulnaris
FDP to ring and little finger
All the small muscles of the hand excluding LOAF

Question 6

What muscles does the radial nerve supply?

Answer 6

Triceps 
Brachioradialis 
Supinator 
Wrist & finger extensors 
Abductor pollicis longus

Question 7

Where does compression of the radial nerve usually take place?

Answer 7

Against the humerus

Question 8

How does a radial nerve compression present?

Answer 8

Wrist drop, loss of finger extension and loss of sensation over the anatomical snuff box

Question 9

Superficial branch of the peroneal nerve motor supply to -

Answer 9

ankle evertors

Question 10

Superficial branch of the peroneal nerve sensory supply to -

Answer 10

skin on the lateral side of the lower leg

Question 11

Deep branch of the peroneal nerve motor supply to -

Answer 11

Toe and ankle dorsiflexors

Question 12

Deep branch of the peroneal nerve sensory supply to -

Answer 12

1st webspace of the foot

Question 13

L3 nerve root compression

Answer 13

Sensory loss over ant thigh

Weak quads

Reduced knee reflex

+ve femoral stretch

Question 14

L4 nerve root compression

Answer 14

Sensory loss over ant knee
Weak quads

Reduced knee reflex

+ve femoral stretch

Question 15

L5 nerve root compression

Answer 15

sensory loss on dorsum of foot

weakness in foot and big toe dorsiflex

reflexes INTACT

positive sciatic stretch test

Question 16

S1 nerve root compression

Answer 16

Sensory loss over posterolateral aspect of foot

Weakness of plantar flex

reduced ankle reflex

+ve sciatic stretch test

Question 17

Femoral nerve lesion presentation

Answer 17

Weak knee extension

loss of patella reflex

numbness over ant thigh and medial thigh and lower leg

Question 18

Sciatic nerve lesion

Answer 18

weakness in knee flexion and foot movements

pain and numbness from gluts to ankle

Question 19

Obturator nerve lesion

Answer 19

numb over medial thigh

weak hip adduction

Question 20

How is femoral nerve injured

Answer 20

hip and pelvic fractures

Question 21

how is obturator nerve injure

Answer 21

ant hip dislocation

Question 22

how is lat cut nerve of the thigh injured

Answer 22

compression of nerve near ASIS

Question 23

tibial nerve injury usually due to ?

Answer 23

rare - popliteal lacerations

Question 24

+ve trendelenburg sign often due to lesion of which nerve

Answer 24

superior gluteal nerve

Question 25

radiculopathy =

Answer 25

conduction block in the axons of a spinal nerve or its roots

Question 26

Causes of spinal nerve compression

Answer 26

``` Disc prolapse Degenerative disease of the spine Trauma Malingancy Infection - osteomyelitis ```

Question 27

Red flags for CES

Answer 27

Urinary incontinence / retention Bowel incontinence Saddle anaesthesia

Question 28

Red flags for infection causing radiculopathy

Answer 28

Immunosuppression IVDU fever (unexplained)

Question 29

Red flags for fracture causing radiculopathy

Answer 29

Steroid use Trauma Osteoporosis

Question 30

Red flag for malignancy causing radiculopathy

Answer 30

past hx of malignancy > 50

Question 31

First line pain relief in radiculopathy 2nd line

Answer 31

Amytriptyline Gabapentin

Question 32

Treatment for muscle spasms in radiculopathy

Answer 32

benzodiazepines e.g. diazepam

Question 33

Gold standard test for cervical myelopathy

Answer 33

Cervical MR