Peripheral nerve entrapment Flashcards
(18 cards)
What is neuroparaxia
Transient nerve dysfunction with no damage to nerve or sheath, will fully recover
What is axonotmesis
Complete disruption of nerve and sheath (disruption of axon but schwann cell myelin sheath intacct). Recovery can happen if offending force removed quickly
What is neurotmesis
Complete nerve division
What are the 3 types of acute nerve injury
division, crush or stretch
Name some chronic nerve injuries
COmpression (narrow point on nerve with firm boundaries (carpal tunnel)
Stretching
Name some positive (abnormally excited) symptoms of nerve damage)
Pain, paraesthesia (tingling) and muscle spasm
Name some negative (reduced conduction of impulse) symptoms of nerve damage
Numbness, weakness/wasting, and loss of autonomic finction/sweating
What is carpal tunnel syndrome
Entrapment of the median nerve as it passes through the carpal tunnel
Pressure on the nerve results in tingling/numbness in area supplied by the nerve
How may carpal tunnel syndrome present in history
Tingling/numbness in thumb to radial half of ring finger
Difficulty with fine objects, woken up in early morning with symptoms. Symptoms on use
Describe how a carpal tunnel syndrome may present in examination
Thenar muscle watinf, reduced sensation thumb to 1/2 ring finger, weak hand grip, reduced abduction of thumb, may have positive tinels or phalens tests
What do nerve conduction studies show
Conduction veloscity, latency and amplitude
What are the two ways in which the median nerve can become compressed in the carpal tunnel?
Volume of canal decreased (fracture, ganglion, arthritis)
Volume of contents increased (Tenosynovitis, bleeding, abnormal muscle or arteries)
How can CTS be treated
Activity modification, wrist splintage, oral NSAIDs, steroid injection, operative release
Where can the ulnar nerve experience entrapment
Cubital tunnel (elbow) Wrist (guyons canal)
What are the symptoms of ulnar nerve entrapment
Tingling at ulnar border and fingers, positive tinels at elbow, wasting hypothenar eminence, ulnar clawing
WHAT is froments sign
Weak adductor pollicus, positive compensatory flexion at IP joint of thimb when gripping paper to fist
What are the treatments for ulnar nerve compression
Non-op, release, transposition or medial epicondylectomy
What is saturday night palsy
Radial nerve compression, pressure over radial nerve in spiral groove posterior humerus
